What Happens To Obamacare In A Trump Administration?

Nov 9, 2016
Originally published on November 9, 2016 1:43 pm
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STEVE INSKEEP, HOST:

Let's hear what a Clinton supporter said at Hillary Clinton's headquarters as the night went wrong for them.

RENEE MONTAGNE, HOST:

Kim Frederick's known as a super volunteer from Texas, wore a Superwoman cape and boxing gloves to the venue, but began folding up her costume earlier than she had planned. She's a lesbian who lives in Texas, and she told NPR's Tamara Keith she is scared.

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KIM FREDERICK: I knew that we had problems in America. I knew they were large, especially being a woman, especially being lesbian. I'm quite aware that we have issues. What I didn't know was that it was more than half the country. And that is terrifying.

INSKEEP: Just top drop in a footnote, we don't actually know the final popular vote total and whether Donald Trump or Hillary Clinton got more votes. But, of course, we know the electoral vote total and the election result. Now, NPR political correspondent Sarah McCammon was at Trump headquarters last night, where the mood was much more upbeat, as you would imagine. Josephine Blackwell from Alabama said those who are worried about a Trump presidency should instead be excited.

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JOSEPHINE BLACKWELL: Now, I live in the Black Belt of Alabama, close to Selma. And our black population have felt like nobody really cared for years, and this is hope for them, too. So we're - we're excited. We're just really excited.

MONTAGNE: Another reason Trump supporters may be excited - the president-elect has promised to repeal and replace the Affordable Care Act. Now, having retained both the Senate and the House and having the White House, the Republican Party has a real chance to repeal Obamacare.

INSKEEP: Let's talk about how Donald Trump could go about doing that. NPR lead political editor Domenico Montanaro is with us throughout the morning, and we also have NPR health policy correspondent Alison Kodjak. Alison, good morning.

MONTAGNE: Good morning.

ALISON KODJAK, BYLINE: Good morning.

INSKEEP: Glad you're here. Domenico, is it as simple as just passing a bill here? Can you simply - can you simply ram this through quickly - a change?

DOMENICO MONTANARO, BYLINE: No, I don't - I don't think that, you know, ramming something through very quickly is - is what can be done.

INSKEEP: First you have figure out what it is, I suppose.

MONTANARO: Well, I do think, though, that - that there is the possibility that Republicans in - will consider a kind of maneuver similar to reconciliation, where they can try to pick away or chip away or even go nuclear. You know, there's some discussion as to whether or not they would go to what's - the - to get rid of the filibuster, like Democrats toyed with doing to get rid of the filibuster for judges.

INSKEEP: Because they'll have a narrow majority in the Senate. There are many ways that Democrats in the minority could stop them, but they might just override the rules, you're telling me.

MONTANARO: That's - that's correct.

INSKEEP: Alison Kodjak, what are the possibilities here?

KODJAK: Well, you know, they could - they could do exactly what Domenico just said. Or if they can't get a bill actually through, they can actually destroy Obamacare from within. They could not fund it. They could change the regulations in order to completely alter how Obamacare is structured and works through regulation. That would, in some ways, make it work the way that Donald Trump has said he wants the health care system to work and some Republicans have, with different kinds of health plans and tax cuts.

MONTAGNE: Well, you've said that, but, you know, he's said, I'm going to - I'm going to get rid of it, and I'm going to replace it with something better. What could possibly be better?

KODJAK: Well what he's talked about is replacing it with what's called health savings accounts, which basically allows people to save money, tax-free, in order to pay for their own health care and get rid of a lot of the regulations around Obamacare, including the mandate that requires people to buy health insurance, which is what he and most Republicans say is the worst part of the law. Transcript provided by NPR, Copyright NPR.