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Trump moves – again – to repeal Obamacare. Democrats – again – pounce.

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Trump moves – again – to repeal Obamacare. Democrats – again – pounce.

Nov 28, 2023 | 8:51 am ET
By Hugh Jackson
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Trump moves – again – to repeal Obamacare. Democrats – again – pounce.
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"He wants to remain a senator doesn't he?" Donald Trump said of Dean Heller at a White House luncheon in July 2017, at which Trump was pressuring Republican senators to repeal the Affordable Care Act. (Photo by Michael Reynolds - Pool/Getty Images)

In 2012, then-Nevada Gov. Brian Sandoval announced that Nevada would expand Medicaid under the Affordable Care Act. He was the first Republican governor in the nation to do so.

Five years later, in June 2017, then-U.S. Sen. Dean Heller appeared with Sandoval at a press conference to say he could not support Pres. Donald Trump’s plan to repeal the Affordable Care Act.

The next month, Heller’s resistance had earned him a seat next to Trump during a White House luncheon. Heller was “the one we were worried about,“ on health care, Trump said. “You weren’t there. You’re going to be.”

And then Trump, gesturing at Heller, said to the room and its TV cameras, “He wants to remain a senator, doesn’t he?”

Heller did. And a few weeks after his White House lunch date, Heller, voted for a measure to repeal key portions of the Affordable Care Act, and co-sponsored a bill to cut Medicaid.

After the 2018 election, Heller would no longer, as Trump put it, remain a senator.

Heller’s tortured efforts to navigate the politics of health care weren’t the only reason he was defeated by Democrat Jacky Rosen in 2018.

But the Heller example illustrates how the issue has been a treacherous one for Republicans, who in recent campaign cycles have mostly refrained from attacking the ACA, aka Obamacare.

Trump, now the presumptive Republican presidential nominee, has put the issue back on the table anyway. 

“The cost of Obamacare is out of control, plus, it’s not good Healthcare. I’m seriously looking at alternatives,” Trump wrote on his Truth Social website over the weekend. “We had a couple of Republican Senators who campaigned for 6 years against it, and then raised their hands not to terminate it. It was a low point for the Republican Party, but we should never give up!”

Trump was referring to the late Arizona Republican Sen. John McCain, whose dramatic thumbs down gesture in the well of rthe Senate stopped Trump’s repeal effort in its tracks.

While Republicans might prefer that Trump not make repeal of Obamacare a campaign issue, again, Democrats Monday were quick to highlight Trump’s remarks.

“Donald Trump Recommits to Ripping Away Affordable Health Care From Nevadans With Preexisting Conditions,” read the top of a statement issued by the Nevada State Democratic Party. 

“Trump’s vision for Nevada is to kick people off their insurance, ratchet up health care costs, and roll back President Biden’s work to make prescription drugs more affordable,” state party chair Chair Daniele Monroe-Moreno said in the statement.

The reelection campaign of Pres. Joe Biden, who as vice-president famously called passage of the ACA a “big f***ing deal” when the legislation was approved by Congress in 2010, issued a statement saying Trump “was one vote away” from repealing the ACA as president, “and we should take him at his word that he’ll try to do it again.” 

Many health policy experts from both right and left advocate for reforms to the ACA. 

But the ACA’s next significant appearance in Congress will likely be over whether to continue expanded subsidies for those buying insurance on ACA exchanges. The subsidies were first made more generous under the American Rescue Plan Act, and then those expanded subsidies were extended under the Inflation Reduction Act. The more generous subsidies are scheduled to expire at the end of 2025.