Dems find way to go on offense with ObamaCare

Dems find way to go on offense with ObamaCare
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ObamaCare isn’t generally a favorite topic for Democrats in tight Senate races around the country.

Premium hikes announced this fall have made negative headlines, adding to criticism of President Obama’s signature legislative achievement. 

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The Affordable Care Act has never been that popular in any event, and it was widely blamed for huge Democratic losses in the 2010 midterm elections. 

Yet in this fall’s pitched battle for the Senate, Democrats have found a part of ObamaCare that they want to tout: its expansion of Medicaid, the healthcare program for the poor. 

That fight for the Senate could be decisive for ObamaCare. If Donald TrumpDonald John TrumpDemocrats blast Trump for commuting Roger Stone: 'The most corrupt president in history' Trump confirms 2018 US cyberattack on Russian troll farm Trump tweets his support for Goya Foods amid boycott MORE wins the presidency and Republicans keep the Senate and the House, they would be able to repeal the law, jeopardizing coverage for the 20 million people who have gained it under the health law. 

Republicans currently have a four-seat advantage in the Senate, and control of the chamber is a toss-up. 

Medicaid expansion has been one of the major ways that ObamaCare has expanded coverage, and it comes without the premium increases or other complications in the law’s better-known marketplaces. 

That’s resulted in tangible healthcare gains for millions of people, and Democratic Senate candidates have been happy to criticize Republicans who want to take away those gains or to prevent them from being implemented in their states.  

Thirty-one states have so far accepted ObamaCare’s expansion of eligibility for Medicaid. The expansion has contributed to about 16 million more people being enrolled in Medicaid compared to the pre-ObamaCare average, according to data compiled by the Kaiser Family Foundation. 

States expanding the program include Senate battleground states like Indiana, where Donald Trump’s running mate, Gov. Mike PenceMichael (Mike) Richard PenceThe Hill's Morning Report - Presented by Facebook - Justices rule Manhattan prosecutor, but not Congress, can have Trump tax records Trump says he'll wear mask during upcoming trip to Walter Reed Trump to visit Georgia next week MORE (R), worked in favor of the move. 

It was also expanded in Ohio, where Republican Gov. John Kasich favored it, and New Hampshire, where expansion won support from Republicans in the state legislature. 

In the Granite State, Gov. Maggie Hassan, the Democratic Senate candidate, has sought to put Republican Sen. Kelly AyotteKelly Ann AyotteBottom line Bottom line Bottom Line MORE on defense. Hassan pivoted on a question about the health law’s effect on small businesses to talk about Medicaid at a debate on Wednesday. 

“Now we know for small businesses there are some real challenges with the ACA, but one of the things that the ACA allowed us to do in New Hampshire was put together our bipartisan Medicaid expansion program which is providing healthcare to over 50,000 hard working Granite Staters,” Hassan said. 

“If you repeal the ACA, you pull the rug out of those folks and my opponent has voted to repeal Medicaid expansion now five times,” she added, speaking of Ayotte.

Republican candidates have been treading carefully on the topic, emphasizing that they do not want people to lose coverage. 

Ayotte said at the debate that a repeal bill passed by Republicans last year phased out Medicaid expansion over two years, instead of immediately. 

“I did vote five times to see if we could repeal and replace the Affordable Care Act, but I’ve also voted, when it came to vote on Medicaid expansion, to expand that for two years so that we could have more flexibility for states in serving those populations,” Ayotte said at the debate. 

Ayotte spokeswoman Liz Johnson wrote in an email that Ayotte “believes strongly that we must replace the health care law without pulling the rug out from people who are now relying on Medicaid expansion.”

Johnson wrote that a new president could work with Congress during the two-year phase out of Medicaid expansion “to give states flexibility to improve health care coverage, increase patient choice, and reduce health care costs.”

Asked for more specifics on that replacement plan, or whether Ayotte would seek a way to keep Medicaid expansion in place, spokespeople for the campaign did not respond. 

In Pennsylvania, Democrat Katie McGinty has touted the 625,000 people who gained coverage under Medicaid expansion.  

She said at a debate that expanding Medicaid is “the right thing to do. We don't just take it away.” 

Her opponent, Sen. Pat Toomey (R), said at the debate that he favored a “transition” period for people currently on ObamaCare. 

His campaign did not respond to questions on whether Toomey supports keeping the Medicaid expansion in place in Pennsylvania or how that transition period for people currently enrolled would work.

In Indiana, Pence as governor worked to establish a compromise version of Medicaid expansion that includes conservative twists like requiring enrollees to pay premiums. 

Democratic Senate candidate Evan Bayh said at a debate that his opponent, GOP Rep. Todd YoungTodd Christopher YoungA renewed emphasis on research and development funding is needed from the government Senate Republicans defend Trump's response on Russian bounties Stronger patent rights would help promote US technological leadership MORE, “wants to take insurance away from 350,000 of our fellow Hoosiers.” 

“This is something that Governor Pence did, that I agree with, that Congressman Young wants to undo,” Bayh added. 

Young’s campaign did not respond to questions about whether he supports Medicaid expansion in Indiana, or whether he worries about those people losing coverage if ObamaCare were repealed. 

The debate over Medicaid expansion does not always translate into political advantage for Democrats. 

Advertisements often attack Democrats for other, more prominent, parts of ObamaCare, like the rising premiums. Democrats acknowledge work needs to be done to improve the law to bring costs down, but argue against fully repealing it and depriving the 20 million people who have gained coverage of their insurance.  

For example, a Republican-backed ad in Indiana points to “higher premiums” and “fewer choices” under ObamaCare. 

The ad continues: “Evan Bayh cast the deciding vote for ObamaCare.”