The GOP Has Tried and Failed Hundreds of Times To Repeal and Undermine It
15 years ago, President Obama signed the Affordable Care Act (ACA) into law, and it has become a pillar of health care that Americans rely on. Millions of Americans depend on the ACA to not only stay healthy but also for financial security. The law requires insurance companies to cover preventative care, such as vaccinations, contraception, and cancer screenings. It has decreased income inequality, increased access to preventative care, and saved lives. Not a single Republican voted for the ACA in 2010; since then, they have continuously worked to repeal and sabotage the law. The ACA has survived countless repeal attempts, yet time and again, Republicans have worked to destroy the ACA and its protections for over 100 million people with pre-existing conditions.
Here are just some of the ways Republicans have sabotaged the ACA over the years:
- March 23, 2010: Republicans Unanimously Opposed The Affordable Care Act. On March 23, 2010, President Obama signed the Affordable Care Act (ACA) into law, which enshrined health care protections for hundreds of millions of Americans, provided for states to expand Medicaid coverage to a greater range of income levels, created ACA Marketplaces to offer health care coverage to qualifying individuals, mandated health insurance coverage for every American, and more. Democrats in Congress passed the Affordable Care Act (ACA) without a single Republican vote in either the House of Representatives or Senate. Republicans stood united against the law and immediately vowed to repeal it.
- 2011: As Soon As Republicans Re-took Control of The House of Representatives, They Voted To Repeal the ACA. After retaking control of the House of Representatives for the first time since the ACA was passed in 2010, Republicans immediately took a vote to repeal the ACA. Every single House Republican voted for the repeal bill, which the Democratic-controlled Senate later refused to pass.
- 2012: Republicans Unsuccessfully Challenged the ACA in Court. In 2011, dozens of Republican-led states joined a lawsuit against the Obama administration challenging the constitutionality of the ACA. After months of appeals, the Supreme Court agreed to hear the case and eventually ruled 5-4 to uphold the law. After the Supreme Court released its ruling, several top Republicans vowed to continue efforts to repeal the ACA.
- 2013: Republicans Refused To Fund the Government Without Delaying or Repealing the ACA, Causing A 16-Day Government Shutdown. In October 2013, Republicans shut down the federal government for the first time in 17 years and refused to fund the government without repealing the ACA or delaying its implementation. After 16 days, House Republicans relented and passed legislation to fund the government without any substantial changes to the health care law, other than stricter income verification requirements for consumers shopping for health insurance on ACA Marketplaces.
- 2015: Republicans Passed A Bill Repealing The ACA That Was Vetoed By President Obama. In October 2015, Republicans in Congress used budget reconciliation to bypass the Senate filibuster and pass a budget that included provisions repealing core parts of the ACA. President Obama vetoed the bill, and the ACA remained intact.
- 2017: Days After Taking Office, President Trump Cancelled ACA Enrollment Outreach Advertising During Open Enrollment. Within days of taking office, Trump canceled television/online advertising outreach for ACA enrollment, leading to an estimated 480,000 fewer Americans enrolling in coverage.
- 2017: Republicans Tried and Failed To Repeal The ACA. In 2017, Republicans in Congress infamously tried and failed to repeal and replace the ACA, introducing their own plan known as the American Health Care Act (AHCA), which eventually failed in the Republican-controlled Senate.
- 2017: Republicans Passed Donald Trump’s Tax Plan, Gutting The ACA’s Individual Coverage Mandate. In late 2017, Republicans passed the Tax Cuts and Jobs Act, Donald Trump’s tax plan, which included a provision gutting the ACA’s individual mandate by ending the tax penalty for not having health insurance. Trump later bragged about ending the individual mandate in an October 2019 speech in Florida, telling a crowd, “We eliminated Obamacare’s horrible, horrible, very expensive and very unfair, unpopular individual mandate. A total disaster. That was a big penalty. That was a big thing. Where you paid a lot of money for the privilege […] of having no healthcare.”
- 2017: The First Trump Administration Cut Enrollment Outreach Funding By 90 Percent. In the fall of 2017, the Trump administration significantly cut federal funding for Navigator programs designed to help people find health insurance on ACA Marketplaces by around 90 percent.
- 2017: The First Trump Administration Halved The Duration of Open Enrollment. In the fall of 2017, the Trump administration also halved the duration of Open Enrollment, reducing the period from three months to just 45 days, which contributed to a dramatic slowdown in ACA enrollment during the first Trump administration compared to both the Obama administration and later the Biden administration.
- 2017: The First Trump Administration Abruptly Ended ACA Subsidies To Marketplace Insurers, Sowing Disarray. In the fall of 2017, the Trump administration abruptly stopped paying subsidies to health insurers offering coverage through ACA Marketplaces. The move ended cost-sharing reduction payments and caused premiums to spike and insurer participation in ACA Marketplaces to drop. Trump bragged about the cuts, declaring, “I knocked out the hundreds of millions of dollars a month being paid back to the insurance companies by politicians. […] This is money that goes to the insurance companies to line their pockets, to raise their stock prices. And they’ve had a record run. They’ve had an incredible run, and it’s not appropriate.”
- 2017: The First Trump Administration Undermined Medicaid Expansion, Pushing States To Submit Waiver Programs Limiting Coverage. Shortly after taking power, the first Trump administration began pushing states to adopt Medicaid expansion waivers circumventing ACA enrollment and undermining its consumer protections by imposing bureaucratic work reporting requirements, premium restrictions, and eligibility restrictions for state Medicaid enrollees. Throughout Trump’s first term, he approved 13 state Section 1115 Medicaid expansion waivers.
- 2018: The First Trump Administration Approved and Promoted Junk Plans Circumventing ACA Consumer and Coverage Protections. In 2018, the Trump administration began approving and enabling junk plans, including short-term plans and association health plans, that do not have to follow the consumer protection and minimum coverage standards set out by the ACA. An analysis of short-term plans conducted by KFF found that none of the plans studied covered maternity care, 62 percent did not cover substance abuse treatment, and 71 percent did not cover outpatient prescription drug services. Similarly, association health plans are allowed to charge people more based on their age, health status, and gender. AHPs have a long history of fraud and unpaid claims and provide weaker cost and protection coverage. Trump touted his efforts in a 2019 White House address, bragging, “We took swift action to open short-term health plans and association health plans to millions and millions of Americans.”
- 2020: The First Trump Administration Asked The Supreme Court To Overturn the ACA. In 2020, the Trump administration explicitly asked the Supreme Court to overturn the ACA. Ever since the 2012 Supreme Court ruling upholding the constitutionality of the law, Republicans across the country had been supporting efforts to overturn parts of it in court. After years of appeals, the Supreme Court finally ruled in favor of the ACA in 2021.
- NOW: The Second Trump Administration Has The ACA In Its Crosshairs. In his second term, President Trump has picked up right where he left off in 2020, cutting nearly 90 percent of ACA Navigator funding once again, shortening the open enrollment period again, and imposing new requirements making it more difficult to enroll in marketplace plans. His administration is also targeting core parts of the ACA; he endorsed plans to slash Medicaid expansion funding and his administration has targeted preventive services like vaccines that are covered under the ACA. The Trump White House is also firing thousands of government employees at HHS who ensure that the ACA continues to be enforced and implemented without interruption.