How the renewed Obamacare debate is shaping the 2024 election

The Affordable Care Act, also known as Obamacare, has resurfaced as a campaign issue and one that could help determine the outcome of which party wins the White House.

Republicans were engaged in a concerted effort both to repeal and replace former President Barack Obama‘s hallmark Obamacare legislation for nearly a decade following its signage in March of 2010. Efforts to reverse the healthcare overhaul fell flat, and Democrats took control of the House of Representatives following the 2018 midterm elections.

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“I think it’s pretty obvious the Democratic House is not going to be interested in that,” then-Senate Majority Leader Mitch McConnell (R-KY) said in 2018, conceding the GOP full assault on the law hit a ceasefire.

Stuck with a Democratic House during the remainder of his presidency, former President Donald Trump failed to pass his healthcare reforms to repeal Obamacare.

Over time, Obamacare has grown in popularity and Republicans have avoided pledges to repeal it for fear it is a losing issue politically.

By the early 2024 election cycle, “Obamacare” was all but gone from the vocabulary of most, if not all, candidates’ campaigns.

That changed last month, however.

Trump, the unpredictable firebrand that he’s proven to be, revived it close to midnight on Nov. 28. “Getting much better Healthcare than Obamacare for the American people will be a priority of the Trump Administration,” he wrote on Truth Social. “It is not a matter of cost, it is a matter of HEALTH. America will have one of the best Healthcare Plans anywhere in the world. Right now it has one of the WORST!”

The former president has become increasingly likely to be the Republican nominee in 2024 as he expands his lead over the primary field, and with his renewal of the Obamacare fight, he provided Democrats and President Joe Biden’s reelection campaign what they viewed as a political gift to embrace ahead of the general election.

Biden’s campaign quickly seized on his unexpected Obamacare comments, revisiting Trump’s yearslong history of similar remarks. The campaign shared a video last month scrolling through a list of past pledges to replace Obamacare made by Trump, reminding voters of his stated intentions.

As of May 2023, favorable views of Obamacare had risen to 59%, up from 46% in April 2010. Unfavorable views of the policy remained steady at 40%, per the KFF Health Tracking Poll.

In a general election that seems likely to be a rematch between Trump and Biden, just a few policies could sway the electorate, especially as voters continue to sour on both candidates over their ages, fitness to serve, and legal troubles.

What Democrats have been relying on before the Obamacare comment had been abortion, which has appeared to become an electoral loser for Republicans since the overturn of Roe v. Wade in the summer of 2022 and subsequent state-level actions to restrict abortion access.

But at a time when Trump and Biden are nearly deadlocked in polls ahead of a 2024 contest, any policy concern that moves the needle is significant.

While the attacks from Democrats and Biden’s campaign have been primarily lobbed at Trump, who brought renewed attention to Obamacare, Trump also opened up his Republican opponents and other GOP candidates across the country to scrutiny over their past Obamacare comments.

This way, whether Trump is the nominee or not, Obamacare is likely still going to be ammunition for Democrats in the pivotal 2024 election.

In a video posted recently to Biden’s account on X, formerly Twitter, Obama joined his former vice president to capitalize on the campaign opportunity. Biden asked his former running mate jokingly if Obamacare is “still a thing.”

“Yes, Obamacare, the Affordable Care Act, Bidencare, whatever you call it — yes, it is still a thing,” Obama said.

“The other side’s been trying to repeal it every year since it’s existed. But we’ll keep fighting to protect it,” the former president continued.

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Democrats view Obamacare as a winning message when looking to win over independents, specifically those in a few key swing states who could decide the 2024 election.

According to KFF, 62% of independents view the Obamacare policy as favorable. This marks an increase from 54% of those in the group who said the same in 2021.