Med­ic­aid, pro­tec­tions for pre-ex­ist­ing con­di­tions pop­u­lar

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di­tions – even af­ter long try­ing to re­peal those pro­tec­tions.

Th­ese safe­guards, once iso­lated to a hand­ful of states, were en­acted na­tion­wide for the first time through the health care law and guar­an­teed by fi­nan­cial as­sis­tance to help lowand mod­er­ate-in­come con­sumers buy health cov­er­age.

Now Pres­i­dent Trump and other GOP lead­ers, many still smart­ing from their failed push to re­peal the law last year, no longer even make a pre­tense of of­fer­ing an al­ter­na­tive to the cur­rent law.

“The Amer­i­can peo­ple have given us di­vided gov­ern­ment,” Se­nate Ma­jor­ity Leader Mitch McCon­nell, R-Ky., said Wed­nes­day, ac­knowl­edg­ing that re­peal is no longer an op­tion. “I think the mes­sage is: ‘Fig­ure out what you can do to­gether, and do it.’ ”

To be sure, an­tipa­thy to the health care law re­mains high among many con­ser­va­tives.

The two po­lit­i­cal par­ties still hold starkly di­ver­gent views of where to take Amer­i­can health care, with many Democrats eye­ing ways to open up the gov­ern­ment Medi­care or Med­ic­aid pro­grams to more peo­ple, and Repub­li­cans look­ing for ways to scale back gov­ern­ment reg­u­la­tion of health care, as the Trump ad­min­is­tra­tion has al­ready started to do.

Repub­li­can lead­ers also con­tinue to har­bor dreams of dra­mat­i­cally scal­ing back fed­eral spend­ing on Med­ic­aid and Medi­care.

Trump’s own 2019 bud­get en­vi­sions hun­dreds of bil­lions of dol­lars in cuts to Med­ic­aid.

GOP gov­er­nors and state at­tor­neys gen­eral, mean­while, con­tinue to push a law­suit, backed by the Trump ad­min­is­tra­tion, to wipe out the health care law and its pre-ex­ist­ing con­di­tion pro­tec­tions na­tion­wide. The case is cur­rently be­fore a fed­eral judge in Texas.

Such re­trench­ments have long been at odds with pub­lic opin­ion.

Even when the health care law it­self could barely get the sup­port of four in 10 Amer­i­cans, polling by the non­profit Kaiser Fam­ily Foun­da­tion showed that as many as 75 per­cent of Amer­i­cans liked its key com­po­nents, such as ex­pand­ing Med­ic­aid and pro­hibit­ing in­sur­ers from turn­ing away sick con­sumers.

Med­ic­aid, in par­tic­u­lar, has proven re­mark­ably pop­u­lar, even among Repub­li­cans.

But un­til this week’s elec­tions, it was un­clear what price Repub­li­can politi­cians would pay if they tried to take th­ese pro­tec­tions away. The ver­dict was dev­as­tat­ing. Vot­ers on Tues­day pun­ished GOP law­mak­ers like New Jersey Rep. Tom MacArthur, a lead ar­chi­tect of the House Repub­li­can plan in 2017 to roll back re­quire­ments that health plans of­fer com­pre­hen­sive cov­er­age to peo­ple with pre-ex­ist­ing con­di­tions.

MacArthur was among more than two dozen House Repub­li­cans who lost their seats Tues­day.

In Texas, Repub­li­can Sen. Ted Cruz, an­other lead­ing pro­po­nent of scal­ing back pro­tec­tions for pre-ex­ist­ing con­di­tions, man­aged to hold on to his seat against a spir­ited chal­lenge from Demo­cratic Rep. Beto O’Rourke.

But Cruz pre­vailed by slightly more than 200,000 votes, whereas the Repub­li­can gu­ber­na­to­rial can­di­date in Texas beat his Demo­cratic op­po­nent by more than 1.1 mil­lion votes.

“Sen. McCon­nell has said out loud what many Repub­li­cans have been think­ing,” said Jen­nifer Young, a vet­eran GOP lob­by­ist and se­nior of­fi­cial at the De­part­ment of Health and Hu­man Ser­vices un­der Pres­i­dent Ge­orge W. Bush. “Many Repub­li­cans are more than ready to shift their at­ten­tion to other health care pri­or­i­ties.”

Else­where, Repub­li­can politi­cians such as Ne­braska Gov. Pete Rick­etts sim­ply tried to get out of the way of pop­u­lar pushes to ex­pand Med­ic­aid cov­er­age.

Rick­etts, who once railed against the Af­ford­able Care Act and re­sisted ex­pand­ing Med­ic­aid cov­er­age in Ne­braska, never took a po­si­tion on this year’s Med­ic­aid bal­lot mea­sure. It passed 53 per­cent to 47 per­cent.

In Idaho and Utah, Med­ic­aid mea­sures won 61 per­cent and 54 per­cent of the vote, re­spec­tively.

Idaho’s mea­sure got an 11th-hour boost when the out­go­ing Repub­li­can Gov. Butch Ot­ter en­dorsed it, not­ing: “We can­not con­tinue to let hard­work­ing Ida­hoans go with­out health care.”

With Demo­cratic gu­ber­na­to­rial vic­to­ries in Kansas and Wis­con­sin on Tues­day, it is now pos­si­ble that as many as five more states could soon be ex­pand­ing Med­ic­aid cov­er­age through the Af­ford­able Care Act.

That would leave only a dozen hold­outs, mostly clus­tered in the Deep South.

Whether those states will em­brace uni­ver­sal cov­er­age for their res­i­dents is un­clear. But the tide of pub­lic opin­ion is mov­ing away from those who con­tinue to re­sist it.

Exit polls Tues­day showed that nearly six in 10 vot­ers said it should be the re­spon­si­bil­ity of the fed­eral gov­ern­ment to make sure all Amer­i­cans have health care cov­er­age, a core prin­ci­ple of the law Obama signed eight years ago.

The exit polling tracks with other sur­veys that have shown the share of Amer­i­cans back­ing such a role for the fed­eral gov­ern­ment has in­creased steadily over the last decade.

“Repub­li­cans are go­ing to find that they op­pose cov­er­age at their own po­lit­i­cal peril,” warned Brad Wood­house, ex­ec­u­tive di­rec­tor of Pro­tect Our Care, a lib­eral ad­vo­cacy group formed last year to fight GOP ef­forts to roll back the health care law.

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