Many of them will find that the safety net is fraying or nonexistent — in large part due to the actions, over a decade, of Republican officials. Some 14 states, all with either Republican governors or GOP-controlled state legislatures, have yet to take advantage of the Affordable Care Act provision expanding Medicaid to low-income adults, though at least two were reconsidering that stance prior to the pandemic.
Obamacare back in the spotlight
At a briefing this week, Trump and Vice President Mike Pence were asked to explain the administration’s “rationale” for not creating a special enrollment period.
“I think it’s one of the greatest answers I’ve ever heard, because Mike was able to speak for five minutes and not even touch your question,” Trump said, applauding Pence’s evasiveness.
Massachusetts Sen. Elizabeth Warren took a different view. In a video posted online Friday, the Democrat warned that the current “health crisis” is quickly creating a concurrent “health insurance crisis.”
“It’s time for the federal government to just step up and say, ‘We’re going to cover everyone who doesn’t have health insurance,” Warren said.
“We are running the bad health care (system) much better than it was ever run and we’re making it better, but it could be much better than it is,” Trump said of Obamacare, though his administration has yet to release a replacement plan. “And so what we want to do is terminate it.”
Democrats who organized to defend the law in 2017, and used the GOP’s attempts to gut the law against it a year later, have already begun to pivot in an effort to connect the issue with the administration’s coronavirus response.
“It’s hard to imagine anything worse during the spread of a virus than taking away health care if people get sick. Republicans have never had a way of justifying their plans that take away health care but now that costs are, sadly, more real,” Jesse Ferguson, a Democratic strategist, told CNN on Friday.
Meanwhile, Protect Our Care, a group founded by a former Obama administration health official, has emerged from that fight as a leading liberal watchdog and rapid response group dedicated to tracking Republican attacks on Obamacare and other public health services. It has rebranded its newsletter as the “Coronavirus War Room.”
A repeat winner for Democrats?
Polling continues to show Democrats, up and down the ballot, with an advantage over Republicans on health care, which is now guaranteed to remain a point of sharp contention, likely at or near the top of voters’ concerns, as the general election approaches this fall.
The intensity of concern over the issue — and its potential to drive up enthusiasm among Democrats later this year — was evident even before the coronavirus effectively paused the primary campaign.
For voters overall, 26% said health care was the most important issue in deciding their vote for president, narrowly beating the economy, at 23%. Concerns over the two are likely to overlap as the death toll from the coronavirus rises alongside jobless numbers.
Meanwhile, the Affordable Care Act hit its highest favorability rating in the nearly 10 years that Kaiser has tracked opinions. Some 55% of the public viewed the law favorably and 37% held unfavorable views, the poll found.
Former Vice President Joe Biden, the likely Democratic presidential nominee, hammered Trump on Thursday over the administration’s Obamacare policies.
“The President must change course and allow open enrollment in the Affordable Care Act, as even Republican governors have called on him to do,” Biden said in a statement. “He should also drop his support for a lawsuit that would undo the ACA, because it would cost almost 20 million Americans their care — the last thing we should pursue during a public health emergency.”
In the absence of federal action to broaden coverage, the initiative has shifted to governors and other local leaders.
Eleven states that run their own Obamacare exchanges, along with the District of Columbia, have launched temporary special enrollment periods so their uninsured residents can obtain coverage outside the usual time frame. And while those who lose their job-based coverage are able to sign up for Obamacare policies, the President’s action would have eliminated some paperwork requirements for those already facing major life changes amid the pandemic.
But Democrats have been divided about how far to push reforms. The party’s left flank, led by Sen. Bernie Sanders, is pushing for “Medicare for All,” a program that would guarantee coverage to every American — a promise, as Sanders’ campaign has reminded voters over the last few weeks, that could have helped slow the initial spread of the coronavirus.
Despite their differing scopes of their ambitions, Democratic leaders are broadly pushing in the same direction: toward expanding coverage through proactive public policy measures.
That same pledge was the key to the party’s sweeping victories in the 2018 midterms.
Nancy Pelosi, who has won and lost her House speakerships amid squalls over Obamacare, pointed to the issue in the aftermath of that election.
“Health care was on the ballot,” she said, “and health care won.”