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This is a sign of the importance of the problem that several candidates in the tight race feel compelled to react.
For months, Democratic candidates have turned their sights on health care, while Republicans have spoken little. Sign of the power of the problem, Republicans are now playing in defense and are publishing a wave of announcements promising to preserve the protections for Americans suffering from pre-existing health problems.
Commercials omit the fact that protections were a central element of the Affordable Care Act and that the Republican Party worked tirelessly to repeal the law, through legislation and trial.
Republicans in Congress recently introduced limited legislative proposals to protect certain pre-existing conditions in the event of a reversal of the health law. One, a resolution of the House, would have no force of law, even if it was passed. The other would have a major loophole: insurers should cover people who already have an illness, but not necessarily. blanket take care of these particular diseases. (Neither is about to become law.)
As in some Democratic ads, many Republican ads feature family members with health problems. Some respond directly to critics of a Democratic rival. Many cite the votes for Republican bills that would have remodeled large portions of Obamacare last year – the same votes that Democrats used as proof that Republicans want to limit health coverage.
The protection of pre-existing conditions is popular and surveys suggest that voters trust Democrats and Republicans more in health care. A few months ago, Republican candidates were happy to focus messages elsewhere – about the economy or immigration policy. They are defending themselves now less friendly territory.
Here are some examples of this new crop of G.O.P. ads and a little context.
The Republican candidate: Josh Hawley, Attorney General of Missouri, challenges Senator Claire McCaskill.
L & # 39; s ad: A tight picture of Mr. Hawley talking in front of the camera shows images of a field where his family and children play with brightly colored footballs. Mr. Hawley describes how one of his "two perfect little boys" is suffering from a rare condition that would be considered a pre-existing condition. "We know what it looks like," he said, before saying that he supported "forcing insurance companies" to cover pre-existing illnesses. The boy hits a ball through the field.
The strategy: Mr. Hawley is part of a group of officials from 20 states who have filed an appeal against the constitutionality of the Affordable Care Act. If the trial succeeds, the entire law, including its guarantees of affordable coverage for already sick Americans, could be eradicated. (The Trump administration has stated in court that most of the law should be maintained, but that its pre-existing conditions of protection are protected, alone, should be invalidated.Ms. McCaskill used Mr. Hawley's participation in the prosecution as the central course of his campaign and highlighted his personal experience with breast cancer.
Mr. Hawley says he is supportive of the protections for those already affected, but he does not know if the policies he supports would provide the same protections that people like his son currently enjoy. If his lawsuit invalidates the entire health care law, the country would come back to a time when people who were already sick could not sometimes subscribe to coverage. Republicans may pass a law restoring consumer protection in Obamacare, but Hawley has not yet explicitly approved such a strategy.
In an interview this summer, Hawley said he supports unspecified policies to protect these clients and allow young adults to continue to benefit from their parents' health plans. "We can do these things outside of the Obamacare structure," he said, recommending less stringent regulations regarding insurance benefits.
Last year, Republican repealing bills provided for certain protections for those who remained insured without interruption of coverage. But they would have allowed some state insurance companies to avoid covering certain types of medical treatment or to charge higher prices to the sicker customers who had let their coverage expire.
The Republican candidate: Dana Rohrabacher is an outgoing member of the 48th district of California who has been sitting in the House of Commons since 1989. He is challenged by a lawyer and real estate businessman, Harley Rouda, to a very close race.
L & # 39; s ad: Mr. Rohrabacher stands beside his wife, while his daughter Annika sits on a swing. Rohrabacher explains why health care is "personal" for his family: "When my daughter Annika was 8, she had leukemia. It was devastating for my family, but it came out of it. "Annika's photos in a hospital bed and wheelchair are replaced by footage of the Rohrabacher family walking along a beach (Mr. Rohrabacher wears a wetsuit and wetsuit) a surf board ).
"That's why I'm fighting both sides, and I'm fighting for people who already have it," he said, clenching his fist. After Mr. Rohrabacher approves the advertisement, Annika adds, "And me too."
The strategy: Mr. Rohrabacher really has a new strategy to try to protect Americans with pre-existing conditions, a strategy that contradicts the dominant approaches of the two political parties. His proposal, explained In an editorial this summer, commercial plans would avoid covering pre-existing conditions, but would allow affected patients to obtain Medicare coverage for these ailments only. The advertisement presents Mr. Rohrabacher as a creative and non-partisan legislator, personally interesting to health care, rather than following Republican leaders.
But when it was about more realistic choices Regarding the management of the health system, Rohrabacher also voted last year for the Health Health Act, a bill that would have upset large parts of the health care system. Obamacare. The bill would have significantly reduced the Medicaid program, which covers many American children, and weakened the protections afforded to patients already suffering from previous conditions in states that had abandoned the usual Obamacare rules. His unusual proposal seems to tie his support for this bill to his commitment to the Americans as his daughter. But his commitment is an imperfect match with his legislative record.
The Republican candidate: Dean Heller, a Republican senator from Nevada, is in a tight race for re-election against Jacky Rosen, a member of the state's Third District Congress.
L & # 39; s ad: To understand this ad, you almost need to see Mrs. Rosen's attack on Mr. Heller, who compares him to a man in the air, insensitive and dislocating, describing his changing positions during the cancellation of the effort. cancellation of the Obamacare campaign.
Mr. Heller's advertisement shows the tube man waving on a screen next to a television camera and a director's chair bearing the inscription ROSEN. "Jacky Rosen's idea of repairing health care: campaign advertising," says Heller, as the camera zooms out. Heller blames Rosen for failing to advance health care legislation by saying, "I am fighting to protect pre-existing conditions and increase funding for Nevadans who need it the most. Jacky, I'll stack my record against yours every day. The advertisement ends with another shot of the man tube.
The strategy: Mr. Heller found himself in a difficult situation when Republican repeal bills were introduced in the Senate last year. Republican leaders really needed his vote to advance a bill and he had promised, as a candidate, to repeal Obamacare. But the Nevada governor opposed the law, saying it would hurt the state. First of all, Mr. Heller objected to the Senate bill. In the end, he voted for a cleaner plan that would have preserved pre-existing protections while eliminating other key elements of Obamacare. (He also expressed support for a bill that would have replaced the Obamacare insurance markets with a comprehensive state subsidy program that would have allowed them to completely eliminate the protection of pre-existing conditions.)
It is true that Mr. Heller proposed more health legislation at the last convention than his opponent. After all, he was part of the Republican majority that controlled the legislative agenda. But none of the health care bills cited by Mr. Heller in his advertising became law, and one might wonder if their effects would match those he claimed. These are the same bills and votes that Ms. Rosen cited as evidence that Mr. Heller would reduce health coverage. The reference to Ms. Rosen's advertisement suggests that voters have enough memory to deserve an answer.
The Republican candidate: Kevin Cramer, a congressman from North Dakota, runs to overthrow Democratic Senator Heidi Heitkamp.
L & # 39; s ad: There are cows. "Come on, Heidi, the word has come out," says the ad's narrator, citing information reporting facts verifying the facts of Ms. Heitkamp's ads criticizing Mr. Cramer's medical record. "It's a debacle," the voice said, as the cows trotted on the screen, chased by a lasso cowboy. The narrator explains that "Kevin Cramer voted for a coverage guarantee for pre-existing conditions". Ms. Heitkamp's commercials on health care, says the narrator, "do not pass the smell test." A moos cow.
The strategy: Like Mr. Heller, Mr. Cramer attempts to characterize his votes in favor of the repeal of Obamacare as efforts to preserve protections for pre-existing conditions – and he responds to the announcements democratic issues highlighting the problem. This statement is much more complex for Mr Cramer than for Mr Heller, despite some criticism of the details of Ms Heitkamp's announcements. Cramer voted in favor of the Health Health Act, a bill that would have allowed states to weaken protections for Americans with pre-existing conditions. If the bill had been passed, North Dakota might have preserved Obamacare's rules, but it's different than "guaranteed coverage."
Mr. Cramer also recently co-sponsored a non-binding House resolution that argues that the protection of pre-existing diseases should be included in future health reform bills. This suggests that Mr. Cramer is engaged on the issue, but this is also different from a guarantee.
Margot Sanger-Katz is a domestic and written health care correspondent for The Upshot. She was previously a journalist with the National Journal and Concord Monitor and editor-in-chief of Legal Affairs and Yale Alumni Magazine. @sangerkatz • Facebook
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