How the 2024 presidential election may threaten health coverage for millions

A record number of people in the United States are signing up for health insurance coverage through the Affordable Care Act, also known as Obamacare, government data shows. Despite the record enrollment, experts warn that the outcome of the presidential election in November could jeopardize coverage for millions.

Former President Donald Trump has renewed his threat to get rid of the health law if he wins a second term. What’s more, if Republicans gain control of Congress, experts say they would likely let expire the discounts that make Obamacare more affordable for millions of people.

“This election has huge health impacts,” said Chris Meekins, a health policy research analyst at the investment firm Raymond James.

Worries about health care costs are a major reason for negative views of the U.S. economy, a KFF poll released Wednesday found. Nearly three-quarters of adults fear they won’t be able to pay for their medical bills. And 50% of people in the U.S., including almost a quarter of Republicans, actually want the next president and Congress to expand what the ACA does. Only a third of adults support scaling back the law (14%) or repealing it entirely (18%), the new poll found.

As of Jan. 24, more than 21 million people had signed up for 2024 health insurance plans through Obamacare, according to the latest data from the Department of Health and Human Services — already surpassing the 16 million total sign-ups during the 2023 enrollment period.

While some of that surge in sign-ups is due to people losing Medicaid coverage, a large portion of it is in response to the government-backed subsidies passed through the Inflation Reduction Act, Meekins said.

The subsidies, which significantly lower the cost of monthly