Opponents of the Affordable Care Act have all but given up on repealing the law and have instead focused on impeding implementation. Some states will allow the federal government to operate their insurance exchanges.
Likely incoming Senate Majority Leader Mitch McConnell, R-Ky., has said he will repeal the Affordable Care Act in its entirety. In addition to winning the Senate, Republicans also expanded their majority in the House in the midterm elections, setting the stage for ongoing ACA repeal efforts. However, full repeal of the ACA will be difficult, as Senate Republicans do not have a filibuster- or veto-proof majority.
Opponents of the Affordable Care Act have shifted from trying to repeal the law in its entirety to repealing parts of the law, overseeing implementation tightly and preparing to act in anticipation of the law's ultimate failure, according to interviews with Republicans in the House and Senate.
The city of San Francisco is moving toward covering gender reassignment surgery for residents who do not have insurance. For now, though, the city does not have the ability to provide procedures such as genital reconstruction at its public hospital and clinics, according to a city health official.
The GOP victories in Congress may give the party a chance to stop or at least water down President Barack Obama's agenda on health care. While experts say a repeal is unlikely, Republicans may try to eliminate funding for some health care reform provisions. Newly elected GOP governors in states across the country also may seek to slow the pace of implementation.