The Impact of the Affordable Care Act on Donald Trump’s White House Victory: A Decade and a Half Later

Fifteen years back, the inception of the Affordable Care Act laid the groundwork for 's triumph in the White House. The vehement conservative opposition to the Democrats' sweeping healthcare initiative spawned a newly emboldened far-right faction in Congress, galvanized a cohort of incensed political newcomers, and nearly deprived of a second term.

Donald Trump
Donald Trump (Image source: Twitter)

Now, after a steadfast passage of 14 years, those same agitators appear to have swayed Trump, who spent years vehemently denouncing the law colloquially dubbed Obamacare, into perceiving it as potentially advantageous politics, if not prudent policy.

Recalling Trump's 2016 campaign, it's worth noting its foundation on two pillars: the spurious and racially charged assertions that Obama wasn't a native-born citizen of the and an unwavering disdain for Obamacare. Trump scarcely missed an opportunity to condemn the law as a “catastrophe” or assert that it “stinks,” often asserting a new initiative was perpetually “two weeks” away. As recently as a few months ago, he pledged to dismantle it if given a second term, rallying his supporters with cries of “We must never relent!” in a November post on Truth Social.

Curiously, in recent years, a shift has occurred. Obamacare's appeal has surged as more Americans engage with a healthcare system fundamentally overhauled in incremental stages, while antipathy towards the Obamas has waned. Nonetheless, sporadic derogatory remarks persist. Consequently, attacks on the 44th President's enduring legislative legacy now carry less impact, reverberating scarcely beyond a feeble murmur.

Read More: President Joe Biden Conveys Profound Grief and Disappointment Following the Tragic Loss of Humanitarian Aid Workers

Fast forward to 2024, and Obamacare appears unlikely to implode; rather, it may even gain fortification should Trump secure a return to the White House. In a recent string of communications, the former President is communicating to voters… Well, here's one of his social media musings in all its glory:

This typographical turnaround, if indeed that's what it is, was far from assured. During the law's formative stages, opponents instilled in true believers the notion that it would result in healthcare service rationing and, perhaps, even “death panels” tasked with conducting cost-benefit analyses of treatments. Following months of legislative maneuvering, the bill passed Congress in March 2010 without a single Republican vote in favor, with 34 House Democrats opposing its final passage.

Initial polling deemed the overall package a political dud. In May 2010, a plurality of 44% of voters held an unfavorable view, a sentiment largely unchanged through the November election, which saw Democrats suffer significant losses in both the Senate and House. A Kaiser Family Foundation poll in May showed 85% of Republicans shared an unfavorable view. Despite months of Democratic explanations, that figure only dropped to 79% come Election Day.

In essence, while Obamacare may have represented sound policy, it proved politically inept. The arduous 14-month journey to enactment left even its champions somewhat embittered.

It wasn't until the fall of 2013 that individuals could enroll in private health insurance through a federal portal plagued by glitches and poor public relations. For a considerable stretch, Obamacare brought affliction rather than relief. It was here that Trump seized upon an often-overlooked segment of the GOP base, stoking distrust.

Initially successful, this tactic faltered as the benefits of the law became apparent. Over time, polling improved. Parents realized their young adult children could remain on their health plans as they embarked on their careers. While healthcare costs didn't decrease—in fact, they rose—patient experiences improved, even as medical bankruptcies persisted. However, the notion of harsh care rationing failed to materialize, and dismantling a program affecting 45 million people—a sizeable portion of all Social Security beneficiaries—proved a political liability.

This sentiment wasn't prevalent when Trump and his allies assumed control in early 2017. Repealing Obamacare topped their agenda. Trump issued executive actions—later rebuffed by the —and pressured Capitol Hill allies to comply.

“In March 2017, Trump lamented, “Obamacare unfortunately will implode. It's in for a rough year.”

Trump's predictions proved erroneous, and he now pins his hopes on a collective amnesia that has excused many of his reversals. By now, most Americans are unfazed by his about-turns; his support for TikTok, following attempts to ban it, surprised few. However, while opposition to Obamacare was integral to Trump's political identity, a TikTok ban was not.

It appears Trump has finally grasped that flawed though it may be, the healthcare law benefits millions, perhaps acquiring a status akin to Social Security's sacrosanctity. The Supreme Court repeatedly rejected efforts to dismantle it. Kaiser polling shows 59% of Americans view the Affordable Care Act favorably, including 33% of Republicans. A March 22 report indicates 45 million Americans benefit from the law in some way. The days of “repeal and replace” seem distant as Trump acknowledges the absence of a viable alternative.

Forty states, including GOP-led ones, along with D.C., participate in Obamacare's Medicaid expansion programs. Even as Trump reiterates his desire to repeal his predecessor's despised legacy law, Republican lawmakers distance themselves, unwilling to “walk the plank” alongside him.

appears keen to compel Trump to defend his long-held stance or admit to a significant U-turn. In his State of the Union address, the current President taunted the former: “My predecessor, and many in this chamber, seek to strip away prescription drugs by repealing the Affordable Care Act. I won't allow it. We've thwarted you 50 times before, and we'll do so again.”

For his part, Trump seems to acknowledge that the 51st time could prove most consequential: his upcoming fall campaign. His desire to reclaim power—and perhaps evade federal prosecutions—overrides more than a decade of anti-Obamacare rhetoric with scarcely a blink.

Leave a Reply