WASHINGTON — In one online ad, Democratic House candidate Angie Craig of Minnesota blasts GOP Rep. Jason Lewis for voting “to dramatically increase the cost of insurance and kick millions off health care.”
Rep. Jacky Rosen, a Democratic Senate candidate from Nevada, in another ad, highlights Sen. Dean Heller’s pledge to oppose a Republican attempt to repeal the Affordable Care Act, before ultimately backing the effort under pressure from President Trump.
And Democratic House candidate Antonio Delgado of New York has an ad that points to GOP Rep. John Faso’s vote for repealing the ACA, known as Obamacare, after promising a woman with a brain tumor on video that he would not take away her health care.
Friday marks the year anniversary of House Republicans’ vote to repeal and replace the Affordable Care Act. It was the first vote of a months-long effort from congressional Republicans to get rid of the law. It ultimately failed in the Senate, but it left many Republicans on record voting to remove millions of Americans from the rolls of the insured — and Democrats are hammering them for it.
After years of playing defense on health care, Democratic candidates have made it a top issue this election cycle. They are pledging to fix the flaws in Obamacare while targeting Republican attempts to “sabotage” it and take coverage away. And grassroots organizations that protested Republican efforts are keeping up the pressure with events planned around the anniversary.
“This is going to be a continuing conversation throughout the election,” said Sen. Chris Van Hollen, of Maryland, chairman of the Democratic Senatorial Campaign Committee. “I’m seeing this as an issue in every state.”
Rep. Ben Ray Lujan, of New Mexico, chairman of the Democratic Congressional Campaign Committee, told reporters recently, “Republicans are going to have one heck of a time having to explain themselves.”
Last spring, Democrats warned the repeal vote would have negative political consequences for the GOP. Grassroots groups staged rallies and protests across the country, in support of preserving Obamcare. When the House vote closed on May 4, 2017 — it passed by a single vote — some Democrats began chanting "Na na na na, hey hey, hey, goodbye!"
Democrats know what it’s like to be on the losing side of this issue. During the run-up to the 2010 elections, constituents’ rage — partly over health care — drove many Democrats to skip in-person town hall meetings. The party lost 63 House seats and majority control in what President Obama described as a “shellacking.” Republicans spent years promising to repeal the law.
Now, views on the topic have shifted. Because of Obamacare, roughly 20 million people who were previously uninsured got access to health care. At the height of the repeal debate in the Senate last summer, 60% of Americans said the federal government is responsible for ensuring health care coverage for all Americans, the highest number in nearly a decade, according to a Pew Research poll.
“It isn’t that people fell in love with the ACA — with the exchanges and mandates and controlled benefits and everything — they didn’t,” said Robert J. Blendon, a professor of health policy and political analysis at Harvard University. “They just couldn’t imagine taking some coverage away from those people."
Had the Republican repeal effort passed both chambers, it would have unraveled many of the law’s popular consumer protections and overhauled the insurance market. A report from the Congressional Budget Office said that the House-passed bill would lead to 23 million fewer people having health insurance, although the CBO estimated other drafts of the bill went as high as 24 million.
"The Democrats don’t have to run on how well the ACA works … all they have to say is we’re not going to let them take the 24 million people off,” Blendon said.
Recent polls show voters trust Democrats more than Republicans on health care.
“I can’t think of a campaign, from the reddest of districts to the bluest of districts, that isn’t talking about health care repeal and what the administration’s sabotage would mean to the health care system,” said Jesse Ferguson, a Democratic strategist now working on health care policy who worked at the DCCC in 2010.
Democrats' strategy is to acknowledge flaws with Obamacare. Rather than repealing it, many are campaigning on the need to repair it by lowering drug costs and premiums and continuing to expand health care coverage.
“I’m acknowledging that things need to be fixed,” said Craig, who is running in Minnesota’s 2nd Congressional District. “(Republicans) didn’t get it done with control of the House, the Senate and the White House.”
In New Jersey, Democratic House candidate Mikie Sherrill is campaigning for an open seat now held by a Republican. She said she hasn’t found anyone in her district who disagrees with the goal of providing quality and affordable health care for everyone.
“I say that in the progressive parts of the district, the red parts of the district, and I never hear anyone say, ‘No we don’t,’” she said.
In North Dakota, Sen. Heidi Heitkamp is campaigning for re-election against GOP Rep. Kevin Cramer in a state Trump won by 36 points. Cramer is proud of his vote to repeal Obamacare. Still, Heitkamp said she’ll defend her vote to oppose the “horrible” repeal and replace legislation “any day.”
“Many, many of the changes that were recommended by the Republicans would have dramatically affected both affordability and accessibility” of health care in North Dakota, Heitkamp said.
Republicans may have failed to fully dismantle the law but they have taken other steps to try and blunt it. They used tax reform legislation — which did pass — to strike Obamacare’s “individual mandate,” requiring that everyone buy insurance or face a tax penalty. On Tuesday, Trump's former Health and Human Services Secretary Tom Price said that decision would drive up costs.
And Trump halted subsidies to insurers that helped bring down out-of-pocket costs for consumers. Congress so far has been unable to reach a compromise to reinstate the subsidies and block premiums from rising in the fall.
Conservatives worry health care could dampen their 2018 prospects, but only because they haven’t gone far enough in repealing it. Republicans will be on “the losing end of the debate unless they take proactive steps to deliver on the campaign promise that’s been years in the making,” said Dan Holler, a vice president of Heritage Action, the political arm of the conservative Heritage Foundation.
“There’s obviously been a fundamental shift in the politics of health care and Democrats in many ways feel emboldened,” Holler said. “They feel emboldened not because Obamacare is working… but Democrats right now are on offense because Republicans haven’t delivered a policy outcome.”
Other Republicans think the party should try to make Democrats look out-of-touch by tying them to a "single-payer," government-run health care system.
In the House, 122 Democrats have signed onto a single-payer bill now led by the Democratic National Committee’s deputy chair, Rep. Keith Ellison of Minnesota. Sen. Bernie Sanders, I-Vt., has 16 Democratic co-sponsors for his version in the Senate.
Support for a single payer system has grown with Democrats, but it is about as popular as “bee stings and damp socks” with Republicans — and it can be used to split the Democratic base, said Matt Gorman, a spokesman for the National Republican Congressional Campaign Committee.
“Democrats favor single-payer, so we’re going to talk about the tax increases and spending that would come with it,” Gorman said.
Moderate Democrats, however, have a different health care message. Rep. Ami Bera, of California, one of two Democrats in Congress who are doctors and a founding member of the bipartisan Problem Solvers Caucus, said he has been advising 25 to 30 candidates about campaigning on health care. He aims to "move the conversation away from single payer" coverage to universal coverage that could include both public and private insurance.
He wants candidates to be thinking about this issue now, so that if Democrats find themselves with majority control of the House or the White House, they’ll have “concrete ideas” on how to get everyone insured.
“We can’t find ourselves in the same situation Republicans did,” he said.