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Speaker Mike Johnson Suggests Republicans Will “Reform” ACA Out of Existence

The Affordable Care Act is very popular, with three in five Americans rating it favorably, according to a recent poll.

Speaker of the House Mike Johnson speaks to supporters of former President and Republican presidential candidate Donald Trump, at a Trump Force 47 campaign office in Bethlehem, Pennsylvania, on October 28, 2024.

In an appearance at a political event in the key swing state of Pennsylvania earlier this week, Speaker of the House Mike Johnson (R-Louisiana) suggested that, if Republicans win the White House and Congress in next week’s elections, there would be a “very aggressive” first 100 days of policymaking, including major changes to the Affordable Care Act (ACA), sometimes referred to as Obamacare.

Repealing the ACA has been a huge priority for Republicans ever since it was passed — former President Donald Trump and Republicans tried and failed many times while he was in office to end or “replace” the law, and Republicans have attempted to get it repealed around 100 times in total.

However, the ACA is widely popular — a KFF poll from April, for example, showed that 62 percent of Americans had a favorable view of the law, while only 37 percent had an unfavorable view on the policy.

Likely due to the policy’s popularity, Republicans have mostly downplayed their disdain for the ACA this election season. But when an audience member asked if Johnson’s comments on changes to the policy meant that Republicans would attempt to repeal the law, Johnson responded in the affirmative.

“No Obamacare?” that person asked.

“No Obamacare,” Johnson responded.

Johnson later tried to walk back his comments after they were met with widespread backlash, blatantly lying about what he said during the event.

“Despite the dishonest characterizations from the Harris campaign, the audio and transcript make clear that I offered no such promise to end Obamacare,” Johnson said in a statement.

Johnson did admit during the event that the ACA “is so deeply ingrained, we need massive reform to make this work and we got a lot of ideas on how to do that.”

But the kinds of “massive reforms” he’s talking about would likely create a “Ship of Theseus” situation, where so many changes to the law would effectively make it completely different from what it once was.

Indeed, days after Trump’s September debate with Vice President Kamala Harris, in which the GOP nominee for president said he had “concepts of a plan” to change the ACA, his vice presidential running mate Sen. J.D. Vance tried to explain what Trump meant. In doing so, Vance suggested changes that would render one of the most popular parts of the law moot — the stipulation barring insurance companies from using preexisting conditions to block patients’ coverage.

We should “not have a one-size-fits-all approach that puts a lot of people into the same insurance pools, into the same risk pools, that actually makes it harder for people to make the right choices for their families,” Vance said last month, advocating instead for different pools based on people’s health and age.

Vance claimed he and Trump would still “make sure preexisting conditions are covered,” but the system he’s advocating for would create financial burdens that would essentially block people with those conditions from getting care anyway.

“Trump’s concept of a plan would take access to medical care away from millions of Americans,” New York Magazine’s Jonathan Chait wrote at the time.

“This is what Vance means when he says that people should be able to pick plans that make sense for them, or alludes to ‘risk pools’ — Healthy people get to buy into super cheap insurance [while] sick people get shunted into plans that are unsustainable,” doctor and social media influencer Áine Yore said in reaction to Vance’s proposal.

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