Policy Experts Say Quick Repeal and Replace of ACA Unlikely

The path to repealing the biggest health reform legislation in a generation suddenly became very clear early Wednesday, the day after Donald Trump won a stunning victory and the Republican party retained control of Congress.

With Republican control of the White House, Senate and House of Representatives, President-elect Trump's threats to repeal the Affordable Care Act are now quite real. Despite the GOP control, however, health policy experts have said taking health insurance coverage away from those who just received it will be difficult.

House Speaker Paul Ryan said Wednesday he expected to “hit the ground running” after the inauguration and finally fix the ACA, which he described as “collapsing under its own weight.”

Ryan, who was a reluctant Trump supporter, credited the GOP sweep to the president-elect and noted that Trump is asking Congress to repeal the ACA.

Senate Majority Leader Mitch McConnell also told reporters that repealing the ACA was high on the GOP agenda. "I would be shocked if we didn't move forward and keep our commitment to the American people," he said.

President Barack Obama's signature healthcare reform law—with its success in pushing the U.S. uninsured rate to a record low, requiring individual health insurance coverage and expanding Medicaid in all but 19 states—is now all up in the air. Analysts have estimated that repeal would add $353 billion to the federal deficit and that as many as 20 million people would lose coverage.