Health Care to Define Elections

Philip Rucker says health care will define coming elections in The Washington Post.

With one hasty and excruciatingly narrow vote, House Republicans have all but guaranteed that health care will be one of the most pivotal issues shaping the next two election cycles — including congressional, gubernatorial and state legislative races in the 2018 midterms and President Trump’s likely reelection bid in 2020.

Just as Democrats were forced to defend Obamacare in the 2010 midterms — the result was a coast-to-coast drubbing that President Barack Obama called a “shellacking” — Republicans this time will be in the hot seat.

GOP members of Congress will be asked to defend their votes for a bill that could strip insurance from 24 million Americans and jack up premiums and deductibles for the country’s sickest and oldest citizens.

Governors, gubernatorial candidates and state legislators, meanwhile, will be asked whether they intend to “opt out” of provisions in the Affordable Care Act that are overwhelmingly popular with voters, as is permitted under the Republican plan. Their plans for state Medicaid programs also will be scrutinized if massive GOP cuts to Medicaid funding are realized.

“Health care will be a defining issue,” said John Del Cecato, a Democratic strategist. “It’s hard to say if it will be the only issue between now and 2018, but I can’t recall a vote this significant in terms of its political potential in 20 years.”

On Friday, the Cook Political Report, which evaluates the political environment in all 435 congressional districts, shifted its assessments in 20 House races in favor of the Democrats — some from solidly Republican to likely Republican, others from likely Republican to leaning Republican, and more still from leaning Republican to toss-up.

Thursday’s vote “guarantees Democrats will have at least one major on-the-record vote to exploit in the next elections,” wrote David Wasserman, the report’s House editor. He added that the new dynamic “is consistent with past scenarios that have generated a midterm wave” and “almost a mirror image of 2010.”

Polling shows that the public disagrees with Republican health-care plans. Thirty-seven percent of Americans support repealing and replacing the law known as Obamacare, while 61 percent want to keep it and try to improve it, according to a Washington Post-ABC News survey in April.

A Quinnipiac University survey in March found that American voters overwhelmingly disapproved of an earlier version of the House health-care plan by 56 percent to 17 percent.

Away from the White House, there was a palpable sense of doom among some GOP campaign operatives, who imagined how easy it would be for Democratic challengers to launch potent attacks about health care. Even many House Republicans who voted for the bill are already distancing themselves from it, arguing that problems would be solved in the Senate.

“What we’ve done here is political malpractice,” said Rick Wilson, a GOP strategist who is sharply critical of Trump. “Democrats will run ads with weeping parents who can’t cover their premiums and Little Johnny dying. . . . Or ‘Congressman Smith voted to end coverage of preexisting conditions. That means 875 people here in X district who have cancer cannot be covered.’”

Wilson added, “Republicans in the House right now should be on their knees praying for the Senate to kill this,” arguing that the line of attack would be less powerful if the bill does not become law.

Jesse Ferguson, a Democratic operative who has advised scores of House candidates, said, “It doesn’t take even a good ad-maker to figure out how to tell the story of the damage that this bill does to people’s health care, whether it’s the AARP saying it charges people over 50 five times more, or the American Cancer Society saying it guts protections for preexisting conditions. There’s no real way to defend that to voters.”