Republican lawmakers and candidates across the country are suddenly telling voters they’ll protect preexisting conditions rules, brushing aside the fact that many voted to repeal the Affordable Care Act dozens of times and that GOP leaders pledge to resume that fight in 2019.
The shift reflects the growing popularity of Obamacare and Democrats’ success in using the issue to make a compelling closing argument in the midterm races.
A handful of Republican lawmakers and candidates, including Costa Mesa Rep. Dana Rohrabacher and Missouri Senate hopeful Josh Hawley, have filmed ads about their children’s medical conditions — the kinds of health problems that without Obamacare’s protections would make insurance coverage unaffordable. Others have made promises in videos and debates.
Rohrabacher filmed an ad with his daughter, who was diagnosed with leukemia at age 8.
“For her and all our families, we must protect America’s healthcare system,” he said. “That’s why I’m taking on both parties and fighting for those with preexisting conditions.”
“Earlier this year we learned our oldest has a rare chronic disease, a preexisting condition,” Hawley said in his own ad. “We know what that’s like. … I support forcing insurance companies to cover all preexisting conditions.”
Rohrabacher voted to repeal Obamacare — along with its protections for preexisting conditions — dozens of times, including as recently as 2017.
Hawley is one of several GOP state attorneys general leading a lawsuit to invalidate the Affordable Care Act, including preexisting conditions rules. The Trump administration supports the suit, arguing that the preexisting condition provision in particular should be eliminated. It was the White House’s decision in that suit that gave Democrats greater leverage to push the issue of healthcare on the campaign trail this year.
Despite that, President Trump on Thursday tried to give the GOP additional cover on the issue. “All Republicans support people with preexisting conditions, and if they don’t, they will after I speak to them. I am in total support,” he tweeted.
Even Sen. Ted Cruz (R-Texas), who led a government shutdown battle over Obamacare in 2013, said in a debate this week that he wants to repeal the law, but protect preexisting conditions.
In fact, it’s hard to find any Republican who isn’t promising to keep the preexisting conditions requirement, which has become one of the most popular parts of the Affordable Care Act. The rush of ads and promises underscores how quickly the politics of healthcare have changed for the GOP, a party that has made opposition to Obamacare a key part of its election strategy every year since 2010.
The ads are aimed at independents and the voting bloc expected to be pivotal in House races around the country: college-educated, white women in suburban districts, said GOP strategist Matt Mackowiak of the Potomac Strategy Group. “Democrats have been on the attack on preexisting conditions for months. I think it’s fair to say Republicans have not forged a consensus on how to respond, legislatively or politically.”
Polls show that women are more likely than men to be concerned about healthcare. And generally, Democrats and independents count healthcare as their most important issue in this election cycle, according to a recent poll by the nonpartisan Kaiser Family Foundation. Republicans say they’re driven by the economy, jobs and immigration, followed by healthcare and gun policy.
Preserving protections for people with preexisting conditions is voters’ top concern among healthcare issues, according to another Kaiser poll of voters in two battleground states: Florida and Nevada. Nearly 70% of voters in both states said they’re more likely to cast their ballot for a candidate who wants to preserve the ACA’s rule than not.
Those kind of polls have forced Republicans to try to reassure voters that they won’t eliminate preexisting conditions protections, even if they keep control of Congress. ACA supporters say that pledge is unlikely to ring true to anyone who followed the GOP’s high-profile but unsuccessful attempt to repeal the law in 2017.
“The problem for Republicans is that their well-known, multiyear opposition to the healthcare law, that includes protections for people with preexisting conditions, is baked in the cake,” said Brad Woodhouse, president of Protect Our Care, an advocacy group in support of the law. “No undecided voter is going to believe now, all of a sudden, that Republicans have a newfound propensity for protecting peoples’ healthcare.”
Senate Majority Leader Mitch McConnell (R-Ky.) reinforced that idea this week when he said that if Republicans keep the majority in the Senate, they may try to repeal the law again.
“If we had the votes to completely start over, we’d do it,” McConnell told Reuters. “But that depends on what happens in a couple weeks. ... We’re not satisfied with the way Obamacare is working.”
The 2010 law prohibits insurance companies from denying coverage to people with preexisting conditions or charging them more than other people. Republicans argue that they can protect people with pricey health conditions through other policy means, such as charging people additional fees if they go without insurance coverage when they are healthy. Policy experts are skeptical that such an idea would do enough to incentivize people to maintain insurance coverage.
“Democrats have done a masterful job of saying if you’re not for the ACA’s version [of preexisting conditions rules], you’re against everything,” said Rodney Whitlock, a vice president of health policy at ML Strategies and a GOP health policy expert.
The preexisting condition issue has come up in elections up and down the ballot and across the country.
Wisconsin Gov. Scott Walker, a Republican whose state is among those suing over Obamacare, has also leaned on his family’s experience to explain why he cares about the issue.
“I will always cover preexisting conditions, period,” he said in a tweet. “My wife is Type 1 diabetic. My mother is a cancer survivor. My brother has a heart condition. Covering preexisting conditions is personal to me. And it’s the right thing to do.”
In nearby Indiana, the GOP Senate candidate, Mike Braun, doesn’t have a record of voting for Obamacare repeal legislation, but is still trying to blunt any GOP liability on the issue.
“Mike Braun knows you should never go broke because you get sick,” the Indiana Republican’s latest video says, adding that he “fought” the insurance companies covering his small business.