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Obama on Obamacare: Vox interviews the president on January 6

We’ve been covering the Affordable Care Act since Congress began debating it, back in 2009. We’ve covered its drafting, its passage, its Supreme Court challenges, its implementation — and now with the election of Donald Trump, we may be on the cusp of covering its repeal and possible replacement.

Next Friday, we will sit down with President Barack Obama to discuss this crucial part his legacy — one that Republicans are dead-set on dismantling. We’ll be conducting the interview in front of an audience that we’ve partly selected from our Facebook community for Obamacare enrollees, which we launched last month and has grown to over 1,000 members. And we’ll be streaming it live here on Vox and on Facebook.

Obamacare is a cornerstone of President Obama’s legacy. That’s all about to change.

Twenty million Americans have gained health insurance under the Affordable Care Act. The uninsured rate in the United States is at an all-time low, and fewer people are skipping doctor visits to save money.

Chart showing the continued decline of the uninsured rate for early 2016
Vox / Sarah Frostenson

Having coverage has become more common than wearing a seatbelt — but that all might be about to change.

President-elect Trump and congressional Republicans have promised to repeal the Affordable Care Act and replace it with something much better.

Economists, however, are skeptical that Republican plans will cover as many people as Obamacare currently does. Estimates predict that the plans the GOP has offered so far will lead to anywhere from 3 to 21 million Americans losing health coverage, depending on which plan Republicans pick.

Republicans have attacked Obamacare viciously. Some of the problems they point out are quite real. The Affordable Care Act’s marketplaces have struggled to attract health insurers who want to sell coverage, creating serious questions about the sustainability of a major piece of the law. About half of Obamacare enrollees say that they’re unsatisfied with the high costs of premiums and deductibles.

But there is a philosophical divide in the party between those who really just want repeal, and those who actually believe in some kind of replacement. And many of the GOP’s own constituents want something to protect them in times of health emergencies and financial distress. On a recent visit to a Kentucky town that went overwhelmingly for Trump, I talked to people like Debbie Mills, a 53-year-old Obamacare enrollee who supported Trump — but also didn’t expect him to actually end the program that provides her coverage. “I’m hoping that they don’t, ’cause, I mean, what would they do then?” Mills asked when we spoke.

Will Republicans fix those problems? Or will they make them worse? What should anyone trying to reform or replace the law know about what the administration found trying to implement it? That’s what we want to talk to the president about: the lessons he has learned from six years of implementing the biggest health coverage expansion in decades, his thoughts on its political vulnerability now, and the challenges Republicans may confront as they embark on a similar task.

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