Out of the blue, former President Donald Trump has raised the prospect of another election-year fight over the Affordable Care Act in battleground congressional districts such as San Diego’s 49th represented by Democrat Mike Levin.
Other Republicans had shown little appetite for what likely would be another futile, and potentially politically damaging, attempt to overturn what has become known as Obamacare.
The health care program passed in 2010 under President Barack Obama provides coverage for some 40 million people, according to the Department of Health and Human Services, with polls showing increased public support for the program over the years.
In recent days, Trump has called for doing away with the ACA, just as he did as president, and replacing it with some other health plan he has not yet produced.
Among the popular ACA components: insurers cannot refuse coverage for people with pre-existing conditions or charge them more, and must allow coverage for dependents up to age 26.
The potential loss of those provisions — and coverage in general — was highlighted by Democrats six years ago when House Republicans passed a bill to dismantle the ACA and offered a vastly scaled-back alternative that would have left millions of people without coverage. The measure was defeated in the Senate.
That vote was one of several factors that helped Democrats retake control of the House in 2018. That’s when Levin was first elected to Congress, flipping what had long been a reliably Republican district that straddles the San Diego-Orange County line and previously had been trending Democratic.
Levin was among many Democrats who were quick to note that Trump was targeting the ACA again.
“Over the weekend, Donald Trump doubled down on his commitment to destroy the Affordable Care Act,” Levin said Monday on X (formerly Twitter). “Let me be crystal clear, all Americans deserve access to affordable, quality health care. I’ll fight to make sure they have that access.”
As a candidate in 2018, he vowed to protect the ACA from future attacks.
“The bill didn’t pass,” he noted at the time, “but the damage that they’re trying to do to the Affordable Care Act continues.”
President Joe Biden quickly zeroed in on Trump’s renewed pledge to do away with the act, which the former president repeated Wednesday on social media.
Biden, who has been struggling with low approval ratings, revamped his schedule to focus on Trump’s threat. The president’s campaign also scheduled television ads contrasting legislation he got passed to lower prescription drug prices with Trump’s plans to repeal the Affordable Care Act, according to The New York Times.
How this may affect the 49th Congressional District race probably depends on whether Trump continues to push against the ACA. Whichever of the handful of Republicans running in the 49th district emerges from the March primary to take on Levin almost certainly would be pressed to take a position on legislation to repeal it.
The notion that Republicans would make another run at Obamacare, something they have done periodically over the past 13 years, wasn’t even on the campaign radar nationwide. Several news organizations reported the GOP had abandoned its “repeal and replace” strategy after repeated failures.
Earlier this year, House Republicans introduced a package of bills collectively known as the CHOICE Arrangement Act that could reduce some consumer costs partly by rolling back consumer protections, according to National Public Radio.
But the Republican Party is Trump’s party and if he wants to take aim at Obamacare again, GOP leaders may well follow his lead. There’s been little public discussion among Republicans in Congress or candidates about what they’ll do.
Until now, the developing broad campaign themes for Democrats nationally had been focused on infrastructure spending, social program expansion to assist families, and protecting Social Security and Medicare from cuts suggested by Republicans. Warding off further efforts to limit abortion rights and calling attention to Trump’s assault on democracy also are at the top of the Democratic Party’s list.
Locally, Levin has pushed for expanding clean energy, bolstering assistance for veterans and resolving the nuclear waste storage issue at the shuttered San Onofre nuclear power plant.
Republicans have been keying on consumer frustrations with continued high prices — despite improving economic indicators — along with concerns about immigration and crime, even though crime rates remain comparatively low from past years. Divisions among Democrats over the Israeli-Hamas conflict may become a wild card for the GOP in next year’s campaign.
A fight over the Affordable Care Act almost certainly would be an advantage for Democrats. A move to repeal it would seem a dead letter in this Congress, but there’s no guarantee that would be the case if Republicans take full control in Washington.
In 2017, the GOP held the White House, Senate and House and still couldn’t repeal Obamacare, but their efforts to do so helped knock them out of power. After Democrats took control of the House, they gained the Senate and White House in 2020.
A poll published in May of this year by KFF, formerly known as the Kaiser Family Foundation, found that 59 percent of those surveyed had a favorable opinion of the Affordable Care Act — 16 points higher than when Obama left office in January 2017. Not surprisingly, there’s a huge split between Democrats who favor the health program and Republicans who don’t.
Other than just after it was approved, the ACA mostly was in negative public opinion territory until a few months before the Republican-controlled House voted to repeal it in May 2017. Obamacare’s popularity has been on the rise since.
A New York Times story in advance of the 2020 elections had the headline “Health Care Powered Democratic Wins in 2018. The Party Hopes for a Repeat.”
In an analysis of the 2018 midterm elections, the Gallup organization said voters were focused on health care, with 41 percent telling exit pollsters it was the most important issue to their vote — the highest of any issue rated. Immigration was listed by 23 percent and the economy by 21 percent.
A subset of voters may have been key to the election outcome — those who approved of Trump on the economy but disapproved of him on health care.
Gallup called these people “Healthcare Swing Voters.”
