The Republicans’ effort to dismantle Obamacare fell apart. But that doesn’t mean the Affordable Care Act is safe.

Over the past couple weeks, a Republican effort spearheaded by Paul Ryan attempted to push through the American Health Care Act, which was designed to strip away many of conservatives’ least favorite aspects of Obamacare, while changing the rules to benefit the wealthy and kick the poor and sick off of their insurance, especially if that insurance is subsidized (or outright paid for) by taxpayers.

Trump, who doesn’t understand the issues surrounding healthcare and doesn’t consider it a signature issue, told Republicans they had to hold a vote this past Friday, or give up on the issue for the time being. Paul Ryan was forced to admit he did not have the votes from his own party to pass the AHCA. Democrats did a victory lap and the GOP was, to put it mildly, embarrassed. No one came out of this looking good, except for Trump’s opposition.

There may be the urge to rest easy and consider Obamacare safe, though, and that would be a bad idea. Trump still controls the regulatory apparatus of the federal government, which is how much of the ACA is implemented and administered. He can have it turned into a morass of nonsensical rules, defang the requirements on insurers, and deal other blows to the law’s efficacy. In addition, the ACA is constantly under attack via lawsuits that are always working their way through the legal system. Since the federal government is the defendant in these cases, and the Justice Department is generally called upon to serve up a defense, Trump could simply elect not to do so–and let the law be further weakened by making it easier to obtain judgments against it.

The good news is that the Affordable Care Act remains intact for the time being. There will be no “repeal and replace.” The bad news is that administrative, regulatory, and judicial efforts against it will continue, and those may receive less notice from the general public. I’ll do my best to keep you updated of such developments as they occur, though. Keep fighting!

Photo by David Lacasse