REPUBLICANS’ ADS ATTEMPT TO RATIONALIZE ACA VOTES
protections while eliminating other key parts of Obamacare. (He also noted his support for a bill that would have replaced Obamacare’s insurance markets with a block grant program to states that would have allowed them to eliminate pre-existing conditions protection altogether.)
It is true that Heller has advanced more pieces of health legislation in the last Congress than his opponent. He was, after all, part of the Republican majority that controlled the legislative agenda. But neither of the health care bills Heller cites in his ad has become law, and it’s questionable whether their effects would match his claims in the ad. These are the same bills and votes that Rosen has cited as evidence that Heller would pare back health coverage. The reference to Rosen’s ad suggests it has been memorable enough to voters to merit a response.
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The Republican candidate: Josh Hawley, Missouri’s attorney general, is challenging the incumbent, Sen. Claire Mccaskill.
The ad: A tight shot of Hawley talking into the camera is cross-cut with images from a field where his family and children are playing with brightly colored soccer balls. Hawley describes how one of his “two perfect little boys” has a rare disease that would be considered a pre-existing condition. “We know what that’s like,” he says, before saying that he supports “forcing insurance companies” to cover pre-existing illnesses. The boy kicks a ball across the field.
The strategy: Hawley is among a group of Republican officials from 20 states who have brought a lawsuit challenging the constitutionality of the Affordable Care Act. If the suit succeeds, the entire law, including its guarantees of affordable coverage for Americans with prior illnesses, could be eradicated. Mccaskill has been using Hawley’s participation in the suit as a central line of attack in her campaign, and has highlighted her personal experience with breast cancer.
Hawley says he supports protections for those with pre-existing conditions, but it’s not clear whether the policies he supports would provide the same protections that people like his son currently enjoy. If his lawsuit invalidated the entire health care law, it would return the country to a time when people with prior illness sometimes couldn’t buy coverage at all. Republicans could pass a law restoring Obamacare’s consumer protections, but Hawley has not yet explicitly endorsed such a strategy.
In an interview this summer, Hawley said he supported unspecified policies to protect such customers and to allow young adults to remain on their parents’ health plans. “We can do those things apart from the structure of Obamacare,” he said, recommending a less stringent set of regulations on insurance benefits.
Last year’s Republican repeal bills provided some protections for people who remained insured without interruptions in coverage. But they would have permitted insurance companies in some states to avoid covering certain types of medical treatments or to charge higher prices to sicker customers who had let their coverage lapse.
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The Republican candidate: Rep. Dana Rohrabacher is an incumbent congressman from California’s 48th District who has served in the House since 1989. He is being challenged by a lawyer and real estate businessman, Harley Rouda, in a very close race.
The ad: Rohrabacher stands beside his wife, while his daughter, Annika, sits on a swing. Rohrabacher explains why health care is “personal” for his family: “When my daughter Annika was 8 years old, she was afflicted with leukemia. It was devastating for my family, but we got through it.” Photos of Annika in a hospital bed and a wheelchair are replaced with video footage of the Rohrabacher family walking along a beach (Dana Rohrabacher wears a wet suit and carries a surfboard).
“That’s why I’m taking on both parties and fighting for those with pre-existing conditions,” he says, shaking a fist. After Rohrabacher says he endorses the ad, Annika adds: “And so do I.”
The strategy: Rohrabacher really does have a novel strategy to try to protect Americans with pre-existing conditions, one that is at odds with the dominant approaches of both political parties. His proposal, explained in an op-ed this summer, would allow commercial plans to avoid covering pre-existing illnesses, but allow affected patients to get Medicare coverage for those ailments alone. The ad casts Rohrabacher as a creative and nonpartisan lawmaker, with a personal interest in health care, rather than one who follows Republican leaders.
But when it came to more realistic choices for managing the health care system, Rohrabacher also voted for the American Health Care Act last year, a bill that would have upended large parts of Obamacare. The bill would have made large cuts to the Medicaid program, which covers many American children, and weakened protections for patients with prior illnesses in states that pursued waivers of Obamacare’s usual rules. His unusual proposal appears to tie his support for that bill with his commitment to Americans like his daughter. But his commitment is an imperfect match with his legislative record.
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The Republican candidate: Rep. Kevin Cramer of North Dakota is running to unseat Sen. Heidi Heitkamp, a Democrat.
The ad: There are cows. “Come on, Heidi, the word’s out,” the ad’s narrator says, citing news reports fact-checking aspects of Heitkamp’s ads that criticized Cramer’s health care record. “It’s a stampede,” the voice says, as steers trot across the screen, pursued by a cowboy with a lasso. (Side note: Is this a stampede?)
The narrator explains that “Kevin Cramer voted for guaranteed coverage for pre-existing conditions.” Heitkamp’s health care advertisements, the narrator says, “don’t pass the smell test.” Then a steer moos.
The strategy: Like Heller, Cramer is trying to characterize his votes to repeal Obamacare as efforts to preserve protections for pre-existing conditions — and he is responding to Democratic ads highlighting the issue. That claim is a bigger stretch for Cramer than it is for Heller, despite some quibbles with details of Heitkamp’s ads. Cramer voted to support the American Health Care Act, a bill that would have allowed states to weaken protections for Americans with pre-existing conditions. If the bill had become law, North Dakota might have preserved Obamacare’s rules, but that is different from “guaranteed coverage.”
Cramer also recently co-sponsored a nonbinding House resolution that argues that pre-existing condition protection should be in future health overhaul bills. That suggests Cramer is engaged on the issue, but that also is different from a guarantee.