Numerous Republicans who are supporting attempts to dismantle Obamacare are simultaneously campaigning for election on their support for a core provision of the law.
The GOP spent the eight years since the Affordable Care Act 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.
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 Senator Claire McCaskill and Indiana Senator 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."
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.