The GOP's Health Care Headache: Why Republicans Can't Let Go of the Past

The Affordable Care Act (ACA), often called Obamacare, has become a major political challenge for Republicans. Despite its growing popularity, with 57 percent of Americans now supporting it, the GOP recently voted to let key subsidies expire. This decision could lead to significant premium hikes for over 20 million people, potentially affecting the party's standing in the 2026 midterm elections. Republicans have long struggled with health care politics. Unlike other conservative parties worldwide, which generally accept universal health coverage, the GOP remains opposed to expanding access. This stance is becoming increasingly unpopular, as more Americans believe health care is a government responsibility. The U. S. system makes universal health care difficult to achieve. The legislative process requires multiple majorities, and the Senate gives conservatives disproportionate power. Additionally, the employer-based insurance system, which emerged during World War II, complicates reforms. Congress has historically prioritized preserving insurance for those who have it over extending benefits to the uninsured. The ACA broke through this gridlock by maintaining the employer-based system while expanding coverage options. It provided Medicaid for low-income workers and subsidized coverage for higher-income individuals without employer coverage. Despite Republican predictions of failure, the exchanges worked well, drawing millions of customers and bending the health-care-cost curve downward. Republicans have yet to adjust to the changed political landscape. Taking away or making insurance more expensive is far more challenging than blocking reform efforts. Some Republicans, like House Speaker Mike Johnson, dismiss the ACA's success, calling it a "broken system" and ignoring its 24 million beneficiaries. Former President Donald Trump has also struggled with health care policy. He promised to "repeal and replace" the ACA with a better, cheaper system, but this proved impossible. In his second term, he suggested giving people money directly to buy insurance, ignoring the complexities of medical care and the need for insurance. The GOP's refusal to adapt to the ACA's success could have significant political consequences. Until Republicans acknowledge the importance of health care access, they risk alienating millions of Americans who benefit from the ACA.