Health care battle playing out in Senate race
WASHINGTON — If health care wasn’t already at the front of voters’ minds after six months of a pandemic, the vacancy on the Supreme Court may well put it there heading into November — with the high court slated, aweek after the election, to take up a Texas-led lawsuit that aims to end the Affordable Care Act.
Republicans, led by President Donald Trump, are again promising to protect those with preexisting conditions who have benefited from the ACA’s most popular measures, should the legal challenge they’re backing succeed. On the other side are the Democrats, hammering the same health care theme that helped them take control of the House in 2018.
In Texas, it’s a battle playing out in a Senate race between U.S. Sen. John Cornyn — who was instrumental in the GOP’s failed bid to end the ACA in Congress — and MJHegar, a former Air Force pilot who has remained laser-focused on reminding voters of Cornyn’s role in that effort since she jumped into the race more than a year ago.
At the heart of the fight is polling that shows large majorities of voters, even Republicans, want the protections for preexisting conditions to stay. While Trump on Thursday signed an executive order essentially promising they won’t go anywhere, his administration hasn’t put forth a detailed
plan to preserve them.
Cornyn, meanwhile, is co-sponsoring legislation meant to do that.
“The real bottom line is, everybody agrees that whatever it is — whether it’s the ACA or a substitute or some alternative — it has to cover preexisting conditions. That is a universally held conviction,” Cornyn said in an interview. “The argument that the only way you can do that is through the ACA is just wrong. That’s where the battle has been.”
The GOP legislation would bar insurers from denying coverage to those with preexisting conditions, from charging them higher premiums and from excluding preexisting conditions from coverage.
Experts on health care policy, however, say the Republicanbacked bill has gaps that would allow insurers to once again impose annual or lifetime coverage limits, exclude benefits such as maternity and mental health care, and sell plans without limits on out-ofpocket costs, among other things. They say there are no current GOP proposals that would offer all of the protections and benefits of the ACA, the law also known as Obamacare.
“These are Christmas balls with no Christmas tree,” said Arthur “Tim” Garson, a professor of management, policy and community health at the University of Texas School of Public Health and a former director of the Texas Medical Center Health Policy Institute who supports keeping in place the ACA.
Meanwhile, Republicans are poised to put another conservative justice on the high court — clinching a 6-3 majority. Trump reportedly plans to announce on Saturday that Amy Coney Barrett, a judge on the U.S. Court of Appeals for the 7th Circuit, will be his pick for the seat. Senate GOP leaders have said they’re confident they have the votes to confirm.
With little they can do to stop it, Democrats have sought to frame the Supreme Court fight as an election issue.
“Cornyn has been trying for years to dismantle the ACA, and now he finally may get his chance by rushing through a lifetime appointment in the midst of an election and effectively silencing the voice of the American people,” Hegar said. “Texans see who is really fighting to protect their health care and they know it isn’t Senator Cornyn.”
Texas still leads in uninsured
Affordable health care is an issue with added import in Texas, which leads the nation with its uninsured rate — a problem only worsened by the coronavirus pandemic, which saw an estimated 1.6 million Texans lose job-based health insurance. Nearly 2 million more could lose insurance if the ACA is struck down.
But Hegar has struggled to get her message across to voters, with one recent poll showing some 50 percent of voters don’t know enough about her, and Cornyn has clearly taken note of how Democrats were able to wield health care against Republicans in 2018.
Cornyn has touted legislation he’s pushed to curb drug prices, targeting pharmaceutical companies’ aggressive efforts to protect patents and avoid generic competition, and to ensure people who lose their jobs during the pandemic can keep health insurance at least until the end of 2020.
“We know there are some elements there is consensus on, like reducing prescription drug costs,” Cornyn said.
The Republican senator isn’t alone in working to bolster his health care credentials. Trump’s new executive order declares it the policy of the United States for people with preexisting health conditions to be protected — a mostly symbolic move that comes as his administration also is backing the Texas-led challenge to the ACA, which currently offers those protections.
“We’re making that official,” Trump said during a speech on health care in North Carolina this week. “We’re putting it down in a stamp, because our opponents, the Democrats, like to constantly talk about it.”
Cornyn led anti-ACA charge
In the Texas-led case, the court is slated to hear arguments on Nov. 10. A coalition of Republican-led states argue Trump’s tax overhaul, which Congress approved in 2017, renders the health care plan’s individual mandate unconstitutional because the federal government no longer imposes a tax penalty.
Trump this week also declared victory, whether the Supreme Court strikes down the Affordable Care Act or not.
“Obamacare is no longer Obamacare, as we worked on it and managed it verywell,” Trump said. “What we have now is a much better plan. It is no longer Obamacare because we got rid of the worst part of it — the individual mandate.”
The Supreme Court vacancy stands to alter the Senate race more than just about any other in Texas, as the chamber will decide whether to put Trump’s nominee on the high court.
Hegar’s campaign says she received more than 200,000 donations over the weekend following Justice Ruth Bader Ginsburg’s death. She also stands to gain as outside groups buy ads targeting Cornyn, including Protect Our Care, a Democratic advocacy group focused on defending the ACA.
“No one has been a stauncher advocate against the Affordable Care Act,” said Anne Shoup, a spokeswoman for Protect Our Care. “Really, truly, his record just goes back to the beginning.”
When the GOP tried in 2017 to repeal the ACA, Cornyn served as Republican whip, responsible for rounding up the votes to get it done. Politico deemed him “Obamacare repeal’s top salesman,” a title Hegar has repeated time and again throughout the race.
New push for Better Care Act?
Cornyn then supported the Senate GOP’s replacement plan, the Better Care Act, which Cornyn at the time stressed would “address Obamacare’s ballooning costs for consumers by lowering premiums over time and cutting taxes.”
The Congressional Budget Office estimated it would have saved $321 million over a decade.
But the budget office also said it would have increased the number of uninsured Americans by 22 million. The Urban Institute estimated itwould have grown Texas’ nationleading uninsured rate by more than 21 percent by 2022.
The plan struggled to gain support in the Senate, and Republicans haven’t put out another plan since.
Cornyn said he still supports the Better Care Act, which he said would “help stabilize the insurance markets.”
Cornyn, who gets his own health insurance through the ACA, said he’s seen costs increase: “It’s become increasingly unaffordable, which was supposed to be one of its main selling points.”
But, he said, there isn’t an easy fix.
Hegar backs option
On the campaign trail, Cornyn’s backers say he is “ensuring you can keep your health care.”
A Koch-backed political action committee spending well over $1 million to boost his re-election says health care is central to their pitch in mailers and ads and as they make phone calls and knock on doors in the suburbs.
They say they hear a lot from those voters about wanting to keep the insurance they have.
“Folks are very protective of their private health care insurance if they have it through an employer or if they’ve purchased it themselves,” said Mack Morris, a senior adviser for the PAC, Americans For Prosperity Action. “They also understand the government doesn’t provide the best options.”
Hegar has said repeatedly she wouldn’t favor any plan that strips private insurance plans.
Hegar says she had the best health care when she was in the military andwants that type of government health care to be available to all Americans, arguing that with a Medicare-like option, private insurers will have to “get better to be able to compete.”