U.S. Senate Majority Leader John Thune (R-SD) speaks with reporters after the Senate approved the House resolution to force the release of Justice Department files on the late convicted sex offender Jeffrey Epstein, at the U.S. Capitol in Washington, D.C., U.S., November 18, 2025. REUTERS/Jonathan Ernst
When he was trying to get the Affordable Care Act of 2010, a.k.a. Obamacare, repealed back in 2017, a frustrated President Donald Trump famously commented, "Nobody knew health care could be so complicated." And he saw just how complicated when the American Health Care Act, a Republican ACA replacement bill, went down in defeat in the U.S. Senate that year and Democrats recaptured the U.S. House of Representatives in the 2018 midterms with a net gain of 41 seats.
Health care, according to polls, was the issue that, more than any others, doomed House Republicans in 2018. And MS NOW's Paul Waldman, in a November 28 column, predicts that health care will prove equally toxic for Republicans in the months ahead.
Unlike 2017, GOP lawmakers in Congress aren't pushing bills to outright repeal the ACA but rather, are trying to undermine it by defunding it. The spending agreement that recently ended a partial shutdown of the federal government lacks the ACA subsidies for 2026 that Democrats wanted, and Democrats are warning that millions of Americans will lose their health insurance when premiums become unaffordable.
"And here we are again," Waldman comments. "As in 2017, Trump spent the previous year's presidential campaign promising something better than Obamacare, without specifying what it would be. Now, in the crunch moment, the (Trump) Administration and its supporters are scrambling."
Waldman, a former Washington Post columnist, stresses that the GOP's health care problems go beyond Obamacare and also include Medicare and Medicaid.
"The truth is that conservatives just don't think it ought to be the government's job to provide health care access — even though today, the U.S. government gives health care coverage to more people than ever," Waldman laments. "Add together Medicare, Medicaid and the TRICARE system for the military and veterans, and more than 150 million Americans, or nearly half the country, enjoy government health insurance. Conservatives would much rather the private sector handle the provision of health insurance, and their preference is always for the government to do less."
Waldman continues, "Witness the deep Medicaid cuts that were included in their Big Beautiful Bill, which would lead millions of Americans to lose coverage. Republicans may have made their peace with not going after Medicare — which seniors will defend furiously — but they'll try to cut and privatize everywhere they can, especially Medicaid and the ACA. Yet Americans want the government to help them with health insurance."
Republicans, according to Waldman, are in a "quandary" over health care and are desperately trying to "change the subject."
"Medicare, Medicaid, and the ACA are all extremely popular," Waldman argues. "These premium increases are coming at a moment when the public is already worried about affording the necessities of life…. Trump clearly understands that the pressure is building for him and his party to do something. But he may have an unsolvable problem on his hands."
Paul Waldman's full MS NOW column is available at this link.