Ac­tivists sup­ply key com­po­nent in fight to save Oba­macare

The Washington Post Sunday - - POLITICS & THE NATION - Weigel re­ported from At­lanta. BY MIKE DEBONIS AND DAVID WEIGEL mike.debonis@wash­post.com david.weigel@wash­post.com

Seven years af­ter the pas­sage of the Af­ford­able Care Act, Democrats seem fi­nally to have se­cured a cru­cial el­e­ment for its preser­va­tion: a ro­bust grass-roots move­ment sup­port­ing it.

Pro-ACA pro­test­ers at­tended more than 100 ral­lies held Saturday across the coun­try, or­ga­nized by an ac­tivist group af­fil­i­ated with Sen. Bernie San­ders (I-Vt.). That fol­lowed a con­gres­sional re­cess week dur­ing which GOP law­mak­ers were con­fronted by de­fend­ers of the health-care law in town hall meet­ings across the coun­try. Numer­ous Demo­cratic of­fice­hold­ers also held events tout­ing the law’s suc­cesses.

The surge in ac­tivism comes as con­gres­sional Repub­li­cans pre­pare to take their next steps to­ward re­peal­ing the ACA, also known as Oba­macare, and re­plac­ing it with what they say will be a more free-mar­ket-ori­ented sys­tem that is ex­pected to cost the gov­ern­ment less but cover fewer Amer­i­cans.

The new mo­bi­liza­tion rep­re­sents a stark re­ver­sal of the re­cent po­lit­i­cal dy­nam­ics around health care. Un­til now, con­ser­va­tive ac­tivists have oc­cu­pied the spot­light and re­lent­lessly pushed Repub­li­cans to undo Oba­macare, while Democrats and lib­eral groups largely stayed on the side­lines.

“There is a se­ri­ous grass-roots el­e­ment to this that pre­vi­ously the es­tab­lish­ment Democrats didn’t really tap into,” said Juli­enne Gede Ed­wards, a 28-year-old Mary­land at­tor­ney and colon can­cer sur­vivor, who at­tended a rally in Wash­ing­ton on Saturday and car­ried a sign calling on Repub­li­can law­mak­ers to lay out a health-care plan: “You’ve Had 7 Years — Let’s Hear It!”

In Wash­ing­ton, sev­eral hun­dred pro­test­ers gath­ered Saturday af­ter­noon on Capi­tol Hill, ral­ly­ing in front of a de­serted House of­fice build­ing be­fore march­ing down Penn­syl­va­nia Avenue to the Trump In­ter­na­tional Ho­tel and on to the White House.

The crowd roared when Lance Christopher, a 29-year-old vol­un­teer or­ga­nizer, re­ferred to Pres­i­dent Trump and White House chief strate­gist Stephen K. Ban­non as “fas­cists.”

“If you think you can go to Star­bucks, drink your lat­tes and life will go on as nor­mal . . . you are sadly mis­taken,” Christopher told the crowd. “These peo­ple are here, and they mean busi­ness, and we have to be as equally mo­ti­vated.”

The event was or­ga­nized un­der the ban­ner of Our Rev­o­lu­tion — the grass-roots ac­tivist group that in­her­ited staff and sup­port­ers from San­ders’s in­sur­gent pres­i­den­tial cam­paign.

Had a pro-ACA rally been called sev­eral years ago, “I don’t think many peo­ple would have shown up,” Christopher said in an in­ter­view.

“I think there’s sort of a com­fort­a­bil­ity in the fact that your party oc­cu­pies the White House, or even the Se­nate and House,” he said. And when the tea party move­ment pushed Repub­li­cans to re­peal the law, “We sort of shunned it as a fringe move­ment,” he added.

Now, he said, “We can’t un­der­es­ti­mate any­thing any­more.”

As the pro­test­ers gath­ered out­side the White House, Trump was in­side hav­ing lunch with Wis­con­sin Gov. Scott Walker (R) and Florida Gov. Rick Scott (R), where they dis­cussed “how best to solve the prob­lems of Oba­macare,” ac­cord­ing to a Trump ad­min­is­tra­tion state­ment.

Both Scott and Walker rep­re­sent states that re­fused to co­op­er­ate with the law by ei­ther set­ting up a state-run in­sur­ance ex­change or ac­cept­ing fed­eral as­sis­tance to ex­pand the Med­i­caid pro­gram in their states.

House leg­is­la­tion that will undo key Af­ford­able Care Act pro­vi­sions is ex­pected to be in­tro­duced as soon as Mon­day, ac­cord­ing to con­gres­sional aides. That leg­is­la­tion would ul­ti­mately undo the sys­tem of in­come-based tax sub­si­dies and penal­ties at the cen­ter of the ACA as well as phase out the ex­pan­sion of Med­i­caid, the fed­er­ally funded health-care pro­gram for the poor that now cov­ers 74 mil­lion Amer­i­cans.

In its place, the Repub­li­can plan will prob­a­bly of­fer an age-ad­justed tax credit to help Amer­i­cans pur­chase pri­vate in­sur­ance and boost fund­ing for hos­pi­tals that serve many unin­sured pa­tients.

San­ders, who spent Saturday evening talk­ing to Democrats in Kansas, said that the con­ser­va­tive state was get­ting a hard les­son in sup­ply-side eco­nom­ics. Gov. Sam Brown­back (R), who had signed a se­ries of tax cuts, was among the Repub­li­can gov­er­nors now ask­ing that any re­form of the ACA save the Med­i­caid ex­pan­sion — some­thing Repub­li­cans had sued to get rid of.

“There’ve been mas­sive cut­backs in pro­grams for work­ing fam­i­lies,” San­ders said. “This is what Don­ald Trump is threat­en­ing to do for the whole coun­try — he told work­ing fam­i­lies he wouldn’t cut their So­cial Se­cu­rity or their health care, and we are go­ing to ex­pose him for that hypocrisy.”

Numer­ous GOP aides and law­mak­ers say that the goal of their sys­tem is to en­sure univer­sal ac­cess to in­sur­ance, not univer­sal cov­er­age. But Democrats say that the Repub­li­can plan could po­ten­tially cause mil­lions to lose their cov­er­age, and they have sought to high­light cases of sick Amer­i­cans who might not have been able to ac­cess health care if not for the ACA. A con­sul­tant’s re­port shared at a Na­tional Gov­er­nors As­so­ci­a­tion con­fer­ence this week­end, ob­tained Saturday by Vox, shows that re­cently floated GOP re­place­ment pro­pos­als would in­deed lead to a ma­jor de­cline in the num­ber of in­sured Amer­i­cans.

Some Repub­li­cans have char­ac­ter­ized the protests and the town hall con­fronta­tions as the work of “paid pro­test­ers” and fringe groups, and they say they re­main con­fi­dent that vot­ers want the ACA re­pealed and re­placed. Oth­ers have promised to pre­serve the more pop­u­lar el­e­ments of the law.

Polling con­tin­ues to show an uptick in pub­lic sup­port for the law, but it re­mains deeply di­vi­sive. The most re­cent Kaiser Health Track­ing Poll showed the high­estever level of fa­vor­a­bil­ity to­ward the ACA, 48 per­cent fa­vor­able ver­sus 42 per­cent un­fa­vor­able, although the pub­lic re­mains al­most evenly dead­locked on whether to re­peal the law.

Jane Kleeb, the chair of Ne­braska’s Demo­cratic Party, said that defending the ACA had been a non-starter in her con­ser­va­tive state. In 2012, Repub­li­cans helped scare Demo­cratic Sen. Ben Nel­son into re­tire­ment over his vote for the law. Two years later, they elected Sen. Ben Sasse (R-Neb.), who promised to re­peal it.

“No­body was talk­ing about it — ev­ery­body’s head was in the sand, even pro­gres­sives,” Kleeb said. “We didn’t feel like we got ev­ery­thing we wanted.”

Those doubts, she said, dis­ap­peared when Trump won and Repub­li­cans promised to gut the ACA. “All the farm­ers I work with are self-in­sured,” she said. “They need their in­sur­ance costs to stay down, and they need ru­ral hos­pi­tals to stay open. That only hap­pens if Oba­macare stays in place.”

The re­cent uptick in en­gage­ment ap­pears to be be­cause of peo­ple like Nis­sen Rit­ter, a 57year-old res­i­dent of Chevy Chase, Md., who does not per­son­ally ben­e­fit from ma­jor ACA pro­grams but has family mem­bers who do — and who had not at­tended a po­lit­i­cal rally for years be­fore Trump’s elec­tion.

Rit­ter said she had not felt com­pelled to march for health care be­fore­hand: “I as­sumed that the peo­ple would want that. And so I felt like I didn’t need to say any­thing at the time. But now I’m sorry I didn’t.”

Asked whether she plans to at­tend more protests, she said, “One hun­dred per­cent.”

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