16 November 2016 - Donald Trump’s election as President puts the future of the Affordable Care Act (ACA) in jeopardy. 

Full repeal is unlikely, given a probable filibuster by Senate Democrats, but major changes through the budget reconciliation process (which cannot be filibustered) are nearly certain. At the same time, eliminating insurance coverage for the millions of people now aided by the ACA carries its own political risks for the new administration. Complicating matters further is growing concern even among ACA supporters about the long-term viability of many of the insurance exchanges, through which more than 10 million people currently purchase private coverage (typically with federal subsidies). 

Several commercial insurers are either exiting or scaling back their participation in these marketplaces, and many smaller nonprofit insurers have shut their doors. One study predicts that 35% of U.S. communities will soon have only one available exchange insurance option.

Read New England Journal of Medicine article