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Democrats attacking Trump, Republicans over health care case

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U.S. Rep. Kendra Horn
U.S. Rep. Kendra Horn

The latest legal challenge to the Affordable Care Act, and the Trump administration’s support for scrapping the law, has galvanized Democrats who see health care as a winning political issue next year.

“Don’t let President Trump fool you,” Senate Democratic leader Chuck Schumer, of New York, said at a news conference at the U.S. Supreme Court last week.

“(Republicans) are not the party of health care. They are the party that wants to end health care.”

In a series of tweets last week, President Donald Trump said Republicans “are developing a really great HealthCare Plan” and that a vote would be taken “right after the Election when Republicans hold the Senate & win back the House.”

Republicans tried that in 2017, when they held both houses of Congress and the White House, and came up just short of repealing parts the Affordable Care Act.

“And we got a bracing lesson in how good an issue that is for Democrats in the 2018 elections,” said U.S. Rep. Tom Cole, R-Moore.

Democrats won the House last year, and health care was a theme common to many races.

Freshman U.S. Rep. Kendra Horn, D-Oklahoma City, said health care was a major issue in her upset win last year over GOP incumbent Steve Russell.

“Aside from education … that was the most common issue that people brought to me, the most common thing that they raised on occasion after occasion,” Horn said, adding that she heard many stories about people with serious illnesses who couldn’t have obtained health insurance without the Affordable Care Act.

Horn said a lawsuit in Texas, which poses an existential threat to the Affordable Care Act, will help keep health care at the forefront of issues.

“Because of this lawsuit, but for so many other reasons, I think health care is going to continue to be a major issue in this next election cycle and probably beyond that,” she said.

Cole said Democrats “clearly plan to run on health care in the 2020 election, both congressionally and presidentially. This (lawsuit) gives them something to talk about. At the end of the day, though, a lot depends on what happens in the court case itself.”

Judge scraps Obamacare

The case is currently before the 5th U.S. Circuit Court of Appeals, based in Texas.

Late last year, a U.S. district judge in Texas ruled that the Affordable Care Act is unconstitutional and that none of the law should remain on the books.

The ruling was seen as a victory for 20 states, led by Texas, that challenged the law.

The states contended that eliminating the tax penalty for not buying health insurance — which was part of the tax reform bill of 2017 — also eliminated the U.S. Supreme Court’s rationale in 2012 for upholding the Individual Mandate as an allowable exercise of Congress' power to tax.

The Texas judge agreed, writing, “Given that the Individual Mandate no longer ‘triggers a tax,’ the Court finds the Individual Mandate now serves as a standalone command that continues to be unconstitutional under the Interstate Commerce Clause.”

Trump said in a tweet, “Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!"

Led by California, a coalition of 16 states and the District of Columbia quickly appealed the decision.

The Trump administration, through the U.S. Justice Department, declined to defend the law, telling the 5th Circuit court in a letter last month, “The Department of Justice has determined that the district court's judgment should be affirmed” and that the administration “is not urging that any portion of the district court's judgment be reversed."

House Democrats condemned that position in a resolution last week that passed 240-186 mostly along partisan lines.

House Speaker Nancy Pelosi, D-Calif., told reporters, “We are fighting the president and saying, ‘This is the law of the land.’ It is the responsibility of the Justice Department to uphold the law of the land, and now he’s reversing that.”

Republican states behind challenge

Dozens of groups have weighed in with the appellate court, with most on the side of protecting the law.

The Oklahoma Hospital Association joined a brief saying the Affordable Care Act “contained landmark provisions that have made a sea change in health care delivery, coordination, and payment. These reforms have modernized the way hospitals and health systems deliver services. The law also invested in the health care workforce, prioritized wellness and prevention, and launched new initiatives to study and compare health care quality.”

All 20 of the states that challenged the law were won by Trump in 2016.

Unlike his predecessor, Scott Pruitt, who helped develop a Republican strategy to dismantle the Affordable Care Act, Oklahoma Attorney General Mike Hunter declined to involve his office in the current challenge.

The law is a policy matter best left to Congress, Hunter said, and his office determined that it “wasn’t appropriate for us to get involved.”

Most of the states defending the law were won by Democrat Hillary Clinton in 2016, though some Republican states are siding with them.

Regardless of which side wins there, the case is expected to wind up before the U.S. Supreme Court, which then would be forced to decide again whether the law survives.

'Health care a Democratic issue'

Republican congressional leaders have ruled out writing health care legislation before next year’s elections, and most have been far less critical in public of a law that used to be political gold for the GOP.

Cole said Republicans, including himself, still oppose the law, but not all of it.

“Republicans have changed in that a number of these ideas, they now accept,” he said.

“We have bent over backwards to prove we’re for (covering people with) pre-existing conditions. … Every Republican now can quote you two or three times they voted for pre-existing conditions.”

In Oklahoma this year, nearly 151,000 people signed up for health insurance through healthcare.gov, the federal exchange, according to the Health and Human Services Department.

Of those, about 139,000 receive tax subsidies or cost-sharing reductions, making the average premium $77 per month.

That enrollment came even though there is no longer a penalty for not having insurance.

Horn said the enrollment “tells me that people understand the value of having coverage for health care. There is a need, because we’re still the second-highest uninsured state in the nation.”

Before the Affordable Care Act, she said, it was “next to impossible” for many people, including the self-employed, to purchase health insurance.

She said Democrats will continue emphasizing that the law requires insurance companies to provide coverage for people with pre-existing conditions, that it eliminates lifetime caps on insurance company payouts and allows people under 26 to stay on their parents’ policies.

They also will focus on lowering the cost of prescription drugs and fine-tuning other parts of the law, she said.

Cole said Republicans likely will try to shift the debate to the proposal by some Democrats for a Medicare-for-all guarantee. That approach will raise concerns among numerous populations about cost and fairness, he said.

Cole acknowledged a Democratic advantage, particularly since the penalty was eliminated for not purchasing insurance.

“Health care is usually a Democratic issue, just like defense is usually a Republican issue,” he said.

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<strong>U.S. Rep. Tom Cole</strong>

U.S. Rep. Tom Cole

<figure><img src="//cdn2.newsok.biz/cache/r960-ceac1c02cad0f844c89e51f83992a2da.jpg" alt="Photo - U.S. Rep. Tom Cole " title=" U.S. Rep. Tom Cole "><figcaption> U.S. Rep. Tom Cole </figcaption></figure><figure><img src="//cdn2.newsok.biz/cache/r960-24a11e67b6ae99363e52363c56feeac6.jpg" alt="Photo - U.S. Rep. Kendra Horn " title=" U.S. Rep. Kendra Horn "><figcaption> U.S. Rep. Kendra Horn </figcaption></figure>
Chris Casteel

Chris Casteel began working for The Oklahoman's Norman bureau in 1982 while a student at the University of Oklahoma. Casteel covered the police beat, federal courts and the state Legislature in Oklahoma City. From 1990 through 2016, he was the... Read more ›

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