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WASHINGTON – In announcements, debates and the election campaign, Republican candidates forego their promise to "repeal and replace" the Affordable Care Act and swear that they have never voted for the cancellation of protections granted to people with pre-existing health problems – and never will.
But as candidates seek to appease voters who say health care is their main concern, their leaders stay the course, creating a clash between campaign promises and party agendas if Republicans get out of power. Congress.
Representative Steve Scalise, whip of the House majority and possible speaker, promised to review the bill to replace the Affordable Care Act, passed in the House last year but died in the Senate. "As long as we can continue to improve things, we will do it," he said in an interview, "but we must finally repair this failing system."
This is not the message voters are hearing. Some of the campaign's claims have been bold – Senator Ted Cruz of Texas, during a debate this week with his Democratic rival, the representative Beto O'Rourke, said he had never taken aim pre-existing conditions, even though "Cruz amendment," proposed during the Senate debate on the repeal of the Affordable Care Act, specifically allowed insurance companies to offer plans that do not benefit from 39; none of the protections afforded by the national success of President Barack Obama, including for pre-existing diseases.
In the House, dozens of legislators who have voted several times to repeal the Affordable Care Act have introduced or signed resolutions affirming the importance of coverage for people with pre-existing conditions, even though these votes would have weakened or deleted these protections.
Some, like representative Dana Rohrabacher, Republican of California, have have posted ads explaining their support for the issue, and others have completely removed critical mentions of the Affordable Care Act from their websites.
"They are just now trying to hold the House, and then they will re-evaluate their position," said Tim Chapman, executive director of Heritage Action, a conservative lobbying group.
If we are to believe the language of the election campaign, this re-evaluation could be dramatic. New York Republican Representative John J. Faso voted last year to repeal the Affordable Care Act, following an extremely close vote. Now in the political struggle of his life, Mr. Faso said he hoped the Congress would adopt a more bipartisan approach.
"The most important, in my opinion, would be to win the membership of a number of Democrats," he said, adding, "If we try to adopt a one-party approach I think it's doomed to failure. "
Republicans are betting that voters will distinguish their attempts to repeal the Affordable Care Act from the issue of pre-existing conditions. They argue that their alternative bill, the American Health Care Act, would ensure that people with pre-existing illnesses could benefit from insurance, although the bill would have left states seek exemptions that would weaken these protections. It would also have eliminated rules preventing insurance companies from charging patients more pre-existing conditions.
But the political winds have changed. A Fox News poll released this week found that 54% of those surveyed had a favorable view of the Affordable Care Act, reaching record levels.
Health care remains the main issue for mid-term voters, according to a poll released Thursday by the non-partisan Kaiser Family Foundation. When asked who considers it very important to describe what health care issue concerns them, almost one in five indicates the need to increase access, and many fewer mention opposition to the Care Act. affordable, reveals the poll. These findings are consistent with those of a previous study that showed broad support for the provision of the Health Act preventing insurance companies from denying coverage based on a person's medical history.
"It seems like a real breakthrough for people; No matter what they understand about how health insurance works, it bothers them to think that insurers might charge you more or exclude coverage for your illness because it pre-existed, "said Karen Pollitz, a senior fellow from the foundation. "It records so profoundly with the public, they want it to continue to be the law of the land."
But Republican leaders have not hesitated. Sen. Mitch McConnell of Kentucky, leader of the majority, told Bloomberg News this week: "It's no secret that we preferred to start from scratch" to repeal and replace the health act.
The Democrats have drawn on McConnell's remarks to prove that the temperate remarks of the Republican candidates are nothing more than a campaign artifice.
"Republican candidates know they are the losers of the issue, so they cover their footsteps," said Leslie Dach, president of Protect Our Care, a Liberal advocacy group. They broadcast these statements on television, and I think McConnell's statement pulls the rug out of everything they said. "
Representative Nancy Pelosi of California, Democratic leader, accused McConnell of "scrambling the truth".
"If the G.O.P. control the Congress next year, they will return to their monstrous campaign to steal health insurance from tens of millions of families, raise health costs, impose an age-old tax on Americans older and destroy the protections afforded to the 130 million people with pre-existing illnesses "he said.
The Republicans, in turn, accused the Democrats of misrepresenting their position on health, calling their attacks fear tactics.
"They are trying to bite you and change you, so the Republicans seem to be on the defensive," said Rep. Pete Sessions, Republican of Texas. "They will use this desperate lie of an attack on us when in fact we are trying to meet the needs of our constituents."
But during the election campaign, the ads seem to have at least tempered the way in which candidates who were previously in favor of repealing the legislation are willing to discuss the issue.
Mr. Faso is one of more than a dozen Republicans who have signed a contract resolution "expressing the sentiment of the House of Representatives that a replacement of the law on the protection of patients and affordable care should have certain characteristics" presented by Mr. Sessions, stating that it is important to ensure the protection of people with pre-existing conditions.
"I felt strongly that I needed to reiterate my position on this. I just think the stated principles are the ones that could help us move forward, "said Mr. Faso.
It remains to be seen whether this approach will be adopted at the next legislative session. However, Karlyn Bowman, a senior researcher at the American Enterprise Institute, a conservator who studies American public opinion, has emphasized the power of the public as a counterbalance to the governing authority.
"What candidates are hearing locally now is that people are really worried that some of the protections in Obamacare will be removed," Bowman said.
If they are re-elected, will Republicans weigh these concerns when they plan to take other measures?
"I think they'll have to do it," she said.
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