Obamacare in the Trump Era: Where are we now, and where are we going?

The Patient Protection and Affordable Care Act, better known as Obamacare, is the most significant US social policy reform in half a century, and the most politically fractious. Since the law was signed by President Obama, Republicans have mobilised against it, using courts and state governments to undermine the implementation of the legislation, which was set to unfold gradually over a nine‐year period. As we describe in this article, however, the beginning of the Trump presidency in January 2017 marked a turning point in the politics of Obamacare. In the absence of Obama's veto, legislative retrenchment became a viable option for the first time. Yet, a combination of intra‐party conflict and opposition to repeal from key stakeholders doomed Republicans’ initial efforts. Nevertheless, we discuss several reasons to doubt Obamacare's political stability.