As a majority of Americans await the inauguration of a president they didn’t vote for, even more Americans face an unclear future about their health care coverage.
The ACA/Obamacare political and policy battle over the last seven years is the perfect microcosm of the Obama presidency. Some people hate the policy because Obama came up with it (as this classic Jimmy Kimmel sketch shows); some people hate Obamacare on ideological grounds but love the Medicaid expansion, pre-existing-conditions rule and the extension of dependent health care until the age of 26. While millions of Americans approve of the law and have benefited from it, they aren’t as loud (or didn’t receive as much media attention) as those who hate it.
Remember the wooden-block game Jenga, which made a comeback at grown-up “board game parties“ in the early 2000s? The goal is to keep taking blocks from the bottom of the tower and putting them on top without the whole thing falling apart. If you’re careful when you pull, things just wobble; if you’re not, then the whole thing crumbles.
Republicans are realizing that Obamacare is a lot like the game Jenga. You can’t pull out the “bad blocks” of policy—like, say, the public mandate—and keep the “good ones,” like forcing insurance companies to cover people with pre-existing conditions. If you keep messing with it, eventually the whole thing is going to fall apart. Except instead of blocks on the floor, you have 20 million Americans thrown off their health insurance.
Now that everyone is forced into coverage, health care companies want to squeeze every dime out of the consumer. This is often done through “formularies,” which are lists of drugs that companies will and will not cover. Who determines if a drug is covered? Why, advisory nonprofits funded by health-insurance companies, of course.
These complex issues are just the tip of the iceberg America is crashing into while Donald Trump tweets that he’s king of the world. The GOP can’t repeal a policy it can’t replace, and it can’t manage an industry that pays its bills. The little wooden pieces of policy, which represent the lives and well-being of millions of Americans, will end up all over the floor. Except this time, the Republicans in Congress won’t have Obama or a Democratic majority to blame for it.
This article originally appeared online at The Root.