‘Obamacare’ hits record enrolment, but an uncertain future awaits under Trump 2.0

A record 24 million people have signed up for insurance coverage through the Affordable Care Act, former President Barack Obama’s landmark health legislation, as the programme awaits an uncertain future under a Republican-controlled White House and Congress.

Never have so many people enrolled in healthcare coverage through the government marketplace, a point of pride for many Democrats but a red flag to some Republicans.

President Joe Biden has pushed an expansion of the programme, signing into law billions of dollars in tax credits that expanded who qualified for the health insurance and lowered its cost. Millions of additional Americans can now pay monthly premiums of just a few dollars to get coverage.

The increased enrolment is “no coincidence,” Biden said in a statement. “When I took office, I made a promise to the American people that I would bring down the cost of healthcare and prescription drugs, make signing up for coverage easier, and strengthen the Affordable Care Act, Medicare, and Medicaid.”

But incoming president-elect Donald Trump has maligned “Obamacare” for years. He unsuccessfully tried to dismantle it during his first term, and has promised changes – without offering a concrete plan – during his second term. Enrolment dropped during Trump’s first term, with his administration investing less money in the programme, including for navigators who help people enrol in the coverage.

And the tax credits that made the healthcare coverage more affordable for millions will expire at the end of this year, unless Congress passes a new law.

Lawmakers will face a pressure campaign from hospitals and insurance companies, which supply coverage plans for the marketplace, to continue the tax credits. A newly formed coalition of the biggest and most powerful healthcare entities – including the nation’s top health insurers, the largest healthcare systems and notable medical associations – has launched a campaign called “Keep Americans Covered” to lobby Congress on the issue.