Dems See Trumpcare Fallout as 2018 Opportunity

Dems See Trumpcare Fallout as 2018 Opportunity
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After playing defense on Obamacare for four consecutive campaign cycles, Democrats are enjoying the fallout over the new Republican plan they are dubbing Trumpcare.

Armed with a Congressional Budget Office estimate that 24 million Americans will lose their medical insurance under the GOP legislation — and with Republican lawmakers at odds with themselves on how to fulfill their pledge to repeal and replace the current law — Democratic Party strategists see it as a winning issue for the 2018 midterm elections.

Democrats are using the CBO analysis to drive a wedge between President Trump and his own supporters, hoping to win back some of the working-class voters they lost in the 2016 elections. Beyond the headlines emanating from reports of higher premium costs in the near term and an increase in the uninsured rate, Democrats are pouncing on the analysis that lower-income and older voters would be hardest hit by the new policy.

"If there was ever a war on seniors, this bill — Trumpcare — is it," said Senate Minority Leader Chuck Schumer. Trump opponents argue that the now-president promised "coverage for everyone" during the campaign and proudly pledged to leave entitlements alone, upending conservative orthodoxy. The Republican bill would phase out the expanded Medicaid subsidies that were a key component of the Affordable Care Act. GOP leaders characterize this move as the beginning of much-needed entitlement reform. Democrats have a less flattering description: "One of the biggest broken promises the president has ever made," said Schumer.

Congressional Democrats are also heartened that none of their own has defected to support Republican efforts to unravel Barack Obama's signature law. Even vulnerable Democrats running in states Trump won haven’t broken ranks. This includes West Virginia Sen. Joe Manchin, who often crosses party lines. Although 67 percent of West Virginians voted for Trump, Manchin told reporters that the GOP plan would hit his state's core constituencies of elderly voters, the poor and the addicted who have benefited from Medicaid’s expansion.

The CBO's analysis estimated that health insurance premiums would go down for younger people under the GOP plan, but would go up for older people. "By 2026 … premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old — but 20 percent to 25 percent higher for a 64-year-old," the report stated.

Even some of Trump’s Capitol Hill allies such as Sen. Tom Cotton, a conservative Arkansas Republican, have questioned the dismissive White House response to the CBO analysis. In an interview with radio show host Hugh Hewitt, Cotton said the CBO projections were "directionally correct."

"We’ve seen what can happen when health care goes wrong, both with the American people and for folks’ political prospects," he added.

Democrats know those perils well. Republicans gained 63 seats in the 2010 midterms after the passage of Obamacare, officially the Patient Protection and Affordable Care Act.

Democrats signed the ACA into law without any Republican support, and the GOP has campaigned on repealing and replacing it ever since.

Democrats continued to lose congressional seats in subsequent elections. By the time Obama left office, Republicans had won control of both houses of Congress. Gaining the White House was supposed to be the last piece of the puzzle in their longstanding campaign promise to repeal the ACA.

But now they are faced with the political consequences and policy challenges of rescinding a law that has been in effect for seven years — and is apparently garnering increasing public support.

"It's the position that was unpopular for six years but is now popular," said Emily Tisch Sussman, campaign director for the Center for American Progress Action Fund, who maintains that voters have come to appreciate the benefits of the ACA. "They are more willing to champion it instead of passively supporting it."

Campaigning on health care isn't limited to federal office holders and seekers. Democrats see opportunity on the issue in local races, too. California Lt. Gov. Gavin Newsom is writing his own plan for universal health care in his state in preparation for a likely gubernatorial run. His proposal aims to include those who would be left off insurance roles under the GOP plan, according to an interview with the Sacramento Bee.

Democrats say that Republican infighting over new legislation will extend the legislative timeline into the midterm year, meaning lawmakers will have to take difficult votes at a vulnerable time. "From a political perspective, it's to Democrats' advantage to hold a strong line and make Republicans move off of repeal," Sussman said.

Schumer and Democratic leaders argue they would work with Republicans to fix the law if they back away from their promise to repeal it. But few anticipate bipartisanship on this issue —and it’s not clear Democrats even want that.

The Democratic Congressional Campaign Committee has already been targeting Republicans over the new Obamacare replacement plan. The DCCC has pointed to Chicago-area Rep. Peter Roskam, a member of the House Ways and Means Committee, as an example of a vulnerable GOP lawmaker who "will have to own the consequences of voting for this disastrous bill.”

In an interview with Crain's Chicago Business on Tuesday, Roskam suggested he would be open to changes in the bill, specifically the Medicaid elements. Illinois expanded eligibility for the program under the ACA. Roskam's district chose Hillary Clinton over Donald Trump in the 2016 election by about seven points.

Democrats have also raised red flags on the Medicaid component, specifically a provision that would no longer require states to include treatment for the drug addicted and mentally disabled under the program, and would instead give states the jurisdiction.

Throughout the campaign, Trump and other Republican presidential hopefuls spoke often about the opioid epidemic. During a campaign stop weeks before the election in New Hampshire, a state hard hit by heroin overdoses, Trump outlined a plan to address the crisis. In it, Trump proposed expanding incentives for states and local governments to mandate treatment through drug courts. "I would dramatically expand access to treatment slots and end Medicaid policies that obstruct inpatient treatment," he said.

Trump and the White House stand by the GOP plan, and the president has been communicating with leaders and lawmakers behind the scenes. "The president is proud of it," White House Press Secretary Sean Spicer said Tuesday. Depending on the results of the GOP efforts, Democrats may soon use that line in campaign ads.

Caitlin Huey-Burns is a national political reporter for RealClearPolitics. She can be reached at chueyburns@realclearpolitics.com. Follow her on Twitter @CHueyBurnsRCP.

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