The Trump administration has eventually jettisoned a landmark legacy of the Obama era with Thursday’s vote in the House of Representatives on the repeal and replacement of the Affordable Care Act, chiefly without the mandated insurance coverage. Markedly, there is little or no euphoria in the White House not least because the victory has been rather too marginal for comfort (217 to 213 votes). The legislative route ahead is as long as it is uncertain. The figures are suggestive of the discord within the ruling party over whether or not to abrogate Barack Obama’s signature domestic achievement.
His successor’s wafer-thin triumph is bound to be vehemently resented by the people, as was embarrassingly evident during President Trump’s visit to New York on Thursday, the first since his electoral victory. The forward movement in the House faces profound uncertainty in the Senate, where the Bill was immediately rejected by some Republican senators, who have indicated that they could work on a new version of the legislation virtually from scratch. The rumblings of disapproval were heard even before the vote when certain Republican senators had expressed deep reservations about one of the most important provisions of the House bill, which would roll back the expansion of Medicaid under the Affordable Care Act.
The harsh truth being that a vital segment of social security is very unlikely to be universally affordable if the incumbent in the White House has his way. But a softening of the House bill, which could help it get through the Senate, would pose fresh problems. For any repeal measure to become law, the House and the Senate would have to agree on the language, a formidable challenge in the legislative construct. For now, a controversial bill has passed just one chamber of a fractious legislature.
Should the bill attain fruition in the fullness of time, it will eliminate tax penalties for people who go without health insurance. It would roll back state-by-state expansion of Medicaid, which covered millions of low-income Americans. And in place of government-subsidized insurance policies offered exclusively on the terms of the Affordable Care Act, the bill would offer tax credits of $2,000 to $4,000 a year, depending on age. Beyond the nittygritty, the net result could be considerably truncated public spending on health. A groundswell of opposition is evident both at the legislative level and within Trump’s domestic constituency of voters. A flagging plan, that just six weeks ago was considered all but dead, has been revived. The bill now moves to the Senate, where it is expected to face serious difficulties. As Donald Trump punched his hand in the air in celebration on the Rose Garden, he must have been acutely aware of the contretemps ahead. The glory ~ the first in 100 days ~ is uncertain.