Republicans are again trying to repeal Obamacare. This time, they don’t know how much the effort will cost or what the impact will be. We only know that a lot of people will lose insurance coverage and that premiums will almost certainly rise for those who keep it. It’s a politically risky move that could make single-payer the next step in our health care reform process.

The Affordable Care Act is as popular as it’s ever been with more than half the population saying they approve. More than 20 million people have gotten health care coverage. For the first time in history, less than 9% of Americans are uninsured. While costs and premiums are still increasing too fast, they’re rising more slowely than they were before Obamacare was implemented. The program with a contentious beginning has had solid success.

Republicans who control Congress could make the Affordable Care Act stronger by working to stabilize the individual market and containing costs. America pays far more for its health care than other western nations but we don’t get far better outcomes. Improving care and reducing costs is a worthy goal.

Instead, Republicans are hell bent on scrapping Obamacare regardless of the impact on Americans. In doing so, they’ll disrupt the lives of millions of people to score cheap political points. Their base will cheer until they realize they’re the ones paying more and getting less.

They will also speed the way toward single-payer health insurance. Raising premiums, bringing back pre-existing conditions and kicking millions of people off Medicaid will likely create a backlash against Republicans like the one Democrats felt in the wake of the Affordable Care Act. The 2018 election is not looking good for Republicans right now and it will look far worse if they pass the repeal bill. As we emerge from the Great Recession and the upheaval that Obamacare caused, people want stability, not more disruption.

If Republicans repeal Obamacare, they will succeed in spite of Trump not because of him. He’s given no input into designing the current repeal bill and he’s not put pressure on any Republicans in Congress to support it. He’ll take credit for repealing Obamacare to satisfy his base and then turn his aim at the GOP for stripping away insurance and causing premiums to rise—and his base will follow along.

On the Democratic side, there’s momentum for a single-payer plan. If a wave puts Democrats in control of Congress, there’s a good chance a Medicare for All bill passes. Trump would almost certainly sign it since he’s suggested that’s his preference in the past. Then, he gets his cake and eats it, too. He’ll boast that he repealed Obamacare and gave us the universal coverage he promised during the campaign.


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