Red-state Dems embrace key Obamacare rule as election draws near

Each of the candidates is seizing on actions by congressional Republicans and the Trump administration to unravel Obamacare. But instead of highlighting the law in general, they are centering on its rules obligating insurers to cover people with pre-existing illnesses, without charging them more than healthier customers.

The protections have consistently polled as one of the most popular parts of Obamacare, even though more comprehensive coverage has contributed to higher premiums for healthier people.

Manchin, Heitkamp, and Donnelly each face difficult re-election campaigns in states that went heavily to Trump during the 2016 elections. The recent ad campaigns underscore a larger shift in the Democratic Party. For years, Republicans vowed to repeal the law as Democrats tried to defend it and tamp down criticism amid a troubled website launch and public outcry over losing plans and doctors.

Now, Democrats charge that Republicans indicated through their Obamacare rollback votes last year that they would take another swing at it again if elected. They also are highlighting a Trump administration lawsuit arguing that the pre-existing rules need to go because they cannot be severed from the individual mandate that requires most people obtain healthcare coverage. The mandate will be zeroed out beginning in 2019 because of the GOP tax law.

In return for Democratic attacks, Republicans are hammering the party for high Obamacare premiums. Jake Wilkins, North Dakota Republican spokesman, said that Obamacare had “saddled North Dakotans with higher costs, worse care, and fewer options,” and Nathan Brand, spokesperson for the senatorial campaign of state Attorney General Patrick Morrisey in West Virginia, slammed Obamacare’s “skyrocketing premiums.”

The Republican candidates are sticking to their promises to repeal Obamacare, even though the party fell short of its goal last year despite controlling all branches of government. They insist that, even with repeal, they believe in keeping protections for people with pre-existing conditions.

They have pointed out, for instance, that their House Obamacare “repeal and replace” bill included a provision to preserving protections for people with pre-existing conditions. Still, the legislation allowed some room for states to waive the option to charge higher premiums for certain enrollees and didn’t require plans to cover the same benefits as they do under Obamacare.

Democrats’ healthcare strategy has shifted over the course of the election season. In May, Democrats said were already prepared to run confidently on their support Obamacare. At the time, however, they planned to highlight rising premiums as evidence that Trump and GOP efforts to “sabotage” the law had loaded costs onto voters.

Then, the Trump administration announced its court challenge in June, and reports also suggested that Obamacare premiums had leveled off in many states. Now, Democrats have refocused their campaign messaging on the pre-existing provisions.

That strategy has manifested itself during recent weeks. Heidi Heitkamp told the Washington Examiner in a recent interview that she is specifically running on protecting Obamacare. When she campaigned for her first term in 2012, voters often asked her about her stance on the law.

“They don’t ask that anymore,” Heitkamp said. “They say: ‘What’s your position on healthcare?’”

This week she ran a campaign ad touting the fact that she would “never” vote to repeal pre-existing conditions protections, and the ad makes no mention of the Affordable Care Act specifically. Her opponent, Rep. Kevin Cramer, had sided with fellow Republicans to repeal portions of the law as a member of the House.

Manchin’s ad, like Heitkamp’s, features a voter with a pre-existing illness. Both senators’ ads drew attention to the number of people who have pre-existing conditions in their states.

“I don’t know how Patrick Morrisey doesn’t understand diabetes, high blood pressure,” said a woman who had a kidney transplant in the ad for Manchin. “It’s wrong for Patrick Morrisey to want to take away coverage from West Virginians like me.”

Morrisey is among the 20 state attorneys general who initially launched the Obamacare lawsuit before the Trump administration mostly sided with them. Manchin, who some Republicans had hoped would side with them to repeal Obamacare, voted to preserve the law.

Donnelly, who did the same, is challenging his opponent, businessman Mike Braun, to explain why he once said he supported the bills to repeal Obamacare, and has vowed to repeal it if elected.

“Every chance I’ve gotten, I’ve voted to protect healthcare,” Donnelly said in one post.

Each of the candidates spent time talking to voters about pre-existing conditions during the 10-day recess in early August, and is likely to continue, helped along by several key events in the coming months.

Oral arguments in the Obamacare case are Sept. 10, roughly two months before the midterm elections. Democrats also have seized on the case to oppose Trump’s Supreme Court pick, Judge Brett Kavanaugh, saying that the case could one day reach the high court. Democrats will have the opportunity to highlight the case during Kavanaugh’s confirmation hearings set to begin Sept. 4.

But looming as potential fodder for both sides is Obamacare’s open enrollment, when voters will learn about what the costs of their premiums will be. The enrollment period is expected to start Nov. 1, soon before the midterm elections. While Democrats are likely to place blame on Republicans, they will counter that the premiums were rising for some time. They also have been noting that a large number of Democrats are looking not only to preserve Obamacare but also to extend government involvement in the healthcare system.

“Obamacare has hurt West Virginians from all walks of life with higher premiums, fewer healthcare options, and one-size-fits-all government-run healthcare,” said Brand from the Morrisey campaign.