Health Care Issues Portend Big Democratic Gains in 2018

Colorado is among 17 states with rising uninsured rates for the first time since the Affordable Care Act was fully implemented (Gallup).

As soon as Donald Trump was elected President in November 2016, political pundits across the country began speculating that Democrats could have a big year in 2018 by running against the Big Orange Guy. Trump will certainly be a big motivator for a significant percentage of voters, but for many Democratic candidates, winning in November may come down to a familiar issue: Health care.

As Ronald Brownstein writes for CNN:

But in the district-by-district battle to retake the House, many Democrats are focusing less on condemning Trump’s character than on discrediting the Republican agenda. Central to that mission is arguing that the GOP has benefited the wealthy, and burdened the middle class, with its twin legislative priorities of the past 17 months: passing a large tax cut and attempting to repeal the Affordable Care Act…

…Democrats see reason for optimism in polls from the Kaiser Family Foundation showing that more Americans now view the ACA favorably than unfavorably and significantly more trust Democrats than Republicans to handle health care issues. A wide array of other surveys have found rising health care costs spiking to the top of the public’s list of priorities for Washington.

“This is the first real election that the defense of the ACA has turned into an asset,” says Chris Jennings, a veteran Democratic health care expert. [Pols emphasis]

President Trump has a message for uninsured Americans, and Democrats are pouncing.

If Democrats are able to unseat Rep. Scott Tipton (R-Cortez), recent polling indicates that it could be Tipton’s support for the Republican Tax Plan and rolling back health care that will tip the scales. President Trump’s latest proposal to cut $7 billion from the Children’s Health Insurance Program (CHIP) — whether Congress agrees or not — feeds right into this narrative for Democrats. From New York magazine:

Regardless of the fine details, Trump’s proposal offers Democrats a perfect headline: After digging a $1.5 trillion hole in the deficit with tax cuts for the rich, the president and his party are now demanding reductions in federal spending on health care for poor children. [Pols emphasis]

As a political matter, the plan is indefensible; and yet, Trump is ostensibly putting it forward purely for politics’ sake. The federal deficit is expected to grow from $665 billion last year to $804 billion in 2018; cutting $15 billion off the latter sum isn’t going to make any significant difference in the nation’s fiscal health. And anyhow, the package appears to be dead on arrival in the Senate, where John McCain remains sidelined by terminal brain cancer, and Susan Collins has already signaled opposition to CHIP cuts.

Thus, Trump’s proposal is a symbolic gesture that doesn’t actually advance the conservative movement’s substantive goals — but does undermine its electoral prospects. It’s a move driven by a desire to appease the Republican Party’s far-right flank, a contingent so tightly ensconced in its epistemic bubble it cannot recognize the strategic incoherence of its demands. Sometimes Trump’s fealty to that faction and its worldview leads to diplomatic blunders of historic proportions; other times, it merely results in what is, essentially, an in-kind contribution to the Democratic Party.

It also looks like Democrats will have plenty of tangible figures to frame the GOP’s impact on health care as a net-negative for Americans. According to a new report today from Gallup, the uninsured rate is going in the wrong direction:

The uninsured rate rose by statistically significant margins in 17 states in 2017, the first time since the full implementation of the major mechanisms of the Affordable Care Act (ACA) in 2014 that any state had a rate increase. Also, for the first time since 2013, no states had a lower uninsured rate than the previous year. [Pols emphasis]…

…President Donald Trump’s decision in October 2017 to end cost-sharing reduction payments could also potentially result in the uninsured rate rising further. The cost-sharing payments have been made to insurers in the marketplace exchanges to offset some of their costs for offering lower-cost plans to lower-income Americans.

The Republican tax plan remains about as popular as a poke in the eye, and evidence is mounting that giant tax breaks for rich people did nothing to goose the economy. If Democrats can use the unpopular tax plan as an anchor for messaging on rising health care costs and uninsured rates, they’ll have a powerful pitch for voters above and beyond the general discontent with Trump.

And there’s not much Republicans will be able to do about it.

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  1. JohnInDenverJohnInDenver says:

    Costs of Exchange insurance will be starting to trickle out over the next few months. That will catch people's attention as they consider if they can continue to buy insurance.

    Some parts of the country already have the initial requests going public — with increases of up to 90%.

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