Even before Donald Trump officially became the 45th President, he had shaken up America with his list of things he wanted to complete within his first hundred days in office. One critical task on his agenda was to repeal and replace Obamacare. The original plan was to replace the Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare, with the American Health Care Act (AHCA). Despite the handful of executive orders and promises he has made in the first months of his presidency, he has found himself tangled in healthcare and expressed this debacle when he said "nobody knew health care could be so complicated."
It is not news that the ACA, or healthcare in general, is complicated or misconstrued in one way or another. Although Trump had consistently condemned Obamacare over the years, he has also consistently praised universal coverage. Despite Obamacare being a failure, “everybody’s got to be covered” and “the government’s gonna pay for it.” Perhaps the part Trump so greatly detests about the ACA is the colloquial name — Obamacare.
This is where the AHCA comes into play.
The AHCA planned to eliminate the funding of the Prevention and Public Health Fund and instead invest more in the funding for community health centers. Ultimately, this could jeopardize services such as the Planned Parenthood Federation of America. Healthcare would become even more inaccessible. Currently, Congress estimates 22 million people today benefit from the ACA; if the ACA were to be repealed and replaced with the AHCA, approximately 30 million people in America would go without health insurance.
This is not the first time that Trump’s desires have contradicted those of traditional conservative values. He has proposed regulations to trade and potentially placed the First Amendment in jeopardy. Perhaps the repeal and replacement of the ACA divided the White House more than Trump’s other controversial stances.
Opponents of the AHCA were not and are not exclusively Democrats; many Republicans had shown criticism of the plan to “repeal and replace” Obamacare. The bill required a simple majority of 216 votes, meaning no more than 21 Republicans could vote against if the American Health Care Act (AHCA) were to be passed. 33 Republicans explicitly showed their discontent with the AHCA by voting no; 45 were undecided or otherwise ambiguous; nine expressed concerns or were leaning towards voting no.
Furthermore, conservatives in the House were not alone in standing up against the AHCA. The Koch brothers, the nation’s second wealthiest family widely known for their monetary political contributions, especially in the 2016 presidential election, showed their great discontent with Trump’s plan to combat the ACA by giving monetary incentive to Republicans opposing the bill. The Freedom Partners, a nonprofit conservative news source partially funded by the Koch brothers, denounced the AHCA as "Obamacare 2.0".
There is a myriad of reasons conservatives went against this bill. Some Republicans had echoed similar sentiments as the Freedom Partners. Representatives such as Rep. Thomas Massie (R–KY) and Rep. Mo Brooks (R–AL) did not find the AHCA to truly kick out the ACA. Rep. Jaime Herrera Beutler (R–WA) did not see the AHCA lowering premiums, taxes, or expenses.
With all the division it has caused, the ACA has yet to be replaced, and Speaker of the House Paul Ryan stated that "we're going to be living with Obamacare for the foreseeable future". However, people benefiting from the ACA cannot get too complacent just yet. Ryan is still determined to repeal the ACA, Republicans are trying to compromise to create a replacement for the ACA they can all agree on, and Trump still has that list of items he wishes to cross off his agenda. As far as how the replacement for the ACA pans out has yet to be determined.
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