There are relatively few laws that passed during President Obama’s administration that were as controversial as the Affordable Care Act. The Act, widely called ObamaCare, was a compromise that made few people happy. It was a step to close to universal healthcare for Republicans, yet a bill that was too far away from single-payer health care for Democrats. During the 2016 election season, reforms to ObamaCare were part of the Republican platform. Indeed, almost as soon as President Trump was sworn into office people started talking about dismantling the system that had been in place for only a few years. The question now is not whether Obamacare will be replaced, but rather by what.

Repairing the System

Faced with the task of finding a replacement for Obamacare, many Republicans have begun discussing ‘repairs’ to the plan. What repairing Obamacare means is difficult to say, as many Republicans have varying ideas of what it would mean to excise parts of the system and leave others in place. Many tend to favor some of the reforms, including the extra years that young adults can spend on their parents’ plans and the provisions that cover pre-existing conditions. Others have more issues with implementation than the text of the bill itself. Perhaps the most commonly agreed upon change to Obamacare will be the removal of the penalties for not having insurance – a major sticking point over the last several years. One of President Trump’s many campaign promises included to repeal and replace Obamacare with “something terrific.” Almost every Republican agrees with that statement, but Trump has said very little in terms of how this will be done.

Consumer Driven Policies

When replacements have been seriously discussed, it’s usually in terms of making health care more consumer friendly. Recent rumblings from the House and Senate have placed a great deal of emphasis on putting Medicare back in the hands of the states and opening up health savings accounts so that individuals can spend their insurance coverage money as they wish. This seems to be a fairly direct response to some of the biggest criticisms of Obamacare in general, and of the individual mandates in particular.

Likely included in the plans to make health care more consumer-driven will be motions to allow insurance to be sold across state lines. Republicans have long claimed that more competition will drive down prices, and a Republican majority in the legislature and the executive branch seem primed to make those theories become reality.

It’s hard to say what, if anything, will replace Obamacare. It’s almost guaranteed that the single-payer provision will go, and it seems likely that some provisions will stay. The fight to replace Obamacare may not be as controversial as the fight to implement it, but it will be important nonetheless.

Contributed by: Kevin Adam