Bigger picture: the end of Obamacare?

Repeal of president Obama’s flagship act could make healthcare unaffordable for millions of Americans.

Repeal of president Obama’s flagship act could make healthcare unaffordable for millions of Americans.

Picture: iStock

I write this with the results of the recent US presidential election fresh in my mind.

In January 2017, Republican candidate Donald Trump will stand next to outgoing president Barack Obama at the White House and will be inaugurated president. 

I am nearly as shocked by this as I was by the Brexit vote. While I am not affected personally by Mr Trump’s victory, as a health professional in the UK I have an overwhelming sense of despair at what his election could mean for healthcare in the US.

The majority of healthcare provision in the US is private and paid for either through insurance schemes or directly at the point of care. 

Improving access

At his inauguration in 2009, president Obama said: ‘We will raise healthcare’s quality and lower its cost.’ His aim was to improve access to healthcare for the poorest of US citizens. 

When the Affordable Care Act became US law in 2010 it allowed up to 5 million people who had been unable to afford health insurance to access it through their employers or through government schemes. 

Obamacare, as it is called, is unpopular among Republicans. When asked about his plans for the act, Mr Trump said it would be replaced with ‘something terrific’, which would involve making a deal with hospitals. When he has been challenged about his plans he has had little to say.

Since the election Mr Trump has suggested he may not repeal the whole act, but he has been vague about which parts he will keep.

The NHS is struggling to manage increasing demand. Emergency departments have never been so busy, and we face challenges in maintaining the standards of care that patients deserve and we want to deliver. Nevertheless, as a society, we sleep soundly at night knowing our patients can access the help they need free at the point of care. 

About the author


Jacqueline Price is principal lecturer and lead for adult and primary healthcare CPD at the University of Hertfordshire. She is also a member of the RCN Emergency Care Association

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