The deal Pence struck offers some idea of how Republicans might pursue health-care policy if Trump wins in the fall. While accepting a basic premise of Obama's reform, Pence also insisted on a number of conservative modifications for Indiana.
In most states, beneficiaries of Medicaid do not pay premiums or other out-of-pocket expenses. Pence, however, oversaw the creation of a byzantine system that, while expanding access to Medicaid for Indiana residents living in or near poverty, also required them to share more of the cost....
No one is fully exempt from making the contributions. Even those with no income whatsoever must find a way to save a nominal $1 each month to receive the plan's full benefits.
These provisions limited the costs of Indiana's Medicaid program by forcing participants to pay more. Yet the federal government is paying for the expansion anyway and states with more conventional expansions of Medicaid are saving money.
Whatever the motivations, Pence, like Republicans in Congress, found a way to justify their qualified support for some of the ideas in the Affordable Care Act by making conservative modifications.
If Trump and Pence win in November, Republicans' approach to health care could be similar. Making changes while preserving the basic structure of Obamacare could allow them to claim they had fulfill their promise to repeal the act.If this does occur, healthcare in the United States will remain heavily regulated and very socialist leaning,