The Biden campaign has launched a new 30-second ad focusing on the Affordable Care Act, warning voters that Donald Trump is coming for their health care. The $14 million ad buy will run in swing states and reminds voters of Trump’s attempts to repeal the ACA during his presidency. The threat to the law is real, as Trump has consistently tried to undermine or replace it with what he claimed would be “much better healthcare.” The ad not only promises to prevent the repeal of the ACA but also wants to extend vital temporary changes to the program that have made insurance more affordable for millions of Americans.
The Affordable Care Act was created to reorganize the market for individuals buying health insurance independently, prohibiting insurers from charging more or denying coverage based on pre-existing conditions and offering subsidies to reduce premiums. However, some people still faced higher premiums due to less generous subsidies, causing what was known as “rate shock.” In 2021, the American Rescue Plan boosted the ACA’s financial assistance, ensuring that nobody pays more than 8.5% of household income on a standard plan. The impact has been significant, with approximately 15 million Americans saving an average of about $800 a year on their insurance, leading to record-high enrollment in the ACA marketplaces.
Biden wants to make the enhanced subsidies permanent, but the cost of about $25 billion a year presents challenges in finding enough offsetting cuts or revenue. The inability to make the subsidies permanent last time may result in another temporary extension. If Biden and the Democrats remain in office, they are likely to extend the subsidies if they have enough leverage in Congress. However, if Trump and the Republicans take control, the fate of the increased subsidies will be uncertain, given their traditional hostility to government spending on social welfare and Obamacare.
Conservative intellectuals have criticized the extra subsidies as regressive, benefiting higher-income Americans, and as a burden on the federal budget. This reflects a fundamental divide between Democrats, who believe in guaranteeing healthcare as a right, even if it requires significant government spending, and Republicans, who see such efforts as wasteful and inefficient. Biden’s new ad is a bet that the majority of Americans support his healthcare policies, as reflected in polling and recent history of health care debates. The outcome will hinge on voters realizing the importance of the issue in the upcoming election.
