What's New?
Four in five of those taking part in Obamacare in 2025 are from states which voted for Donald Trump, indicating that the President-elect risks backlash from his own base if the incoming administration takes aim at the program.
According to the Centers for Medicare & Medicaid Services (CMS), over three million Americans, including around 500,000 new consumers, signed up for coverage through the Health Insurance Marketplace, established by the Affordable Care Act (ACA), between November 1 and November 22. The majority of these three million hail from Florida and Texas, followed by California with over 280,000 applications.
As highlighted by Reuters, of the more than three million people who have indicated that they will participate in Obamacare in 2025, 82 percent of these people live in states which voted for Trump over Vice President Harris in the recent election.
Why It Matters
The statistic indicates that many of those who voted for the former president to return to the White House may be those most affected if his circle follow through on planned changes to federal services to draw down the national deficit.
During a late-October campaign event, House Speaker Mike Johnson said that reform to the U.S. health care system would be a "big part of the agenda" in Trump's second term. Asked by an attendee whether the changes to health care would mean "no Obamacare," Johnson replied: "No Obamacare."
"The ACA is so deeply ingrained, we need massive reform to make this work," Johnson added, "and we got a lot of ideas on how to do that."
Trump himself floated alternatives to the ACA, stating during the September presidential debate that Obamacare was "lousy healthcare," and that he possessed "concepts of a plan" to replace the program.
During his first term, Trump pursued several strategies to dismantle the ACA, drawing from the Republican "repeal and replace" movement which arose in opposition to Obama's signature legislation.
The most notable of these was the so-called "skinny repeal," a legislative effort led by Trump to scale back some of Obamacare's more controversial provisions, which failed in the Senate thanks to a party-bucking vote from John McCain.
Trump's next term is likely to be defined by aggressive reforms to federal programs, as indicated by the creation of the new Department of Government Efficiency. The advisory body, set to be led by billionaires Elon Musk and Vivek Ramaswamy, has been tasked by Trump with identifying wasteful expenditures, cutting regulations and finding cost-saving opportunities in the federal government in order to chip away at America's ballooning national debt.
When contacted for comment, Trump transition Spokesperson Brian Hughes told Newsweek that President-elect Trump "will deliver on the promise of implementing principles that allow for more choice in the marketplace and efficiency as tools for better, more affordable healthcare."
"President Trump will slash wasteful spending in our broken healthcare system that cripples our nation's budget, return healthcare to the Gold Standard, ensure Americans have better access to healthcare, and Make our Healthcare Great Again!"
What To Know
Nearly 50 million Americans have received coverage through Obamacare since its major provisions came into effect in January 2014, according to September data from the Department of Treasury.
While it has since faced significant Republican opposition, the legislation still enjoys widespread support. According to polling conducted in October by left-of-center public opinion research organization Navigator Research, 59 percent of Americans hold a favorable opinion toward the ACA, compared to 25 who view it unfavorably.
Significantly, a recent Gallup poll found that Republican support for Obamacare had hit an all-time high of 19 percent, up ten percent from 2018.
However, the Congressional Budget Office has warned that millions stand to lose their health care protections if Congress votes against extending ACA subsidies beyond their expiration at the end of 2025.
What People Are Saying
Peter Loge is a former senior advisor to Barack Obama, who also served as a senior health policy advisor to US Rep. Steve Kagen, MD (D-WI), and spoke to Newsweek about the future of the ACA under the next administration.
Commenting on the number of 2025 applicants for Obamacare, as well as the slim majorities that will be enjoyed by Republicans in the next Congress, Loge said that these would likely stymie attempts by Trump to make any changes to health care which could result in reduced coverage.
"The President-elect will need the House to pass any significant health care reform legislation. The Republican majority in the House could comfortably travel in an SUV. To start, the Trump majority in the House will be so small it could travel on a motorcycle with a side-car," Loge said. "The odds that virtually every Republican would vote to hurt their own voters are vanishingly slim."
Loge told Newsweek that the voters who were drawn to Trump in the 2024 election—those struggling with inflation and facing difficulty in making ends meet—"are the very people who are helped most by programs like the ACA, nutrition assistance, and Medicaid."
"Our system can be better, but getting rid of the ACA would make life much worse for millions of people," Loge added.
What Happens Next?
Open enrollment on the ACA Health Insurance Marketplace runs until January 15, after which Americans may lose out on the opportunity for cost-assisted coverage.
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