House Democrats in power for the first time in nearly a decade are opening a sustained campaign to hammer Republicans on Obamacare, seeking to force the GOP’s hand on popular policies like protecting patients with pre-existing conditions.
The rising public support for Obamacare was a winner for Democrats in 2018, and they want to capitalize on that going into 2020, rolling out their own bills to preserve and expand coverage under the Affordable Care Act while plotting a potentially tendentious path toward eventual universal coverage or “Medicare for All.”
“We’re on offense,” said Rep. Jim McGovern (D-Mass.), the new chairman of the powerful Rules Committee. “The American people made it very clear in the last election that health care is important, and they don’t want Republicans screwing around with it. And we’re going to have their backs.”
These legislative efforts are likely to die in a Republican-controlled Senate. And with the court case under appeal and Obamacare in legal limbo for the foreseeable future, there’s little incentive for the deeply divided parties to come together. Democrats’ plans to conduct aggressive oversight — with a sharp focus on health care — are also aggravating their GOP colleagues.
“You don’t sit down at night and have a drink with Kim Jong Un when you’re launching missiles at each other,” Rep. Chris Collins (R-N.Y.) said. “We’re there — many of us are — but not if every hearing is a witch hunt and an inquisition.”
The House Democrats started their very first day in power with a vote to jump into a court battle defending the Affordable Care Act as part of their broad rules package. To ratchet up pressure on Republicans who campaigned on promises to keep the popular health care protections, they’ll vote again next week on a similar stand-alone measure — authorizing the House’s own general counsel to intervene alongside the Democratic states that Thursday filed an appeal of the ruling that would kill Obamacare.
“Many [Republicans], in a very inauthentic way, in my mind, indicated that they were prepared to protect Americans with pre-existing conditions,” said Rep. Hakeem Jeffries (D-N.Y.), the chairman of the House Democratic Caucus. “Now we’re going to give them an opportunity to do so.”
Those votes are just opening salvos from House Democrats, who also plan to go after the Trump administration policies that they say have purposefully undermined Obamacare by depressing enrollment, cutting subsidies, promoting skimpy alternative health coverage, and even having the Department of Justice take the unusual move of supporting key elements of a lawsuit against the federal health law.
And they plan to call those administration officials to account in one hearing after another — including an Energy and Commerce Committee session this month focused on the ACA lawsuit.
The effort is unfolding after a federal judge in Texas in December sided with 20 Republican-led states in invalidating Obamacare — recommending that the entire law be thrown out, jeopardizing coverage for some 20 million people. After the surprise ruling, Democrats immediately rejiggered their plans for the new Congress, elevating legal efforts to protect the ACA to the top of a full agenda that also includes investigating Trump health policies, addressing drug prices, and, in ways yet to be determined, addressing the base’s hunger for Medicare for All.
“If the Supreme Court rules in favor of the Texas court, we’re looking at millions of people all of a sudden uninsured,” said Rep. Raúl Grijalva (D-Ariz.). “That has to take priority.“
The hearings will pick up on those themes. People familiar with the planning said witnesses are likely to include doctors and patients who would be directly harmed by Obamacare’s abrupt elimination.
Democrats also want to roll out legislation to strengthen Obamacare with more generous insurance subsidies, boost outreach funding to promote open enrollment, and restrict short-term health plans that don’t comply with the law and that critics say are undercutting Obamacare coverage while leaving patients vulnerable to big out-of-pocket medical costs.
That may mean putting other health care priorities on the back burner for now — even though much of the base is eager for movement on Medicare for All.
Lawmakers reckon they’ll have just six months to both protect Obamacare and make progress on other health care goals before the 2020 presidential campaign begins to swamp their legislative ambitions, complicating bipartisan work to address issues like surprise medical bills, drug costs, and the opioid epidemic, and delaying the inevitable contentious Medicare for All debate.
“It changes the timing,” said Rep. Pramila Jayapal (D-Wash.), co-chair of the Medicare for All Caucus. “We can’t afford to have 20 million people thrown off of health care when we don’t have anything else ready in place. So we have to do everything we can to shore up the Affordable Care Act while we build the movement and get people on board.”
Jayapal has secured a commitment from Democratic leaders to hold hearings on Medicare for All legislation in the Budget and Rules committees. On Thursday, she said she met with Energy and Commerce Chairman Frank Pallone (D-N.J.) to push for a hearing in front of his panel.
But those hearings are still at least a couple months away, Jayapal said. And there’s no guarantee the effort will progress beyond the hearing stage this year.
Anger from the left over the looming court case will also shape Democrats’ plans for investigating the administration’s health policies. Lawmakers have vowed to dig into the Justice Department’s decision to break with precedent and side with GOP-led states seeking to gut the ACA, rather than defend an existing law that’s already been upheld twice by the Supreme Court.
Trump’s health department is bracing for fire as well. New House Oversight Chairman Elijah Cummings (D-Md.) is already demanding HHS Secretary Alex Azar hand over documents by mid-January detailing his agency’s response to Hurricane Maria in Puerto Rico, and its role in detaining and housing child migrants as part of the Trump administration’s “zero-tolerance” border policy.
“This is a policy of child abuse. That’s what we’re looking at here,” said Rep. Rosa DeLauro (D-Conn.), who chairs the …read more