repercussions for GOP leaders in the states and gives Democrats potential openings as they struggle to reclaim power lost during President Barack Obama’s tenure.
Some Republican governors, in particular, are wary about what their Washington colleagues might do with Obama’s signature law, exposing a fissure in a party that has consolidated control in the nation’s capital and dozens of statehouses around the country in accompaniment with President-elect Donald Trump’s victory in November.
“I think they talk a lot about repeal. I haven’t heard a lot about replace,” Ohio’s GOP Gov. John Kasich said last week in Cleveland, as he warned against making fast, sweeping changes. “The fact of the matter is we have a lot more people covered.” He asked “what happens to these people” in the event of a full repeal.
Democrats, meanwhile, bemoan the possibility of stripping insurance from some 20 million Americans who lacked it before the law was passed in 2010. But they also see a political opportunity after six years of being blamed by Republicans — and often by voters — for every insurance premium or deductible increase, coverage denial or long wait for a specialist.
“You bought it, you own it,” said pollster Paul Maslin of Wisconsin, who has worked for federal and state Democratic campaigns around the country.
Montana Gov. Steve Bullock, a Democrat who embraced the Affordable Care Act in a GOP-leaning state, said the repeal attempts offer another chance to explain the complex law — something even Obama has said he didn’t do as well as he could.
“It’s easy in Washington to say what you’re going to do and not do,” Bullock said. “Outside Washington, this is about communities and people’s lives, and from that perspective, I think good policy also happens to be good politics.”
Trump, House Speaker Paul Ryan, R-Wis., and others have yet to offer details beyond their promise “to repeal and replace Obamacare.”
The law’s main features are insurance exchanges where middle-income consumers buy private policies. Many get premium subsidies financed by taxes on the most generous insurance policies. Secondly, the law expanded eligibility for Medicaid, the government insurance program for the poorest and many disabled Americans. Among the regulatory changes were requiring insurers to cover more healthcare services; preventing insurers from denying coverage because of pre-existing health conditions and limiting lifetime caps on coverage.