WASHINGTON — A record 24 million people have signed up for insurance coverage through the Affordable Care Act, marking a significant achievement for health care access in the United States. This surge in participation comes as the program faces an uncertain future with a Republican-controlled White House and Congress, potentially influenced by President-elect Donald Trump's longstanding opposition to the policy.

This increase in enrollment is seen as a victory for the Biden administration, which has championed the program's expansion. President Joe Biden has facilitated this growth by signing laws that earmark billions in tax credits, broadening eligibility and reducing costs for millions of Americans, many of whom can now afford monthly premiums of just a few dollars. “The increased enrollment is no coincidence,” Biden stated, highlighting his commitment to making health care more accessible and affordable. He affirmed, “When I took office, I made a promise to the American people that I would bring down the cost of health care and prescription drugs” ([AP News](https://apnews.com/article/obamacare-aca-health-care-coverage-biden-trump-0c73dcde4a19aea65cb83de01f2d5d2e)).

However, Trump's presidency brings potential changes that could alter the landscape of health care coverage. He has previously attempted to dismantle the Affordable Care Act during his first term—efforts that resulted in enrollment declines due to reduced investment in the program. As the tax credits supporting affordable coverage are set to expire at year’s end, pressure mounts on Congress to act. A coalition called “Keep Americans Covered,” which includes powerful health care organizations, is lobbying lawmakers to extend these essential credits.

Despite efforts to rally support, the road ahead appears challenging. Many Republicans remain skeptical of the tax credits, fearing the implications of denying constituents health care benefits while grappling with rising costs. Republican Senator Lisa Murkowski recently voiced the necessity of maintaining these tax credits in light of ongoing health care expenses ([South China Morning Post](https://www.scmp.com/news/world/united-states-canada/article/3293937/obamacare-hits-record-enrolment-uncertain-future-awaits-under-trump-20)). Yet, concerns have been raised among some in the party regarding potential abuses of the system, with calls for investigations into eligibility verification processes.

As Trump continues to argue that the Affordable Care Act is “costly” and provides “lousy” coverage, he still lacks a definitive plan to propose improvements. “We have concepts of a plan that would be better,” he remarked during a recent interview ([South China Morning Post](https://www.scmp.com/news/world/united-states-canada/article/3293937/obamacare-hits-record-enrolment-uncertain-future-awaits-under-trump-20)). As open enrollment on HealthCare.gov approaches its deadline on January 15, the future of Obamacare hangs in a delicate balance.