Tradeoffs: What Does President Trump Want to Change in the Affordable Care Act? Speaker Mike Levitt: What Will He Do If Trump Wins the Health Law?

Tradeoffs is a nonprofit health policy news organization. The executive editor is Dan Gorenstein. The story was written by Ryan Levi. Deborah Franklin adapted the story for the web. You can listen to the whole thing here.

The price of health insurance policies you buy on your own went up as a result of the new law. Insurers had to cover more stuff, because of the fact they had to provide coverage for preexisting conditions.

And if we look back at President Trump’s presidency, his budgets proposed converting both the Affordable Care Act and Medicaid into a block grant to states, meaning removing federal rules and giving states a lump sum of money and giving states flexibility in how to use that money. We’ve seen similar plans, for example, from a group of conservative Republicans in the House that would also convert Medicaid in the ACA into a block grant to states, remove federal protections in the insurance market, and cut federal spending by $4.5 trillion over a decade.

The law requires that more than 21 million Americans buy their health insurance through the law by the beginning of next year.

At a campaign stop in Pennsylvania last week, House Speaker Mike Johnson told a crowd that “massive reform” of the health law is needed, adding no specifics. He promised a “very aggressive first-100-days agenda” in the event of Trump’s victory. Johnson said that health care reform will be a part of the agenda.

Harris warned Americans as part of a speech on Tuesday in Washington, D.C. about what might happen if the healthcare law were to be repealed. “You will pay even more if Donald Trump finally gets his way and repeals the Affordable Care Act — which would throw millions of Americans off their health insurance,” Harris said, “and take us back to when insurance companies had the power to deny people with preexisting conditions.”

The upcoming elections could have “enormous” impact on the law, says Larry Levitt, an executive vice president of the nonpartisan health policy research organization KFF. Levitt has studied the ACA since its inception.

He recently shared insights into the ACA’s track record and discussed what “massive reform” from Republicans might look like on the health policy podcast Tradeoffs. Here are highlights from that conversation.

The impact has been significant. If you had a prior adverse medical history before theAffordable Care Act, you would not be allowed to buy insurance on your own. If it was a mild preexisting condition, you might be offered health insurance, but you may have to pay a higher premium or benefits are not included in your coverage.

The federal government provides a tax credit which can help low-income people pay for health insurance under the new law. Is this true? It’s extremely expensive to get health insurance in this country. I mean, health insurance for a family now costs what it would cost to buy a car. For the vast majority [who don’t have job-based insurance], without the federal help to pay a portion of the premium, they simply couldn’t afford coverage.

The quality of coverage has, I think, largely gone up. The benefits — the stuff that insurance companies have to provide — are now more comprehensive. It covers conditions that had already happened. It covers all of these required benefits.

Health insurance is not perfect. Networks — the doctors and hospitals that insurers cover — are often quite narrow. It can be hard to get an appointment. It’s not true just under the law. It’s true for people who get insurance through their employer as well. I don’t think you can pin this on the ACA, but health insurance is certainly not perfect.

The situation with theAffordable Care Act has played a role in presidential elections in the U.S. but this race has been different. The law that was 14 years old has mostly been off stage, as immigration, the economy and democracy dominate the fight between the vice president and the former president.

Most states will be open until January 15. The coverage888-607-888-607-3166 can be888-607-888-607-888-607-3166 can be888-607-3166 if people sign up by Dec. 15. The Idaho openenrollment period is from October 15 to December 15.

The makeup of the Congress could have a large effect on the future of these marketplaces. Unless lawmakers are able to extend them, the extra subsidies that made premiums so affordable will stop at the end of next year.

A majority of Americans get their insurance from their jobs or from a public program. But still, this program has a big impact. As enrollment in the marketplaces set new records in the last few years, the number of uninsured Americans has dropped dramatically.

Premiums are cheap for a lot of people, and there are more plan options than ever. Cynthia Cox is the Director of the Program on the AHCA for KFF, a nonpartisan health research organization.

The secretary of health and human Services tells NPR that more Americans are able to have access to a doctor, a hospital, and their own health insurance because of the policies of the vice president and president. After this year’s open enrollment, he adds, “I have no doubt that we’ll see another record set of Americans who have health care coverage.”

One group that’s newly eligible for these subsidized marketplace plans is Deferred Action for Childhood Arrivals recipients, also known as Dreamers. Secretary Becerra says that an estimated 100,000 DACA recipients are expected to enroll.

“It’s a good day for all these folks because for the longest time they’ve been working [and] paid taxes and not had a chance to get their coverage through the Affordable Care Act — that changes,” he says.

One of the Dreamers was waiting for this. She was nine when she came to the U.S. with her family. She’s now 36, living near Danbury, Ct., and uninsured, since her job with health benefits ended over the summer. That has meant, for example, paying out of pocket at urgent care when a dog bit her a few weeks ago.

“It is stressful,” she says. I need to have a checkup. I do need to go to the dentist now. And you never know when a random emergency’s going to strike.” She planned to sign up as soon as enrollment opened on Friday.