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Obamacare – as the Affordable Care Act calls it – will not appear on the ballot next month. But the fate of the eight-year-old health care law could be decided by the party that will win congressional control in November.
"Medicare for All" – the progressive alternative to Obamacare – also risks gaining or losing ground.
And the Trump administration will seek a green light to continue making changes in health care.
Republican strategist Karl Rove writes about the stakes of the recent Wall Street Journal column. The title described health care as the "sleep problem" of the mid-term elections of 2018.
Republican Lou Hendricks agrees. The Kansas City retiree told investigators that this was mostly health care, as he pondered his mid-term vote.
"One of the great concerns of our family is to ensure that the previous conditions remain covered," Hendricks said.
Senator Claire McCaskill, D-Mo., Who is fighting a tough battle for re-election, is trying to address this concern. McCaskill describes his own fight against breast cancer in a new advertising campaign.
"I do not talk much about it," she says, in a video that shows the senator meeting with other women. "Those who have faced cancer and many other diseases have a pre-existing condition for health coverage."
McCaskill blames his Republican opponent, Missouri Attorney General Josh Hawley, for taking part in a lawsuit aimed at overthrowing Obamacare and the obligation imposed on insurance companies in the United States. offer coverage regardless of the medical history of a person. Republicans insist that they will also protect patients with pre-existing health conditions, although they have been vague in saying how.
The country's democrats have seized on this issue. Health care dominates congressional campaign ads, beating jobs, taxes, and immigration.
"Democrats have focused laser on health care this year," said Erika Franklin Fowler, who follows campaign ads for the Wesleyan Media Project.
This is a reflection of past election cycles, when Republicans launched a blitzkrieg campaign against Obamacare while the Democrats remained largely silent.
"No matter what Americans think of the Affordable Care Act, some of its provisions are very popular," said Franklin. "Once it became clear that these provisions are problematic, I think that has somehow changed the way policy makers will talk about this cycle."
Democrats are determined to protect these popular provisions if they win one of the congressional houses or both in November. On the other hand, if the Republicans keep control, they might try again to repeal Obamacare.
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"Many Republicans want to be able to finish the job," said Jessica Anderson, Vice President of the Heritage Action Conservative Group. "They have been campaigning on this topic for over eight years."
Anderson said that even if the Republicans lost in November, they could make a last-ditch effort to abolish Obamacare during the lame session. The late Senator John McCain, R-Arizona, who helped torpedo the latest repeal effort, has now been replaced by Jon Kyl, a more reliable vote of the GOP.
Whatever party will control Congress next year, the Trump administration will likely continue to try to eliminate Obamacare. For example, the administration has already relaxed the rules to allow uninsured insurance policies with reduced coverage.
"The president will still be in office and his administration will still be active," said Anderson.
But if the Democrats gain control of one or the other room, they could perhaps put a damper on those efforts
"What you will probably see is a much larger and even fiercer oversight of the administration's efforts to change – and many will argue that it is undermining" the Affordable Care Act. said Drew Altman, president of the Kaiser Family Foundation, a health research organization.
In Kansas City, Hendricks described himself as a fan of the Affordable Care Act. But more and more, he is turning to a single payer insurance system, which progressive advocates like to call "Medicare for All".
"This makes the task easier and easier for everyone," said Hendricks, "with the exception of Aetna, Blue Cross / Blue Shield, enter the health insurance company here . "
President Trump has gone on the offensive, claiming without any evidence that any expansion of Medicare would be at the expense of the elderly today.
Even if they win a landslide victory midway through, the Democrats will not have the power to pass "Medicare for All" at the expense of a presidential veto. But they could start the discussion before the next election in two years.
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