The Washington PostDemocracy Dies in Darkness

Republicans’ claim of health-care protection flies in the face of reality

The Washington Post's Paige Winfield Cunningham and Paulina Firozi analyze why candidates are touting protections for preexisting conditions in their campaigns. (Video: JM Rieger/The Washington Post)

President Trump and Republicans repeatedly say that they are protecting Americans with preexisting medical conditions.

It’s a false claim that flies in the face of the reality of the past eight years.

The Trump administration is part of a lawsuit to invalidate the Affordable Care Act’s core protection for people with preexisting conditions such as cancer, diabetes or even a pregnancy.

Many House Republicans have voted more than 70 times to scrap or undermine the 2010 law, which for the first time forced insurers to provide coverage to people who already had medical problems.

But faced with the fact that the protections are wildly popular among voters ahead of Tuesday’s midterm elections, some Republicans have copied Trump’s approach, insisting that they will support what they once opposed with no acknowledgment of their about-face.

“I voted to protect people with preexisting conditions,” Rep. Martha McSally (R-Ariz.), who is running for Senate, said at a recent debate. In fact, McSally voted in May 2017 for a bill that would have weakened the core protection.

Democrats are pummeling Republicans running for House, Senate and governorships over their rhetoric and record on repealing the law. Former president Barack Obama recently accused Republicans of making up the claims that they will ensure coverage for people with preexisting conditions.

“Now that it’s election season, [Republicans] are out there saying, ‘Well, actually we’re going to protect people with preexisting conditions even though we’re going to cut health care,’ ” he said at a rally in Las Vegas, adding: “I can tell you that they have no way of protecting preexisting conditions with anything they propose. They’re just saying it. They’re just making it up.”

Republicans are scrambling to defend their efforts to replace Obamacare, including a claim that people with pre-existing conditions would not face higher prices (Video: Meg Kelly/The Washington Post)

Trump’s vow to protect people with costly medical conditions contradicts his words and actions. On Friday in West Virginia, Trump told rallygoers that his administration was “decimating” Obamacare “strike by strike.”

He had promised repeal of the law on the first day of his presidency, though Congress was incapable of acting that quickly. Months later, when House Republicans were forced to pull a repeal bill or face defeat, Trump told The Washington Post that “the best thing is to let Obamacare explode and then go make a deal with the Democrats and have one unified deal.”

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After the House GOP muscled through a repeal bill in May 2017, Trump celebrated in the White House Rose Garden with Republicans, then weeks later called the measure “mean.”

This summer, Trump’s attorney general, Jeff Sessions, backed an effort by 20 states suing to invalidate the law, arguing in a legal brief that its coverage guarantee is unconstitutional. The basis for the lawsuit from Republican attorneys general is last year’s GOP tax law that eliminated the individual mandate. A federal judge in Texas heard arguments in the case in September but has not issued a ruling.

His administration’s support for the lawsuit has not stopped Trump from trying to convince voters that Republicans will enact their own protections for sick people. “We will always protect Americans with preexisting conditions — always,” Trump said recently at the White House.

Republican candidates in West Virginia, Missouri, Tennessee, Arizona and North Dakota have made similar commitments as they seek higher office, drawing challenges from Democrats.

Last month, Missouri Attorney General Josh Hawley (R) cited his young son’s “hip, bone and joint condition” to argue that he would protect those with preexisting conditions. Hawley is locked in a close race with Sen. Claire McCaskill (D-Mo.) and has said he wants to do away with the Affordable Care Act but find other ways to cover people who are sick.

Hawley, as state attorney general, backed the lawsuit seeking to invalidate the ACA.

“He made a conscious decision to do that knowing there was no backup,” McCaskill said.

West Virginia Attorney General Patrick Morrisey (R), who signed on to the same lawsuit, is encountering similar attacks in his race against Sen. Joe Manchin III (D-W.Va.). “It’s wrong for Patrick Morrisey to want to take away coverage from West Virginians like me,” said a woman in a Manchin campaign ad who said she had a kidney transplant.

To parry the attacks, Morrisey tweeted, “We all agree pre-existing conditions need to be covered.”

Democrats are seeking to turn the tables on Republicans after the GOP used Obamacare for years to shape its message and energize voters. The issue has dominated advertisements in federal races, with the Wesleyan Media Project calling the 2018 vote the “Health Care Election.”

Fact Checker: These Republicans are misleading voters about our Obamacare fact checks

Republicans, especially in the House, have a long history of trying to repeal, dismantle or change the ACA. The party came closest to enacting a replacement plan last year, when the House narrowly approved a bill that would shift power to states to set key insurance rules and substitute tax credits for the law’s subsidies to help people afford coverage.

The final measure would have allowed states to let insurers charge some people with preexisting conditions more for their plans, which is not allowed under the ACA, and provided funds to help defray their health-care costs.

The Congressional Budget Office later estimated that the bill would leave 23 million more people uninsured by 2026, including many with preexisting conditions whose coverage would become prohibitively expensive.

The issue has loomed large as House Republicans run for Senate seats this election. In October, Sen. Heidi Heitkamp (D-N.D.) challenged her opponent, Rep. Kevin Cramer (R-N.D.), on his votes for anti-Obamacare bills during a debate. Cramer had called the law an “unmitigated disaster.”

“You’ve voted five times to repeal the Affordable Care Act,” she said to Cramer. “. . . As we begin the discussion on health care, we have to remember that these patient protections are critical to the life of so many North Dakotans.”

Cramer responded by reading a section of the Republican bill stating that “nothing in this Act shall be construed” as allowing health insurance companies to limit access to coverage for people with preexisting conditions.

In Arizona, McSally has sought to fend off attacks from Rep. Kyrsten Sinema (D) over her health-care votes. Sinema accused McSally during a debate of voting in 2017 to “repeal existing law, [which] would have eliminated the protections for people who live with preexisting conditions in our country today.”

McSally, who told Fox News’s Sean Hannity in October that she’s getting her “a-- kicked” for voting for the GOP bill, called the charge a “flat-out lie” and “classic fear tactics.”

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Sen. Dean Heller (R-Nev.), who is facing a challenge from Rep. Jacky Rosen (D-Nev.), has similarly been put on the defensive.

“I wrote the bill, the repeal and the replacement bill for Republicans, that specifically added preexisting conditions to it, because that’s how I feel about it,” Heller said at a debate.

“I have two children, two grandchildren with preexisting conditions,” he added.

Heller voted last summer for the GOP repeal bill that fell one vote short.

Wisconsin Gov. Scott Walker (R), whose state is helping to lead the anti-ACA lawsuit, said this week that the charge that he wants to eliminate protections for preexisting conditions is the “biggest lie of the campaign.”

Walker has long said he wants to get rid of Obamacare but find another way to cover sick people. But on Thursday, he told reporters that he wants to enact the “same language” from the Affordable Care Act to cover sick people in Wisconsin.

“No matter what happens in the courts or in the Congress, in Wisconsin we’ll codify that, the exact same language that’s in the Affordable Care Act,” Walker said. “We’ll make sure everyone living with a preexisting condition is covered here in the state.”

Democrat Andrew Gillum, who is running against former congressman Ron DeSantis (R-Fla.) for Florida governor, has accused DeSantis of voting “over a dozen times” to repeal the ACA.

“He voted repeatedly to allow insurance companies to deny people with preexisting coverage. . . . That is a fact,” Gillum said.

DeSantis has defended himself by pointing to his vote for the Republican bill. “If for some reason something changes on [the] individual market protections, the court does something, I will happily sign a bill to help folks with preexisting conditions here in the state of Florida,” DeSantis said during a recent debate.