2016 election and the future of the Affordable Care Act: End of the road?

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The outcome of this November's presidential election will lead the future of the Affordable Care Act down one of two distinctly different roads. If Republican Donald Trump wins the day, the “unraveling begins,” notes the Associated Press in a special report. And if Democrat candidate Hillary Clinton prevails, “it gets very difficult for Republicans to keep a straight face about repealing ‘Obamacare.’"

Industry experts tend to agree that a full-scale dismantling of the ACA is unlikely. But the law would undergo significant revisions if Republicans have their way. In June, Republicans released a long-awaited plan to “repeal and replace” the healthcare reform law. Detailed in a document called “A Better Way,” the plan said Obamacare must be fully repealed so the country can “start over and take a new approach.” It weaves together a variety of healthcare policy ideas--and keeps some aspects of the law, including the ban on denying coverage based on preexisting conditions. Trump also unveiled a repeal and replace plan last fall.

Democrats have changes in mind, too. President Barack Obama and Hillary Clinton both support a “public option” plan that would compete alongside private insurers in parts of the country where competition is limited. Clinton has also embraced other progressive healthcare policies in a bid to win over Bernie Sanders supporters who backed the candidate’s idea to create a single-payer healthcare system.

RELATED: Donald Trump, Bernie Sanders, Elizabeth Warren weigh in on Aetna’s ACA move

Millions of Americans would lose their coverage if the ACA is repealed. Repeal could even hurt the healthcare’s industry’s efforts to root out fraud, some say.

Then again, the law has hit some rough waters--most notably as big insurers like Aetna, citing financial losses, pull out of public exchanges. That’s leaving patients in some regions with few choices for coverage--and strengthening arguments for change.  

 
 

The AP story explores these and other issues surrounding what it calls the “final act for Obamacare” in a series of stories it released over the weekend. It features profiles of individuals that represent the broad range of Americans’ experiences with health insurance post-ACA, including:

- A man who got coverage through the ACA … but is still voting for Trump.

- A couple who earn too much to qualify for subsidies … and are bracing for a premium hike next year.

- A cancer patient who couldn’t get coverage before the ACA … and is “terrified” Republicans will repeal the law.

- A young woman who qualified for the ACA provision that allowed her to stay on her parents’ insurance policy … and says it saved her and her family more than $500,000 and provided treatment that saved her life.

- here’s the AP story