America rose to defend healthcare. But Trump’s attack on the poor is not over | Mary O’Hara

Obamacare will be the law of the land for the “foreseeable future”, the speaker of the US House of Representatives, Paul Ryan, admitted in the aftermath of the abject failure of Donald Trump or the Republican party to “repeal or replace” Obama’s flagship Affordable Care Act (ACA) after seven years of bleating about it. The colossal and humiliating collapse of the proposals was met with jubilation last Friday by millions of people, especially the poorest and disabled, who were in line to lose access to healthcare if the American Health Care Act had been successful.

Watching the events unfold I wondered: what if there had been a similar sudden downfall of the austerity programme in the UK in those early days when the dire warnings of the harm it would unleash were being shouted from the rooftops? How many people would not now be turning to food banks or battling to access social care if austerity had been stopped in its tracks?

The political rollercoaster in the US as the new health bill failed to garner the necessary votes to be passed in the house (partly because rightwing hardliners wanted an even harsher version) was stunning. The debacle came against a backdrop of months of anxiety and fear at what would unfold if it were passed and, the closer the vote deadline got, the more it hit home how much ordinary citizens would suffer. Across the country, individuals and groups rose to oppose it, highlighting the potentially devastating consequences for access to reproductive health services and the disproportionate impact on low-income women and children. Disabled campaigners worked tirelessly to draw attention to the particular injustices they would face if the law passed. Last Wednesday, more than 50 disability rights activists were arrested in Washington DC for protesting against it.

As longtime campaigner Bruce Darling from the disability rights organisation Adapt explained, many people risked being placed in institutions rather than supported in their own homes if proposed cuts of $880bn (£705bn) to Medicaid, the government-funded programme that assists the very poorest and disabled people, went ahead. “Disabled people will die,” Darling told me.

Leading up to the healthcare vote I talked to people who were terrified about the impact of the new act. One of these was Marta Conner, a charity consultant from Virginia whose seven-year-old daughter, Caroline, has Rett syndrome, a neurological condition that severely limits her control over her body and means she needs round-the-clock care, expensive medication and specialist equipment. Conner was like many of those speaking out. She told me she felt “it was important to have our voices heard” because children like Caroline and millions more disabled and seriously ill people could lose a lifeline.

According to independent analysis from the non-partisan Congressional Budget Office, the AHCA would have seen 24 million people lose health cover in the next decade – and sent insurance premiums for older people rocketing. And, just to rub salt in the wounds, it would have meant a doling out of tax breaks to the rich.

Nevertheless, despite the healthcare reprieve, if you are poor or disabled in the US right now, the fight for rights to support and quality care is far from over. For a start, the healthcare debate isn’t going to disappear: health insurance remains prohibitively expensive for many and even with the advances of Obamacare, it is not a universal system.

But there are other reasons why complacency is not an option. The attack on the poorest is coming on multiple fronts. Trump’s “blueprint” budget, which was also published this month, is a source of widespread anxiety. It has been overshadowed somewhat by the healthcare issue, but with clear echoes of cuts in Britain, initiatives that help the most vulnerable could be decimated if Trump gets his way.

In a similarly absurd vein to Tory claims of “compassionate Conservatism” while they slash budgets, preside over soaring levels of child poverty and pummel the NHS, Republicans have had the gall to argue that culling anti-poverty programmes such as after-school nutrition initiatives and Meals on Wheels are acts of compassion towards taxpayers. The question now is, can these radical proposals come crashing down as the healthcare bill did? For the sake of the most vulnerable, let’s hope so.