Medicaid repeal

Democrats take aim at GOP's Medicaid repeal 

Party strategists see an opportunity to ding Republicans in tight races for voting to drop thousands from insurance rolls. 

By Burgess Everett

Putting an Obamacare repeal on the president’s desk would mark a major psychological — if not an actual — victory for Republicans. But it also could come with electoral repercussions that Democrats believe could boost their efforts to recapture the Senate in 2016.

This week, Senate Majority Mitch McConnell (R-Ky.) is poised to clinch the elusive 51 votes he needs to pass a repeal after devising a bill to appease a small group of conservative Republican senators. But the new version also would gut an expansion of Medicaid that’s put millions of Americans from low-income households on the insurance rolls.

And it just so happens that some of the most vulnerable Republicans up for reelection next year are from states that have expanded Medicaid and extended health care benefits to thousands of their constituents.

Democrats see a campaign ad that writes itself: Sen. X voted just last year to take away health insurance from tens of thousands of constituents.

“In the states that have [expanded Medicaid], to take it away could cause chaos. So to let ideology overcome practicality is not very good for those senators,” said Sen. Chuck Schumer (D-N.Y.). It “could be a good issue for us.”

Still, Republicans are undeterred. Passing the repeal fulfills a years-long promise from GOP leaders. And now the party can make the case to 2016 voters that the final obstacle to killing the health care law is electing a Republican president who would actually sign a repeal into law.

But Democrats think the GOP has miscalculated. Sen. Jon Tester of Montana, the chairman of Democrats’ campaign arm said “it is an issue any time you talk about access to health care and cost-shifting, which is what we’re talking about … It’s a mistake [for the Republicans], and once again it’s because of the Affordable Care Act.”

And they’re planning to focus their fire on specific, local races where they think a candidate could be vulnerable after voting to repeal Obamacare, gut the Medicaid expansion and defund Planned Parenthood. Sen. Ron Johnson (R-Wis.), for example, is not from a state that expanded Medicaid and has embraced an Obamacare repeal so tightly that voters are well aware of his position.

But there are many other targets. Democrats said that Republican Sens. Kelly Ayotte of New Hampshire, Pat Toomey of Pennsylvania and Rob Portman of Ohio are among the most vulnerable on the issue, but there are 20 GOP senators representing states that have expanded Medicaid, and half of those senators are up for reelection. And GOP House members like Marlin Stutzman of Indiana and Joe Heck of Nevada who are vying to fill open Senate seats could also face attack ads if they were to vote to approve the package when it comes back to the House.

Sadie Weiner, a spokeswoman for the Democratic Senatorial Campaign Committee said Republicans are ignoring other priorities and “spending their time on a bill that would defund Planned Parenthood and take away health care for low-income people across the country. Next November, voters will remember.”

But Sen. Roger Wicker (R-Miss.), chairman of the Senate Republicans’ campaign arm, said the bill’s two-year transition would ensure people aren’t immediately tossed off Medicaid rolls, calling the Obamacare repeal “good politics.” And Republicans are brushing off the Democratic strategy as a retread of failed efforts in 2014 to portray the GOP on the wrong side of voters on Obamacare.

“How many election defeats will it take for Democrats to learn that Obamacare is unpopular and hurting families?” said Andrea Bozek, a spokeswoman for the National Republican Senatorial Committee.

But some senators up for reelection in 2016 are balking at the conservative tilt of the bill. Sen. Mark Kirk (R-Ill.) has voted against defunding Planned Parenthood and though he has questioned Medicaid expansion in his state, he’s widely expected to vote no, aides in both parties said. He has not made an official decision on how he will vote this week, a spokeswoman said.

In New Hampshire, Democratic Gov. Maggie Hassan is leading the charge to keep the state’s more than 40,000 Medicaid enrollees on the health insurance rolls long-term. Hassan is also running against Ayotte next year, who will support leadership and vote for the repeal bill, her office said Wednesday morning.

Through a spokeswoman, Ayotte touted "increased funding for substance abuse treatment and mental health" as well as the two-year Medicaid transition period that gives "states flexibility to address coverage for the uninsured, increase patient choice, and reduce health care costs."

Sen. Jeanne Shaheen (D-N.H.), a former governor, said Ayotte risks major political blowback by supporting McConnell.

“We’ve got 45,000 people now who have access to health care because of Medicaid expansion,” Shaheen said. “Those who vote against Medicaid expansion … do it at the peril of it becoming an issue in the campaign. Because I can tell you, if I were running, I’d make it an issue.”

Portman faces an even tougher dilemma in Ohio. He’s a close ally of leadership, cuts a moderate profile and is from a state where GOP presidential candidate Gov. John Kasich has helped shepherd more than 600,000 people onto health insurance with a Medicaid expansion. Despite the tough position he’s in, Portman will vote for the repeal plan, an aide said.

Sen. John Boozman (R-Ark.) has drawn a strong general election challenger in Conner Eldridge but said he has no qualms about voting to eventually cast off tens of thousands of Arkansans Medicaid rolls, citing the transition period and constituent sentiment on the campaign trail: “It’ll be an issue in the sense that the people of Arkansas very much oppose Obamacare.”

Indeed, save for the rare breed of centrist Republicans like Kirk and Ayotte, many of the senators who are up for reelection in 2016 ran in 2010 as anti-Obamacare candidates. They aren’t going to walk away from Obamacare repeal now simply because Democrats are “champing at the bit to hit them,” as one top Democratic party strategist put it.

The decision by Toomey to strongly support the Obamacare repeal, Medicaid provisions and all, is drawing jeers from his Democratic opponents like Katie McGinty, who says that he’s “promoting his rigid ideology even when it comes at the expense of families that he is supposed to represent.” Former Rep. Joe Sestak, a Democrat, who’s also running to replace Toomey, likewise panned the move: “Shame on Pat Toomey for trying to repeal health care that protects 5.4 million Pennsylvanians.”

Several Republican strategists said that Democrats have miscalculated in previous years by relying on public opinion to shift on the health care law. Five years later, polls still show opposition outweighs support.

“Every one of us has voted to repeal Obamacare. So what Obamacare has done every election cycle is voters have been reminded of how much they hate Obamacare,” Toomey said. “This is a demonstration that we’re going to carry through on our promise.”