Why did Trump win? It wasn’t WikiLeaks. It wasn’t FBI Director Comey. It was an electorate that was profoundly unhappy with the direction of the country. And they were particularly unhappy with President Obama’s signature domestic policy achievement — the Affordable Care Act (ACA) — or as it is commonly known, Obamacare.
Evidence that the ACA was falling apart, along with Hillary Clinton’s commitment to preserve and expand it, sealed the deal for Trump.
Voters remembered the hollow promises that if you liked your insurance you could keep it, and that medical costs would fall.According to Rasmussen Reports, weekly surveys over the past two years showed that two thirds of the country think the country is heading in the wrong direction — the percentage never dipped below 62 and was as high as 72. Few things were as unpopular as Obamacare. From before it was enacted in 2010 to now, public disapproval has always exceeded 50%.
Voters were well aware that this was President Obama’s baby, pushed through by unusual legislative maneuvers — the reconciliation process — without a single Republican vote. They remembered his hollow promises that if you liked your insurance you could keep it, and that medical costs would fall.
Down the election home stretch, voters saw insurers pulling out of healthcare markets all over the county, skyrocketing out-of-pocket costs (deductibles and co-insurance), and steep insurance premium price rises. Premiums for enrollment starting November 1 of this year, just days before the election, increased 25% on average. Some states have huge increases: North Carolina 40%, Pennsylvania 53%, Minnesota 59%, and Arizona 116%.
Through it all Hillary Clinton remained a steadfast Obamacare supporter. She even promised to expand it by adding a “public option.” The only way to get rid of it was to defeat Clinton and other Democrats.
House Republicans have already advanced a well-thought-out plan.There is no question that this election was a repudiation of President Obama’s policies. Donald Trump was not the only winner. Despite ubiquitous forecasts that Democrats would regain control of the Senate and possibly the House, Republicans retained control of both chambers comfortably.
Hillary Clinton was a particularly flawed standard bearer for a third term of Obama policies, but it is unlikely any Democrat who lacked Obama’s likeability and minority bona fides could have prevailed.
Donald Trump hasn’t said much about healthcare policy. But he has been clear about one thing — he wants to repeal Obamacare. In his first hundred days he should, in concert with Congressional Republicans, repeal and replace the ACA.
House Republicans have already advanced a well-thought-out plan — a Better Way — that promotes consumer-directed health care to increase choice and flexibility, decrease costs, protect vulnerable Americans, increase innovation, and preserve Medicare and Medicaid without expanding federal control and regulation. It is a ready template President Trump can utilize to fulfill the wishes of the American people.
This piece is published from AEI
Joel Zinberg
Joel Zinberg, M.D., J.D., F.A.C.S., is a visiting scholar at the American Enterprise Institute, where he works on health policy and health care reform, specifically the impact of laws and regulations on the practice of medicine. At the same time, he is a practicing surgeon specializing in general surgery and surgical oncology at The Mount Sinai Hospital and is an associate clinical professor of surgery at the Icahn School of Medicine at Mount Sinai in New York City.
