All the political skirmishing around the looming government shutdown has obscured the critical reason for it in the first place: Republicans have essentially stopped saying they want to repeal Obamacare, but quietly, they are doing exactly that.
Over the past nine months, Republicans have gone a long way toward dismantling key Obamacare provisions under the misleading guise of reforming or improving our health care system. As a result, more than 20 million Americans face higher insurance premiums next year. And almost 14 million Americans could lose their health insurance altogether over the next decade — an estimated 3.3 million in 2026 alone.
That’s more than 70 percent of those who gained coverage since Obamacare went into effect.
You may be forgiven for missing this headline. There wasn’t one. In 2016, Donald Trump ran on a promise to abolish the program and kept up his crusade throughout his first term, only to have the effort deep-sixed by Senator John McCain. This time around, Mr. Trump has rarely — if ever — mentioned the Affordable Care Act by name. Nor have his fellow Republicans.
But they never stopped trying. And this year they have made substantial progress. The outcome of the looming shutdown will determine whether Democrats can gain back at least a modicum of ground.
Since most of its provisions went into effect in 2014, Obamacare has been stunningly successful at reducing the ranks of the uninsured: from 44.4 million in 2013 to 26.7 million in 2016.
Then three months ago, Congress passed its huge tax and spending package (known as the One Big Beautiful Bill). Tucked into that legislation were a number of granular, difficult-to-comprehend changes to the government piece of our health care system, particularly Medicaid.
One of them, a work requirement for able-bodied adults, is likely to strip health care coverage from millions of Americans who lack the resources to navigate government bureaucracy. According to the Congressional Budget Office, over the next 10 years, that provision will cost 5.3 million people their coverage.
Other changes were so obscure that only dogged health care aficionados can understand them.
Today Americans making less than $150,000 a year who bought insurance on one of the Affordable Care Act’s exchanges can receive a tax credit to offset part of the cost of their coverage. Republicans chose not to extend that tax break in the tax and spending bill. Now, without government intervention, it will expire at the end of the year. That could be responsible for more than a quarter of the lost coverage, and it’s likely to be the focal point of any negotiations during a possible shutdown.
