Can you afford to get sick?
Democrats stopped insurers from denying coverage for pre-existing conditions, capped Medicare insulin at $35, and let Medicare negotiate drug prices. Republicans tried to repeal the health law and voted against the drug-price reforms.
01 / Democrats
Democrats passed the Affordable Care Act, which bars insurers from denying you coverage or charging you more because of a pre-existing condition.
H.R. 3590 - Affordable Care Act 2024 Democratic Party Platform
Key number
$35
hard monthly cap on insulin for everyone on Medicare, down from whatever the manufacturer charged
The Inflation Reduction Act capped insulin at $35 a month for people on Medicare and put an annual ceiling on Medicare out-of-pocket drug costs.
H.R. 5376 - Inflation Reduction Act of 2022 CMS - Inflation Reduction Act and Medicare
That same law gave Medicare the power to negotiate prices directly with drug manufacturers for the first time in its history.
H.R. 5376 - Inflation Reduction Act of 2022 CMS - Inflation Reduction Act and Medicare
Democrats extended enhanced ACA marketplace subsidies through 2025. They expired before 2026 when Congress did not renew them, leaving many buyers with less help paying premiums.
H.R. 5376 - Inflation Reduction Act of 2022 CBO - enhanced marketplace credit expiration and extension estimates
02 / Republicans
The 2024 Republican platform pledges more affordable care through price transparency and more plan choice. It does not name a replacement for the Affordable Care Act.
In 2017, holding the House, Senate and White House, Republicans moved to repeal the ACA. The House passed a repeal bill; the Senate version failed by a single vote.
Not one Republican in either chamber voted for the Inflation Reduction Act - including the insulin cap and Medicare drug negotiation.
CBO projection / 2034
10
M
more people uninsured
3 out of 4
7.5M
lose Medicaid or CHIP coverage
The 2025 reconciliation law cut roughly $990 billion from Medicaid and CHIP over ten years - the largest cut in the program's history - through work-reporting requirements and more frequent eligibility redeterminations. Every Democrat in Congress voted against it.
H.R. 1 (119th Congress), enacted July 2025 CBO - cost estimate for H.R. 1 (119th Congress), July 2025
The single largest driver is the work-reporting requirement, which CBO expects to strip Medicaid from 5.3 million people who are eligible on the merits but fail the paperwork.
CBO - coverage estimates for the 2025 reconciliation law, August 2025 KFF - how the 2025 reconciliation law affects the uninsured rate by state
The receipts
Dark is yea, grey is nay. Each card names who drove the action and how the other party responded. Every one links to the official record.
Aug 16, 2022 · H.R. 5376
Democratic-backedCapped Medicare insulin at $35, capped annual out-of-pocket drug costs, and let Medicare negotiate prices on its highest-spending drugs.
Democrats passed it. No Republican in either chamber voted yes.
Final vote
Vice President broke the tie.
Signed into law. No Republican in either chamber voted yes.
Read the record ↗Jul 28, 2017 · H.R. 1628
Republican-backedRepeal of the Affordable Care Act, passed by the House and taken up by the Senate.
Republicans drove the ACA repeal effort. It passed their House and failed by one vote in the Senate.
Final vote
Passed, May 4, 2017.
Failed, July 28, 2017.
Failed in the Senate by one vote. Pre-existing condition protections survived.
Read the record ↗Jul 3, 2025 · H.R. 1 (119th)
Republican-backedExtended the 2017 individual tax cuts and cut about $990 billion from Medicaid and CHIP, adding work-reporting requirements and more frequent eligibility redeterminations.
Republicans passed it on near party-line votes in both chambers.
Final vote
Vice President broke the tie.
Signed into law on near party-line votes. CBO projects 10 million more people uninsured by 2034.
Read the record ↗