Economist Paul Krugman: Health care reforms could be 'gone by 2026' if Trump wins

26 March 2024

Under President Joe Biden, Obamacare has enjoyed record enrollment in 2024. And the program, according to a Kaiser Family Foundation (KFF) poll released in February, is viewed favorably by 59 percent of Americans.

Yet 2024 GOP presidential nominee Donald Trump has vowed to overturn the Affordable Care Act of 2010, a.k.a. Obamacare, if he defeats Biden in November.

On his Truth Social platform, Trump wrote, "Obamacare is too expensive, and otherwise, not good healthcare. I will come up with a much better, and less expensive, alternative! People will be happy, not sad!"

Liberal economist Paul Krugman, in his March 25 column for the New York Times, warns that Obamacare may be "gone by 2026" if Trump wins the 2024 election and Republicans control both houses of Congress next year — and that includes the ACA's protection for preexisting health conditions.

"Are you better off than you would have been 14 years ago?" Krugman writes. "If you're one of the millions of Americans who have a preexisting medical condition and don't have a job that comes with health benefits, the answer is, overwhelmingly, yes. Why? Because before the Affordable Care Act, a.k.a. Obamacare — signed into law on March 23, 2010, although many of its provisions didn't kick in until 2014 — you probably wouldn't have been able to get health insurance. Today you can, thanks to provisions in the law that prevent insurers from discriminating based on medical history and that subsidize insurance premiums for many Americans."

The economist adds, "These subsidies also provide healthy people with an incentive to purchase insurance, improving the risk pool. And President Biden strengthened the program, notably by extending provisions eliminating the 'cliff' that cut off subsides for many middle-class Americans. But in the near future, you may well lose that hard-won access."

Before Obamacare, health insurance companies considered everything from asthma to heart disease to diabetes a "preexisting condition." The Center for American Progress (CAP) has warned that COVID-19 could be considered a "preexisting condition," and millions of Americans have had it since the 2020/2021 pandemic.

Krugman emphasizes that Trump's threat to abolish Obamacare must be taken seriously.

"In 2017, Donald Trump and Republicans in Congress tried to eviscerate the ACA and almost succeeded in passing a bill that the Congressional Budget Office estimated would have left 22 million more Americans uninsured by 2026," Krugman recalls. "There's every reason to believe that if the GOP wins control of Congress and the White House in November, it will once again try to bring back the bad old days of health coverage. And it will probably succeed, since it failed in 2017 only thanks to a principled stand by (Sen.) John McCain — something unlikely to happen in today's Republican Party, where slavish obedience to Trump has become almost universal…. Ultimately, right-wingers would like to rip up America's whole safety net. But they’ll probably start with Obamacare."

Krugman adds, "If they sweep this year, I won't be surprised if the program is effectively gone by 2026."

Paul Krugman's full New York Times column is available at this link (subscription required).

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