Health care becomes dominant issue in Senate race between McSally, Kelly

Health care, the topic that helped define the 2018 midterm elections and has been an undercurrent in every federal contest since the 2010 passage of the Affordable Care Act, again is dominating Arizona’s U.S. Senate race.

The coronavirus pandemic that has already killed more than 3,000 Arizonans and sickened 150,000 more, along with a related recession that has put millions out of work, has given new urgency to the issue.

Arizona’s leading Senate contenders are talking about health care in a new way, largely through a barrage of TV ads that seek to cast them as the trusted leader on the issue.

Before the pandemic halted traditional, in-person campaigning, incumbent Sen. Martha McSally, R-Ariz., and Democratic candidate Mark Kelly, seemed poised for a fierce contest over their contrasting visions of health care in America, prescription drugs prices and insurance coverage for those with preexisting medical conditions.

Now, for many voters, the issue is largely viewed through the lens of the pandemic.

“People are fearful about their coverage, in terms of how much it’s going

to cost to get a test or get treated,” said Melinda Napoli, 51, a longtime Republican from Mesa who recently reregistered as an independent voter. “And one of the interesting curve balls here is that a lot of people have been laid off, so now they’re asking what their insurance options are. The pandemic has highlighted the whole health care situation.”

As a way to relate to voters on the issue, Kelly, a retired NASA astronaut, talks directly to the camera in his latest TV ad.

“Nothing can prepare you for a health care crisis,” he says, offering an unspoken reference to the 2011 attempted assassination of his wife, former Rep. Gabrielle Giffords, D-Ariz. Giffords recovered from the shot to her head but it left her facing big medical bills and years of physical therapy, which she will need the rest of her life.

On virtual town halls and on Democratic organizing calls, sometimes with his wife by his side, Kelly says he understands the need for urgent care, protection for those with preexisting conditions, and the hardship of soaring medical bills. He says he will work across party lines to lower the cost of prescription drugs, whose costs he ties to the pharmaceutical industry’s influence on lawmakers.

An engineer, Kelly says in campaign remarks that he would advocate for health care policies rooted in science, data, and facts — not partisan loyalty.

He supports a public health care option that would compete with private insurers but opposes “Medicare for All,” a key platform of the Democratic Party’s more progressive wing.

Coverage for preexisting conditions remains a central theme for both campaigns, with McSally having to defend her voting record and Kelly seeking to remind voters about her past votes to undo the Affordable Care Act.

“I think most individuals now recognize that they have protection from losing their health insurance if they had a preexisting condition, and that there are some members of Congress, including my opponent, has voted multiple times to take that away,” Kelly said during a recent interview with The Arizona Republic.

For McSally, navigating the issue is trickier, largely because of her voting record.

In her own TV ads, she calls Kelly’s attacks on her health care position “shameful” and pledges to lower prescription drug prices and to “always protect those with preexisting conditions — always.”

In other TV spots, McSally has turned to others who have serious health problems but who vouch for her commitment to preserving coverage. One came from her former campaign and congressional staffer.

After her narrow 2018 Senate campaign loss to Sen. Kyrsten Sinema, DAriz., which owed in part to the importance of health care as an issue, McSally is trying to fend off lingering concerns that she would support eliminating coverage for preexisting conditions.

Some voters’ wariness toward her on health care is tied to her slew of votes over the years as a member of the House of Representatives to repeal or change the 2010 health care law implemented by former President Barack Obama and Democrats.

As McSally has worked to try to cast herself as a guardian of those with preexisting medical conditions, national fact-checkers have noted she is misleading voters on where she stood on the most significant health care legislation.

In the House, McSally voted for Republican legislation that allowed insurers to charge people with preexisting medical conditions higher premiums, which the ACA prohibited. Health care experts have said that GOP bill, which did not pass, would have undermined coverage for some and made insurance unaffordable.

Ten years after the ACA’s passage, national polling shows the public trusts Democrats on health care more than Republicans.

The public option touted generally by Kelly is popular with Arizonans, according to data from the Democracy Fund + UCLA Nationscape project.

Their surveys have found 58% of Arizonans, including 54% of independents, favor providing an option to purchase government-run insurance to all Americans. The surveys have a margin of error of plus or minus 4 percentage points.

President Donald Trump’s aggressive efforts to undo the ACA at the Supreme Court amid the pandemic further could further complicate McSally’s position.

Some 20 million Americans could lose their health coverage and protections for those with preexisting health conditions is at stake in the case, which won’t be heard before the fall.

In a written statement about how health care is figuring in the race, McSally tethered her Democratic opponent to former Vice President Joe Biden, Trump’s Democratic rival. She accused them of defending the nation’s “broken health care system” and said she is trying to fix it.

“Under the plan they’re defending — and want to expand with even more government control — Arizonans have experienced skyrocketing premiums with no choice and our seniors are having to choose between buying groceries and paying for their prescriptions,” McSally wrote. “That is not protecting people with preexisting conditions.”

After Republicans’ efforts to repeal the health care law, McSally co-sponsored a 2019 GOP bill that sought to ensure coverage for those with preexisting conditions, but the bill did not advance.

More recently, throughout the coronavirus pandemic, McSally has introduced bipartisan legislation that would expand virtual access to health care for those living in rural parts of the nation and on tribal lands and joined colleagues in calling for the permanent access to telehealth services for all Medicare beneficiaries.

She voted for the $3 trillion in federal aid packages intended to help blunt the financial impact of the state-bystate shutdowns. The relief included billions for hospitals, medical gear, and health care providers. McSally has called on Congress to decrease reliance on China for prescription drug ingredients while signing onto legislation intended to lower drug prices.

This week, McSally introduced a bill intended to help those laid off or furloughed because of the pandemic to keep their employer’s health plan through the end of the year.

Kelly has faulted the Trump administration for testing hurdles, slow responses to help the Navajo Nation, and lack of direct aid to local communities.

His broader health care message echoes that of Sinema’s in 2018, where she emphasized at nearly every public appearance the health care law’s protections for those with preexisting conditions.

Democrats’ sweep that year was driven by health care concerns among Democrats and independent voters, said Mark A. Peterson, a UCLA professor of public policy, political science, law.

Heading into the final three months of the 2020 cycle, he said health care is a motivating issue even more so for Democratic candidates — and an even bigger problem for Republicans.

The pandemic has caused people to suddenly need medical care and a way to pay for it, made all the more difficult by a health care system that, outside of Medicare and Medicaid, is built around employer-sponsored insurance. When millions of people are losing their jobs, and therefore their health insurance, the numbers of uninsured will rise dramatically at a time of medical need.

Ironically for Republicans, Peterson noted, the ACA is providing an escape valve for many.

An additional element that adds worry, he said, is whether contracting COVID-19 could be treated as a preexisting condition if the health care law was struck down.

“You put all that together, and frankly the Republicans and Sen. McSally are facing a profound shift in realities,” Peterson said.

After losing her 2018 race for the state’s other Senate seat, Gov. Doug Ducey appointed McSally to the seat once held by the late Sen. John McCain, R-Ariz.

Kelly joined the race in early 2019 and with his biography as a retired NASA astronaut, Giffords’ husband, and a gun control activist, he built a fundraising advantage that McSally has not overcome.

As the COVID-19 crisis has worsened in Arizona and across the nation, polling on the race has put McSally in the danger zone. The nonpartisan Cook Political Report, which analyzes Senate races across the country, just moved the Arizona race from tossup to lean Democratic.

Those types of ratings don’t sway the opinions of voters like Helene Gross, 77, a “die-hard Republican” from Scottsdale. She’s secure with her Medicare plan, has supplemental insurance coverage and a steady income.

Health care isn’t a driving force for her this year — Gross said she’s more concerned about the civil rights protests in cities across the nation and clashes with law enforcement.

Gross intends to vote for McSally and other Republicans.

Asked how she views the administration’s handling of the pandemic, she said: “They’re doing the best they can with an unknown situation. Nobody’s a professional at this, and as far as I can tell, they’re doing an OK job.”

For Democratic voters such as Clarence Winston, a 69-year-old retired forklift operator from Buckeye, the issue of health care shot to the top of his list as this election’s top issue.

It took a three-day stay at the hospital for high blood pressure as the state was posting record numbers of COVID-19 hospitalizations and deaths.

He said he trusts Democrats over Republicans to navigate the state through the crisis.

“I’m baffled by their lack of confidence in the science,” Winston said of some Republicans. “Science is the only way out of this situation.”