An Introduction to Anticipated Changes to the ACA under the New Administration

Since it passed in 2010, the Affordable Care Act has insured millions of people. At the same time, the high costs have rankled Republicans, who have vowed to repeal the law if given the chance. With the election of Donald Trump, conservative members of Congress finally have their opportunity. But, will it actually happen, and how soon could Americans see changes?
The President's Executive Order
On his first day in office, President Trump issued an executive order addressing the Affordable Care Act. In it, he appeared to set a course for dismantling the law; however, no firm timetables were given. Much of this is due to the limitations surrounding executive orders.
Where foreign policy is concerned, executive orders can have a quick, meaningful impact. On the domestic side, however, executive orders are generally limited to setting broad policy direction. In this case, the President's executive order appears to be a gesture aimed at confirming the administration’s commitment to repealing the ACA.
What About Congress?
For years, Republican members of Congress have criticized the Affordable Care Act as a costly and inefficient program. Now that Republicans control the Senate, House and executive branch, the party appears set to follow through on its promise to eliminate the law. At the same time, many congressional Republicans have expressed concerns over repealing the Affordable Care Act without having a replacement health care plan at the ready. While most remain firm on their intent to overturn the ACA, a large number of Republicans have urged a patient approach to ensure that millions of Americans do not lose health care coverage overnight.
What Does the Future Hold?
Right now, it's unclear how the government will proceed with its plans to repeal and replace the ACA. In an apparent reaction to the uncertainty surrounding the law, Affordable Care Act sign-ups have dipped in most states. At the same time, federal health officials recently issued a series of proposed rule changes to protect insurers and to shore up ACA marketplaces, while Republicans work on changing the law.
While some Republicans are urging a total repeal, others say nothing will happen until a replacement has been created. Still others suggest congressional leaders may ultimately decide to make marginal tweaks instead of a wholesale gutting.
Whatever the case, without knowing the long-term future of the ACA, it appears clear that Americans will enjoy coverage for the rest of the year, at least. Beyond that, even members of Congress are unsure what to expect.