• Home
  • Latest
  • Fortune 500
  • Finance
  • Tech
  • Leadership
  • Lifestyle
  • Rankings
  • Multimedia

Trendingnow

1

Mark Cuban says he has the solution to growing income inequality, and it's to reward every employee—from CEO to janitor—with company stock

2

‘I want to die broke’: Billionaire philanthropist Denny Sanford dies after giving away $4 billion

3

'Dr. Doom' Nouriel Roubini says we're headed for universal basic income or 'some form of socialism' as AI revolutionizes work—He calls that optimistic

1

Mark Cuban says he has the solution to growing income inequality, and it's to reward every employee—from CEO to janitor—with company stock

2

‘I want to die broke’: Billionaire philanthropist Denny Sanford dies after giving away $4 billion

3

'Dr. Doom' Nouriel Roubini says we're headed for universal basic income or 'some form of socialism' as AI revolutionizes work—He calls that optimistic
Health

Why Trumpcare’s Death Doesn’t Mean Obamacare Is Saved

By
Sy Mukherjee
Sy Mukherjee
Down Arrow Button Icon
By
Sy Mukherjee
Sy Mukherjee
Down Arrow Button Icon
August 18, 2017, 8:00 AM ET
Add Fortune on Google for similar content.

President Trump’s and the GOP’s efforts to repeal and replace the Affordable Care Act fizzled out this summer in spectacular fashion. But while the sprawling U.S. health care industry was spared an 11th-hour overhaul, a thick cloud of doubt lingers over the $3 trillion sector. At the center of the storm: insurance companies—and the billions of dollars in subsidies they now receive to cover low-income patients via the ACA. Despite the implosion of the repeal bills, many insurers are nonetheless asking for hefty premium hikes that could throw the system into even deeper disarray.

That would offer an ironic denouement to the Republicans’ seven-year quest to vanquish the ACA—which, as the world knows, sputtered out after three failed Senate bills in about as many days and a dramatic late-night vote, the culmination of a battle that exposed enormous intraparty disagreement and highlighted the unexpected unpopularity of repeal.

There are, to be sure, some in Congress who are fending off this surprise ending—and using a rare weapon to achieve it: bipartisanship. The group’s goal now is to do what the previous GOP-only efforts didn’t attempt—to stabilize the shaky ACA markets rather than kill them.

A crucial Senate health committee has scheduled hearings for September to review a bipartisan framework that would guarantee insurers payments (called “cost-sharing subsidies”) that help reduce low-income Americans’ out-of-pocket medical expenditures, carry on the universal coverage mandate, and incorporate GOP proposals to make more bare-bones plans available as well as repeal certain ACA taxes.

The question now, though, is whether such bipartisan problem-solving may be too little too late. Multiple insurance companies say the uncertainty that continues to surround Obamacare has left them no choice but to seek premium hikes, if they are to remain in the various ACA exchanges. These marketplaces—which enable individuals not covered through their employers or government programs to purchase individual plans—look increasingly unstable as insurers pull out of (or even threaten to leave) them.

This time last year, insurers on the individual markets were on “a path toward regaining profitability in 2017,” according to the nonpartisan Kaiser Family Foundation. It’s an open question whether that will still be the case in 2018.

Despite the recent show of bipartisanship, some Republicans in Congress have vowed to resist any attempt to rescue the law. President Trump has, likewise, repeatedly threatened to cut off the cost-sharing subsidies to insurance companies—which alone would send premiums up 20%, according to an August CBO report, and increase the deficit by $194 billion over 10 years.

Indeed, that’s already happening in sporadic cases—and may accelerate soon. In early August, Anthem announced it was cutting back sharply on its participation in Obamacare exchanges in several states, lamenting that “planning and pricing for ACA-compliant health plans has become increasingly difficult due to a shrinking and deteriorating individual market.”

Other major insurers have made similar statements to explain double-digit premium increases. The takeaway? What seems like costly uncertainty now could get a lot more chaotic before the year is out.


Obamacare, by the numbers

10.3 million: The number of Americans as of mid-March who were enrolled in and paying for an Obamacare exchange plan, instead of procuring insurance through an employer or separate federal program.

49%: The highest requested premium increase across 21 major cities for a benchmark ACA exchange “Silver” plan in 2018. Many others had double-digit hikes. At least one insurer, though, did lower its premium by 5%.

23%: The average additional level of premium increase requested by Idaho’s PacificSource Health Plans (on top of a regularly planned 23% hike), due to threats to cut off insurer payments.

7 million: Americans who, in 2017, qualified for the cost-sharing subsidies currently under siege. The subsidies, paid to insurance companies, vastly lower patient deductibles and out-of-pocket costs.


A version of this article appears in the Sept. 1, 2017 issue of Fortune with the headline “Obamacare’s Thousand Cuts.”

About the Author
By Sy Mukherjee
See full bioRight Arrow Button Icon
Add Fortune on Google for similar content.

Latest in Health

Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025

Most Popular

Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Fortune Secondary Logo
Rankings
  • 100 Best Companies
  • Fortune 500
  • Global 500
  • Fortune 500 Europe
  • Most Powerful Women
  • World's Most Admired Companies
  • See All Rankings
  • Lists Calendar
Sections
  • Finance
  • Fortune Crypto
  • Features
  • Leadership
  • Health
  • Commentary
  • Success
  • Retail
  • Mpw
  • Tech
  • Lifestyle
  • CEO Initiative
  • Asia
  • Politics
  • Conferences
  • Europe
  • Newsletters
  • Personal Finance
  • Environment
  • Magazine
  • Education
Customer Support
  • Frequently Asked Questions
  • Customer Service Portal
  • Privacy Policy
  • Terms Of Use
  • Single Issues For Purchase
  • International Print
Commercial Services
  • Advertising
  • Fortune Brand Studio
  • Fortune Analytics
  • Fortune Conferences
  • Business Development
  • Group Subscriptions
About Us
  • About Us
  • Press Center
  • Work At Fortune
  • Terms And Conditions
  • Site Map
  • About Us
  • Press Center
  • Work At Fortune
  • Terms And Conditions
  • Site Map
  • Facebook icon
  • Twitter icon
  • LinkedIn icon
  • Instagram icon
  • Pinterest icon

Latest in Health

Three women chop their way into the record books at Lumberjack World Championships
North AmericaWisconsin
Three women chop their way into the record books at Lumberjack World Championships
By The Associated Press and Ellen SchmidtJuly 20, 2026
13 hours ago
Ferran Torres
SuccessWorld Cup
Spain’s Ferran Torres scored the winning goal in the World Cup—but just four years ago, he was in therapy and stuck in a ‘bottomless pit’
By Emma BurleighJuly 20, 2026
19 hours ago
FDA walks back positive lab test while lettuce recall continues
HealthFood and drink
FDA walks back positive lab test while lettuce recall continues
By Bloomberg, Kristina Peterson, Jessica Nix and Daniela SirtoriJuly 20, 2026
20 hours ago
Pharmacy technician Brandy Leroy fills a TPN bag using the ExactaMix Pro Automated Compounding System
Startups & VentureTerm Sheet
The FDA’s peptide vote could create telehealth’s next multibillion-dollar market
By Lily Mae LazarusJuly 20, 2026
23 hours ago
A decade after the ‘Godfather of AI’ said radiologists were obsolete, their salaries are up to $571K and demand is growing fast
AIthe future of work
A decade after the ‘Godfather of AI’ said radiologists were obsolete, their salaries are up to $571K and demand is growing fast
By Marco Quiroz-GutierrezJuly 19, 2026
2 days ago
How United’s ‘premiumization’ strategy got passengers to swallow higher airfares without a fight
HealthAirline industry
How United’s ‘premiumization’ strategy got passengers to swallow higher airfares without a fight
By Phil WahbaJuly 19, 2026
2 days ago

Most Popular

Mark Cuban says he has the solution to growing income inequality, and it's to reward every employee—from CEO to janitor—with company stock
Success
Mark Cuban says he has the solution to growing income inequality, and it's to reward every employee—from CEO to janitor—with company stock
By Sasha RogelbergJuly 20, 2026
17 hours ago
‘I want to die broke’: Billionaire philanthropist Denny Sanford dies after giving away $4 billion
Success
‘I want to die broke’: Billionaire philanthropist Denny Sanford dies after giving away $4 billion
By Sydney LakeJuly 20, 2026
21 hours ago
'Dr. Doom' Nouriel Roubini says we're headed for universal basic income or 'some form of socialism' as AI revolutionizes work—He calls that optimistic
AI
'Dr. Doom' Nouriel Roubini says we're headed for universal basic income or 'some form of socialism' as AI revolutionizes work—He calls that optimistic
By Jason MaJuly 18, 2026
2 days ago
Warren Buffett says his $147 billion investing career was an accident: ‘I may be one of the 10 luckiest in the world’
Future of Work
Warren Buffett says his $147 billion investing career was an accident: ‘I may be one of the 10 luckiest in the world’
By Sarah GlodekJuly 20, 2026
1 day ago
Current price of silver as of Monday, July 20, 2026
Personal Finance
Current price of silver as of Monday, July 20, 2026
By Joseph HostetlerJuly 20, 2026
1 day ago
It’s not just Taco Bell lettuce and possible glass in Pillsbury rolls: Food and drink recall events reached a 6-year year-over-year high
Retail
It’s not just Taco Bell lettuce and possible glass in Pillsbury rolls: Food and drink recall events reached a 6-year year-over-year high
By Sasha RogelbergJuly 20, 2026
1 day ago

© 2026 Fortune Media IP Limited. All Rights Reserved. Use of this site constitutes acceptance of our Terms of Use and Privacy Policy | CA Notice at Collection and Privacy Notice | Do Not Sell/Share My Personal Information
FORTUNE is a trademark of Fortune Media IP Limited, registered in the U.S. and other countries. FORTUNE may receive compensation for some links to products and services on this website. Offers may be subject to change without notice.