Donald Trump wants to make healthcare great again — again.
The former president ignited a firestorm in Washington with a weekend social media post that called for seeking "alternatives" to the Affordable Care Act, which was passed in 2010 and is more commonly known as Obamacare.
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"The cost of Obamacare is out of control, plus, it’s not good Healthcare," Trump wrote on Truth Social. "I’m seriously looking at alternatives."
Trump noted that Republicans almost tanked the law in 2017, an effort famously shot down by then-Sen. John McCain, saying it was "a low point for the Republican Party, but we should never give up!"
But rather than the GOP, it was Democrats who took quick notice of the comments and have delighted in rebuking them in the days since.
"There are 40 million people in America today who get their health insurance through the Affordable Care Act," President Joe Biden said at a Denver campaign reception. "His plan is to throw every one of them off that legislation. It would mean the number of uninsured African Americans would go up by 20%. Latinos would go up by 15%."
"If Trump has his way, that's gone," Biden added. His campaign has already purchased TV ads contrasting the president's healthcare approach with Trump's, and former House Speaker Nancy Pelosi (D-CA) predicted Democrats will capitalize on Trump's "bad political move” next year.
Republicans have been less assured in their response.
GOP strategist Doug Heye has doubts that Trump has fully thought out what replacing Obamacare would entail.
"If Trump is going to lead Republicans down repeal and replace again, they’ll have to come up with what replacement means, something we could not do in 2014 with the House’s smartest policy wonks working on it," Heye said ."Given that Trump isn’t exactly a policy person, this feels not fully baked."
Sens. Ted Cruz (R-TX) and J.D. Vance (R-OH) have expressed support, but others, like Sen. Mike Rounds (R-SD), said the idea needs more thought. Rounds indicated a concrete replacement isn't ready, telling NBC that "it would require us to start proposing what the change would be now so that we wouldn’t be in a position of repealing without having a better replacement."
Trump has posted twice more, trying to clarify his comments.
“I don’t want to terminate Obamacare, I want to REPLACE IT with MUCH BETTER HEALTHCARE. Obamacare Sucks!!!” he said in one.
Trump wrote in the other that "Getting much better Healthcare than Obamacare for the American people will be a priority of the Trump Administration," adding that the United States has "one of the worst" healthcare plans in the world.
The Trump campaign did not respond to questions from the Washington Examiner. He has released an extensive policy platform for a second White House term, but one that is mostly silent on the healthcare finance system.
Still, the Heritage Foundation's healthcare and welfare policy director, Nina Schaefer, thinks the time is right to call for a change.
"President Trump was right to revive the debate on Obamacare," she said. "Congress should double-down on efforts to expand patient control over healthcare dollars and decisions, offer more coverage choices and options, and give states much-needed flexibility to better design their healthcare markets."
A May 2023 Kaiser Family Foundation poll found that roughly 6 in 10 people say they have a favorable opinion of the Affordable Care Act.
Even if the proposal proves politically popular, implementing it will be difficult. Republicans would need to unify control of the White House and both chambers of Congress given that Democrats strongly support Obamacare. They had that trifecta in 2017, and the effort still failed.
The Department of Health and Human Services estimates that more than 40 million people are insured via Obamacare, though Republicans tend to focus on premium hikes and poor coverage in the wake of the 13-year-old law.
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"Repeal and replace" was a big GOP slogan dating back to the tea party days of the early 2010s, though the rallying cry largely vanished following the 2017 vote.
If anyone can bring it back, it may be Trump, who is now drawing above 60% support in the RealClearPolitics average of Republican primary polls. Doing so may eventually require more details on the idea and a strong GOP message to counter Democratic attacks.