Opinion

Health Care and the Nov. Elections

Several months ago in this column I noted that we were starting to see a shift in how politicians on both sides of the aisle were approaching the Affordable Care Act as a political issue in the upcoming midterm elections. Democratic senators and House members in hotly contested races were firming up support for the new health care law while Republicans were becoming more nuanced in their critique of the ACA. There have been a number of noteworthy recent developments which further illustrate the fact that the political dynamic has clearly shifted.

First out of the block is Arkansas Senator Mark Pryor’s recent campaign ad in which he clearly takes ownership of his vote to enact the ACA. It features both Mark Pryor and his father, former senator David Pryor, and tells the story of the younger Pryor’s struggle with cancer and the Pryor family’s fight with their insurance company to cover Mark’s cancer treatment.

David Pryor: When Mark was diagnosed with cancer, we thought we might lose him.

Mark Pryor: My family and my faith helped me through rough times.

David: But you know what? Mark’s insurance company didn’t want to cover the treatment that ultimately saved his life.

Mark: No one should be fighting an insurance company while you’re fighting for your life. That’s why I helped passed a law that prevents insurance companies from canceling your policy if you get sick or denying coverage for pre-existing conditions.

In the ad Senator Pryor did not explicitly use the term, the Affordable Care Act, but he has clearly shifted strategy from his past reluctance to more aggressively defend the law. Other endangered Democratic senators are moving in this direction as well. In a recent interview with the Fairbanks Daily News-Miner Alaska’s Begich praised ACA provisions that prohibit insurers from denying coverage for preexisting conditions and imposing lifetime caps on coverage. He said while the law wasn’t perfect he has been focused on trying to fix it. And Senator Landrieu (LA) told the Washington Post back in April that it was “a solid law that needs improvement.” While Senator Hagan (NC) has as of yet restricted her ACA comments to criticizing her GOP opponent for blocking in the state legislature expansion of Medicaid and opposing contraceptive coverage (which he has since backpedaled on) don’t be surprised if she finds it increasingly comfortable defending the ACA as we move closer to the election. Democrats are increasingly confident that touting the law’s benefits will help boost voter turnout with parts of their base and independents.

But the changing dynamic does not just apply to Democrats. On September 4, House Majority Leader Kevin McCarthy (R-CA) released the GOP leadership’s legislative agenda for the remaining weeks before Congress leaves for the fall elections. What is noteworthy is what is not on the Republican menu. No more floor votes calling for outright repeal of the ACA. The sole health care measure listed was HR 3522 which

would allow insurance companies to continue to market subpar group health insurance plans. It passed the House on September 11, but will not be taken up by the Senate prior to the recess. Clearly the “repeal it” mantra does not have the lustre it once had in the halls of Congress.

A recent blog post by Heidi Przbla of Bloomberg points out that attacks on the law out on the campaign trail also are losing steam. Ads attacking Democrats in Arkansas, Louisiana and North Carolina for their votes in support of the ACA have been cut way back since earlier this year. The public seems to have moved on, much more concerned about issues relating to the economy and national security.

It is still a long way to November and it still may be an uphill climb for Democrats to keep the Senate. But the Affordable Care Act is no longer the powerful weapon it once was against most endangered red state Democrats.

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