Dem
47
GOP
53
Republicans have been trying to eviscerate or eliminate the ACA for years, even though their voters profit from it more than Democrats' voters do. Donald Trump doesn't care for it much either. In January, Republicans will have the trifecta and could once again try to gut it. Out-and-out repeal of the ACA might prove a bridge too far, but they could cut the subsidies offered to the point few people could afford to buy health insurance on the ACA platforms. That would not be as satisfying for Republicans as a successful vote to repeal the law, but it could be an acceptable second choice. After all, the goal is punishing poor people. Only the Republicans (mistakenly) think it will primarily punish poor Black people in cities, when actually it will punish poor white people in rural areas. But whatever.
Joe Biden is aware of all this and is doing his best to prevent this from happening. Obviously, he can't prevent a Republican trifecta from repealing the ACA law or slashing the subsidies, but he can make the process as painful as possible, and that is what he is working on as his administration winds down. His main goal is to get as many people as possible enrolled in the program before Jan. 20. He knows very well that for people who have heard a little about the ACA and think it is for poor Black people in cities, killing it is not a big deal. But for people actually enrolled in it to discover next year that they won't have health insurance anymore is a very big deal and they are going to blame the guy in the White House. It is always like that.
For 2024, 21.3 million people are covered by the ACA. Most of them are voters. Biden extended the sign-up deadline to Dec 18. Many people put things off and having even a few more days can bring in millions of new people. That is especially important this year, because so much air time on television was devoted to campaign ads that messages to sign up were often drowned out. The more people who sign up this week, the more people who will be unhappy when they learn the Republicans are going to try to kill—or at least starve—the program. (V)