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October 10, 2018 at 11:13 AM
Numerous Republicans who are supporting attempts to dismantle the Affordable Care Act are simultaneously campaigning for election on their support for a core provision of the ‘Obamacare’ law.
The GOP spent the eight years since the ACA was passed attempting to derail it in Congress, the White House and the courts. But those efforts have struck a nerve when it comes to a central element of the law: rules protecting insurance coverage for pre-existing conditions.
(Related: Democrats Aim to Turn Obamacare Into Asset From Burden in 2018)
It’s put Republican candidates from conservative states and swing House districts on the defensive, and given an opening for vulnerable Democrats such as Missouri Sen. Claire McCaskill and Indiana Sen. Joe Donnelly to highlight a favorable contrast with their opponents. For McCaskill, Donnelly and other Democrats running in Republican-dominated states, the debate also is a chance to talk about something other than their votes against Supreme Court Justice Brett Kavanaugh, which energized GOP voters.
The issue illustrates the shift in health care politics since Republicans exploited antipathy to the 2010 law to win subsequent elections. This year is different, as numerous polls show health care as the No. 1 issue for voters in the 2018 midterm elections and that protecting those with pre-existing conditions is overwhelmingly popular across party lines.
Third Rail
“It’s remarkable how much the ACA and the efforts to repeal it have made protections for people with pre-existing conditions something of a political third rail,” said Larry Levitt, senior vice president for health reform at the nonpartisan Kaiser Family Foundation. “You’d be hard-pressed to find a candidate running for office right now who says they’re against protections for pre-existing conditions, but whether they support actual polices to make that protection a reality is a different question.”
Democrats running in states or districts where Trump won in 2016 have zeroed in on the issue in their re-election campaigns.
McCaskill, one of the Senate Democrats most at risk on Nov. 6, has put the issue front and center in her campaign against Republican state Attorney General Josh Hawley. Hawley signed on to a lawsuit started by the Texas attorney general that aims to invalidate the Obamacare law.
Missouri Battle
“Josh Hawley decided to use your taxpayer dollars to file a lawsuit that would take away important prescription drug coverage for seniors through Medicare and end all of the consumer protections under the ACA — including protections for Missourians with pre-existing conditions such as asthma, high blood pressure, cancer or diabetes,” she wrote in an August op-ed for the Springfield News-Leader. Since then, she has posted video testimonials from more than two-dozen constituents who depend on the consumer protections.
Hawley last week released an emotional television ad in which he discusses his son’s chronic disease, and promises viewers: “I support forcing insurance companies to cover all pre-existing conditions, and Claire McCaskill knows it.”
Josh Hawley @HawleyMO Wanted to share a little about my family and our journey, and my commitment to protecting people with preexisting conditions — like my son #MOSen
The backdrop for the debate is the unsuccessful attempt by President Donald Trump and a Republican-led Congress to replace the Affordable Care Act with legislation that would’ve weakened the consumer regulations and, experts said, driven up costs for insurance for sick people while lowering them for healthy people.
Texas Lawsuit
After those efforts failed, the Justice Department backed the Texas lawsuit, which seeks to overturn the health care law on constitutional grounds. The Trump administration, meanwhile, has taken regulatory action to expand the use of short-term insurance plans that don’t have to comply with pre-existing condition rules.
Hawley campaign spokeswoman Kelli Ford said he’s supporting the lawsuit because he views the ACA’s requirement that all individuals have health insurance as unconstitutional. She said Hawley “wants Congress to mandate that insurance companies cover everyone with pre-existing conditions” but didn’t say if he supports requiring a set of benefits to be included in policies.
In his own op-ed published last week, Hawley suggested requiring insurers to offer plans at the same prices regardless of whether the consumer has or had an illness, and have the federal government step in to help pay for costs above a threshold.
Shotgun Blast
GOP Senate candidate Patrick Morrisey, West Virginia’s attorney general, has signed onto the Texas lawsuit. Joe Manchin, the only Democrat to vote for Kavanaugh, has made that a centerpiece of his campaign. He’s run a TV ad in which he fires a shotgun at a copy of the lawsuit, saying Morrisey would “take away health care from people with pre-existing conditions; he is just dead wrong.”
Donnelly and Montana’s Jon Tester, another Democrat running in a state where Trump won, are also trying to capitalize on the issue.
