The 2018 Midterms Are All About Health Care
As the impact of Trump's attack on Obamacare becomes clear to voters, Democrats are going all-in on Medicare for All.
“Real change begins with immediately repealing and replacing the disaster known as Obamacare,” Donald Trump said during one of his final campaign rallies of the 2016 race. “We’re going to repeal it. We’re going to have a really great plan that’s going to cost much less and be much better.” While Trump has kept few of his campaign promises, this one is coming half-true—if not necessarily the way Republicans had planned. Congress failed to repeal the Affordable Care Act, but Trump has attacked the law in subtler, nonetheless devastating ways. For many Americans, Obamacare has effectively ceased to exist.
“Across the country, the details vary but the story is the same. The Trump administration has been rolling back sections of the Obama-era health law piece by piece,” The Wall Street Journal reported on Wednesday. “The result is that the country is increasingly returning to a pre-ACA landscape, where the coverage you get, especially for people without employer-provided insurance, is largely determined by where you live.”
As for a “really great plan that’s going to cost much less,” Trump has been less successful. Last month, he rolled out a rule allowing small businesses to band together to provide cheaper health care to employees—without all of Obamacare’s coverage protections. But on Thursday, Politico reported that the National Federation of Independent Business, a business group that has advocated for so-called association health plans for two decades, won’t be creating such a plan because Trump’s rule is unworkable. Other trade groups are reportedly tepid, too.
In short, the health care system in America, after modest improvements under Obama, is becoming a chaotic mess under Trump—and his political opponents are poised to capitalize on it.
For Republicans concerned about their electoral prospects, Obamacare is no longer such a reliable foe. In 2017, roughly 350,000 Virginians faced the prospect of losing their ACA plans when Optima Health followed the examples of Aetna and Anthem and threatened to pull out of the exchange market. The move would have left nearly half of all Virginia counties without an ACA insurer, with the losses concentrated in Virginia’s western counties—among the poorest in the state. At the time, insurance companies cited market instability for their decisions, and they blamed the Trump administration for causing it. Trump has repeatedly threatened to cut subsidies for the ACA, and insurers worried that would put their profit margins at risk.
Whether or not Republicans succeed there, they have handed Democrats an opening ahead of the midterms, one that may crack even wider as the material consequences of gutting the ACA become clear. That awakening is already underway, if polling is any indication. Health care topped all issues, even the economy and immigration, in a YouGov/Huffington Post survey in April of registered voters’ priorities ahead of the midterm elections; it consistently ranks in the top three. That’s perhaps less surprising in light of a Navigator Research poll this week that found half of Americans say health care is main cost concern. In an ominous sign for the GOP, independent voters said they trusted Democrats more than Republicans, by an 18-point margin, to bring those costs down.
https://newrepublic.com/article/150074/2018-midterms-health-care