San Antonio Express-News (Sunday)
Affordable Care Act offers midterm peril for GOP, Dems
The Republican Party built two midterm wave elections around its opposition to the Affordable Care Act.
In 2010, the GOP ran against a newly enacted ACA (aka Obamacare) and gained 63 House and six Senate seats.
In 2014, a year after website glitches slowed the rollout for the ACA insurance exchanges, Republicans ran against it again, albeit to a lesser extent, and picked up 13 House and nine Senate seats.
A year ago, it looked like Democrats were primed to score some karmic retribution.
GOP leaders found themselves blessed/ cursed with complete control of the federal government and had to deliver on a long-standing promise to repeal and replace the ACA. This repeal effort led to the kind of popular backlash that Democrats had experienced when they passed the law in 2010.
In U.S. District 23, a sprawling piece of political turf that runs from South San Antonio to El Paso County, a progressive Indivisible group held a “die-in” at Republican Congressman Will Hurd’s field office in May 2017 to protest a GOP repeal-and-replace bill.
A month later, as the U.S. Senate prepared to vote on an ultimately unsuccessful repeal bill, public support for the ACA topped 50 percent for the first time in seven years of polling by the Kaiser Family Foundation.
Last December, howev- er, the politics surrounding the ACA became more complicated. The passage of a massive Republican tax cut removed the Affordable Care Act’s individual mandate. (More precisely, it took away the ACA’s tax penalty, levied against those who fail to sign up for health insurance.)
That item in the tax bill destabilized the ACA exchanges — which always depended on inducing young, healthy people to sign up for coverage — and is expected to drive up premiums.
It also boxed in Democrats by practically forcing them to defend the individual mandate, always the ACA’s least popular provision.
Reinstating the mandate almost surely will mean that more people get covered at a lower cost to the federal government. But coming out in favor of the mandate means your opponent can accuse you of favoring a tax hike.
It’s a political challenge facing two Democrats hoping to flip congressional districts that include parts of San Antonio.
Joseph Kopser, the Iraq War veteran and Austin tech entrepreneur running in the perpetually red District 21, expressed his support Friday for a full reinstatement of the individual mandate.
“Without it, Texans will likely be forced to pay more in insurance premiums,” Kopser said in a statement provided to the San Antonio ExpressNews. “This (GOP repeal) is not real reform — it is simply a political stunt, without any consideration of the impact it has on real Texas families.”
Gina Ortiz Jones, a former Air Force intelligence officer trying to unseat Hurd in District
23, supports a sweeping Medicare for All approach that moves beyond the ACA’s multipronged path to universal coverage.
In a Friday statement, Jones sidestepped any specific mention of the individual mandate, while making it clear that she disapproves of the way congressional Republicans and President Donald Trump have tried to sabotage the ACA.
Jones also cited a recent twist in the ACA saga, a Thursday court filing by the Department of Justice declaring that it will not defend key provisions of the health-care law — including protections for people with preexisting medical conditions — against a federal lawsuit led by Texas Attorney General Ken Paxton.
The DOJ filing contends that an individual mandate without a tax to enforce it is unconstitutional and the same goes for the preexisting-conditions guarantee.
Protection for preexisting conditions always has been the most popular piece of the ACA. The Trump administration’s willingness to abandon it could give Democrats a brand new talking point in the ACA debate.
“This Republican Congress, and this administration, have set out from Day 1 to sabotage our health-care system — which is why Texas families are seeing their rates skyrocket,” Jones said. “And just this week we’re seeing a new Republican effort to put an end to protections for preexisting conditions.
“As someone who came home to Texas to care for my mom when she got cancer, I know how important affordable health care is to Texas families, and I’ll get to work immediately to fix our system.”
All this commotion serves as a reminder that Americans are resistant to change when it comes to health care. Voters resisted the ACA’s passage. Then they resisted efforts to repeal it. They might also prove resistant to fixing it.