55986706 - 21 february 2016: republican presidential candidate donald trump speaks to several thousand supporters at a rally in atlanta, georgia.

The reality of Donald Trump’s election as president has finally started to sink in, and with it comes the realization that things are most certainly going to change. Trump’s administration seems very likely to undo one of the major legacies of his predecessor: Obamacare. The question is, how severe of a gutting will it be?

Obamacare: An Overview

Obamacare (more formally known as the Affordable Care Act) was outgoing president Barack Obama’s effort to expand health care coverage for more uninsured citizens and provide special protection, such as not allowing insurance providers to drop customers based on pre-existing conditions and allowing people to remain on the insurance plan of their parents until their 26th birthday.

Opposition

Since its enactment in 2010, Obamacare has been the target of scrutiny from the GOP. Obama’s re-election in 2012 and the Supreme Court ruling it constitutional helped keep it alive. Had Democratic presidential nominee Hillary Clinton won the election, then Obamacare would’ve stayed, with perhaps some modifications to improve it. However, one of Trump’s most significant talking points on the campaign trail was his plan to repeal Obamacare. So now, both his supporters and dissenters are expecting action to be taken.

It Won’t Change Overnight

Trump is still president-elect, but even when he takes the oath of office in January, don’t expect Obamacare to be gone within the first few minutes. Though Trump will have a Republican majority Congress, many of whom are eager to see Obamacare gone, they would need to have a solid plan for how to replace it, which would require drafting and revising new legislation. Dr. J. Mario Molina, CEO of Molina Healthcare doubts the law would be repealed before 2018. Additionally, there will be midterm elections that year, which could theoretically give control of Congress to the Democratic Party, thereby further complicating things.

It Won’t Change Completely

Campaign promises can be hard to keep, and it already seems like Trump’s insistence on repealing completely Obamacare isn’t likely to happen. Trump has already met with President Obama and in an interview with the Wall Street Journal, he says he’s supportive of keeping two major provisions: the refusal to deny coverage based on pre-existing conditions and allowing people to stay on their parent’s insurance plan.

Medicaid Revisions

The Affordable Care Act expanded Medicare coverage for uninsured citizens, and there is speculation that Trump’s plan could greatly reduce the number of those who receive Medicaid. Through a block grant program, states would receive a fixed amount of federal funding for Medicaid, which critics say could jeopardize the number of people able to receive coverage through Medicaid.

Nobody Is Sure What Will Happen

Trump hasn’t been too specific on his plans for dealing with Obamacare. However, since it has been the law for six years now, any severe actions could have fairly dire consequences for the healthcare and insurance industries, and the 22 million who were able to receive coverage under the Affordable Care Act. If people lose their insurance, then insurance companies would lose a great deal of money, and hospitals and emergency rooms would have to figure out what to do with the onslaught of uninsured patients. The day after Trump’s election, there were over 100,000 new buyers into the Affordable Care Act, indicating that people don’t want to take any chances. To some, it quite literally might seem like a matter of life and death.