Republicans fear that a federal judge’s decision Friday striking down the Affordable Care Act will put them in a perilous political position and will hand Democrats a powerful line of attack for next Congress and the 2020 elections.
The ruling by U.S. District Judge Reed O’Connor in the Northern District of Texas strikes down the entirety of the Affordable Care Act, also known as Obamacare. The decision throws out a range of healthcare provisions, including rules that insurers must cover people with pre-existing conditions, the extension of the Medicaid program to the poor, and coverage for maternity care, mental health, and substance abuse disorders.
While none of these effects would occur right away, as the case goes through the appeals process, it’s a boon to Democrats who are eager to campaign on healthcare and pre-existing illness protections, just as they did throughout the 2018 campaign. Throughout the cycle, Republicans were hammered in television ads for voting for bills that would have made coverage more expensive or out of reach for people with pre-existing conditions, such as cancer or diabetes.
“Republicans now have to answer a set of questions that they wouldn’t have otherwise had to answer,” said one GOP strategist on the political challenges of the ruling. “The ruling may have single-handedly galvanized Democrats on an issue where they play a lot of offense and put Republicans on defense for who knows how long.”
The decision came as a reaction to Republicans zeroing out, as part of their tax overhaul law, Obamacare’s fine on the uninsured. O’Connor ruled in the case Texas v. Azar that all of the healthcare law should be thrown out because the penalty on the uninsured, known as the “individual mandate,” couldn’t be severed from the rest of the law.
“Even if you accept at face value this absurd decision that came out of Texas, what this does is put a bull’s eye on pre-existing conditions and other patient protections,” said Sen. Ron Wyden, D-Ore. “Now, there is going to be all kinds of debate about this, but that’s what people around their kitchen table are going to be saying as they begin to learn about it.”
Democratic state officials have already vowed to appeal the case. In Congress, Senate Minority Leader Chuck Schumer, D-N.Y., is pressuring the Senate to bring a measure to the floor that would allow lawmakers to intervene. He also signaled that Democrats are prepared to continue using Texas against Republicans politically.
“It puts a lot of our Republicans in a box because they sort of were, you know, two-faced,” Schumer said Sunday on NBC’s “Meet the Press.” “On the one hand, they said they want to preserve pre-existing conditions and preserve healthcare. On the other hand, Donald Trump and a large number of Republicans brought this court suit, so there are going to be a good number of Republicans that are really going to have to make a decision whether to join us in this intervention or face very severe consequences.”
Rep. Frank Pallone, D-N.J., who is set to be the chairman of the Energy and Commerce Committee, told reporters in a phone call Monday that he plans to hold hearings to examine why the Trump administration did not intervene on the case. The suit was originally brought by more than 20 state officials, who asked that the whole law be struck down. The Trump administration sided with GOP officials, but asked that only the rules on pre-existing conditions be tossed, rather than the entire law.
As Democrats prepare to continue to press the issue, Republicans know that they will need better responses than they provided in the 2018 elections. For example, party leaders argue that while they have suitable proposals to protect pre-existing conditions, they lost the war of words over the last month and need to reconfigure their messaging.
“On things we agree on, like access to your parents’ healthcare until you’re 26 and protecting pre-existing conditions, we’re going to do a better job explaining those two really positive things about the current situation that people like and Republicans say they’re for as well,” said Sen. Roy Blunt, R-Mo. “I think we got behind early on, but winning candidates figured out how to work their way through that, and I expect we’ll see a lot more discussion of that early this time.”
The White House has praised the ruling and invited Congress to pass a new healthcare law.
“As always, the Trump Administration stands ready to work with Congress on policy solutions that will deliver more insurance choices, better healthcare, and lower costs while continuing to protect individuals with pre-existing conditions,” the Department of Health and Human Services said in a statement.
Republican senators on Monday for the most part wouldn’t discuss their opinions on the ruling and instead focused the conversation on renewing calls to replace the healthcare law.
“The ruling should put the pressure on Congress to finally address the millions of Americans who have been hurt under Obamacare,” said Sen. Ted Cruz, R-Texas.
