Johnson is one of five Republican senators openly opposing the Senate version of legislation aimed at replacing the Affordable Care Act (ACA or ‘Obamacare’), with more signalling they will not support it in its current form. Senate Majority Leader Mitch McConnell can only afford to lose two Republican votes. Republicans made repealing and replacing Obamacare a centrepiece of their legislative programme since 2010, but ideological differences between House and Senate Republicans have the potential to derail that effort.
- President Donald Trump will struggle to oust uncooperative Republicans via backing challengers in party primaries.
- Health policy uncertainty will induce insurers to exit public exchanges, even if the bill is delayed indefinitely.
- Successful retrenchment of federal protections would worsen the health outcome disparity between states.