President Elect Donald Trump, along with other high-ranking Republican lawmakers in the House and Senate, have expressed support for repealing the Affordable Care Act (ACA), also known as Obamacare. The ACA was passed in March, 2010 under the Obama administration with the goal of increasing equitable access to healthcare and legal protections against insurance companies. It provides American households whose incomes are between 100% and 400% of the federal poverty level (FPL) with the “premium tax credit”, which are subsidies that lower the cost of healthcare. The act also expands Medicaid to cover all legal adults whose income is below 138% of the FPL. The bill is succeeding in its goals. According to The White House, the rate was 16% prior to March, 2010. As of January, 2024, the rate is now 7.2%. That’s less than half of the old rate. Despite this, Trump endorsed a bill to cut the majority of the act in his previous term in office, which ended up failing. Then recently on Monday October 28th, 2024, Republican House Speaker Mike Johnson said that “health care reform’s going to be a big part of the [Trump administration’s] agenda…No Obamacare.” Yet repealing the ban would be a grave mistake, as it would lead to increased mortality rates, particularly amongst marginalized groups.

By providing insurance to those whose income qualifies under the ACA, the bill is quite literally saving lives. A year before the act was passed in 2010, the Harvard Medical School and Cambridge Health Alliance published a study linking 45,000 annual deaths in America to a lack of healthcare insurance. They go on to specify that, “uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts” (The Harvard Gazette). In this experiment, the only notable difference between these two groups of people is insurance. A 40 percent higher risk of death is large enough to be statistically significant, undeniably correlating healthcare insurance and risk of death. In other words, this study proves that a lack of insurance can be fatal. Under Obamacare, millions of more Americans are now insured than when this study was conducted in 2009. Therefore, millions of more Americans are living without that 40 percent higher risk of death. The ACA is saving lives. As of more recently, Kaiser Family Foundation (KFF), a nonprofit research and journalism organization, found that “over one in five (22.6%) adults without coverage said that they went without needed care in the past year because of cost compared to 5.1% of adults with private coverage and 7.7% of adults with public coverage.” Needed care refers to a variety of medical services, including life saving surgeries, medications, and other treatments. Those with public coverage, such as Medicaid and insurance under the ACA, are able to receive those lifesaving services without the cost being an obstacle.

So if Obamacare were to be repealed, thousands of Americans would likely die because they are unable to afford healthcare, with historically marginalized groups being affected the most. According to the United States Census Bureau, in 2023, 23.6 percent of Hispanic Americans and 11.1 percent of Black Americans were uninsured compared to only 7 percent of white Americans. Even with the act in place, we are facing a considerable racial disparity in insurance rates. It stands to reason that these gaps would only grow if the ACA is repealed, especially considering other factors like racial discrimination in the workforce and institutional racism, leading to higher mortality rates for people of color. Another marginalized group that will be affected is the LGBTQ+ community. While it’s common knowledge that queer people have historically faced lower access to healthcare (think of the AIDS epidemic), a study conducted from January 2021 to February 2022 and published in the American Journal of Public Health proved that this inequality still exists. The study states, “Sexual minority women were significantly more likely to be uninsured than were heterosexual women, and lack of insurance widened the magnitude of disparity by sexual minority status in all measures of access.” Just as with people of color, it’s reasonable to expect that the existing disparity in insurance rates between straight and queer people will only grow in the absence of the ACA. Additionally, since a lack of insurance is already statistically proven to result in poorer healthcare for people in the LGBTQ+ community, this problem will likely worsen without Obamacare. The reason why it’s important to acknowledge which groups of Americans will be affected the most if the act is repealed is because these disparities enforce decades of discrimination. If a marginalized person cannot adequately access healthcare, they are less likely to overcome the systems of discrimination set in place. In order for America to move forward in the fight against bigotry and hate, these insurance rate disparities must be addressed and fixed, not worsened by repealing the ACA.  

Healthcare insurance affects us all, whether you’re a senior thinking about your future after high school or a freshman covered by your parents’ private insurance. For all of us, being insured can be the difference between life and death. That’s why the ACA is so important. It keeps millions of Americans from landing in a situation where they have to decide between bankruptcy or possibly dying. One day it might save you from having to make that same choice.