You just can't keep good health policy down

You just can't keep good health policy down
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Eight years and more than 20 million newly insured Americans ago, former President Barack ObamaBarack Hussein ObamaMillennial momentum means trouble for the GOP Biden's Cuba problem: Obama made a bet and lost Democrats need a coherent response to attacks on critical race theory MORE signed into law the Patient Protection and Affordable Care Act, arguably the most important piece of social welfare legislation since Lyndon Johnson and Congress created Medicare in 1965.

It’s a law that has saved hundreds of thousands of lives, strengthened millions of families, created hundreds of thousands of jobs, stabilized health care in rural America, and significantly reduced the level of uncompensated care that pushed up the cost of health care for everyone. 

Since then, not a day has gone by without conservatives training their venom on the legislation. They tried to kill it in the cradle — filing lawsuits that went all the way to the Supreme Court and celebrating the early problems with the ACA website.


And in what collectively can only be described as an act of legislative insanity, conservatives in Congress have held more than 70 unsuccessful votes to repeal the law — a little more than once a month for eight years. Last year, with Donald TrumpDonald TrumpTrump PACs brought in over M for the first half of 2021 Chicago owes Trump M tax refund, state's attorney mounts legal challenge Biden hits resistance from unions on vaccine requirement MORE in The White House, they tried four more times and failed. 

You’d think with all this ACA bashing the public would have come to hold it in the lowest esteem. But the opposite has happened. The ACA is more popular than ever, according to the Kaiser Family Foundation’s eight-year tracking poll. Since its lowest popularity level in July 2010, when just 35 percent of the public had a favorable view with 50 percent unfavorable, a deficit of 15 percentage points, the pendulum has swung 27 points. It now favored by 54 percent to 42 percent.  

A lot has been written about the midterm elections being a referendum on Trump’s performance in the White House and Paul RyanPaul Davis RyanRealClearPolitics reporter says Freedom Caucus shows how much GOP changed under Trump Juan Williams: Biden's child tax credit is a game-changer Trump clash ahead: Ron DeSantis positions himself as GOP's future in a direct-mail piece MORE’s and Mitch McConnellAddison (Mitch) Mitchell McConnellBiden's bipartisan deal faces Senate gauntlet The Hill's Morning Report - Presented by Facebook - Biden sets new vaccine mandate as COVID-19 cases surge Democrats warn shrinking Biden's spending plan could backfire MORE’s stewardship of Congress, and from a strictly political standpoint that’s true. But what has become crystal clear over the past year is that health care is far and away the issue on voters’ minds:

  • In nationwide polling done by Hart Research for the Protect Our Care coalition, 54 percent chose healthcare as one of the two issues most important to them when voting for Congress in 2018. That is almost double the economy (29 percent) and taxes 28 percent and three times the hot-button issue of the moment, immigration (18 percent) and education (18 percent), government spending (17 percent), national defense (12 percent), and terrorism (11 percent). 
  • In last week’s special election in Pennsylvania’s 18th Congressional District, Health care was the top issue for voters who elected Democrat Conor Lamb in a district that Donald Trump carried by 20 percentage points, according to exit polling by Public Policy Polling. 
  • In last November’s election, in which Democrat Ralph Northam defeated proto-Trump Republican Ed Gillespie in the Virginia Governor’s election, nearly 70 percent of voters said health care was either the most important or a very important issue in deciding how to vote, according to exit polling by Public Policy Polling. 
  • And in the same election, voters in Maine became the first in the nation to expand Medicaid through a ballot initiative that passed easily, 59 percent to 41 percent.

Now, voters in three red states — Idaho, Nebraska and Utah are putting Medicaid expansion initiatives on the ballot for November, and in a fourth, Montana, are preparing a ballot measure that would make the expansion there permanent. It’s currently scheduled to expire in 2019 and they don’t want to leave their health care in the hands of their state legislature.

As they have been on so many other issues, the Trump-Ryan-McConnell troika are tone-deaf when it comes to health care; they want to eliminate coverage for millions while the people want to expand it. But they’re not alone. Across the country, many legislative bodies are simply unwilling or unable to pass laws that voters want and need, and in fact often do the opposite.

Eight years after the enactment of the ACA, voters are no longer willing to take it as Trump and Congress threaten to heartlessly take health care away from their fellow citizens, or their state legislative officials refuse to expand Medicaid, putting their political ideology ahead of the well-being of their constituents.

Voters are now standing up to their elected leaders. In a poetic twist, it’s no longer health care that’s on the run, it’s the politicians who want to take it away.

Jonathan Schleifer is executive director of The Fairness Project, a non-profit organization advancing economic fairness through ballot initiatives.