Play Live Radio
Next Up:
0:00 0:00
Available On Air Stations

Health Care Debate Over Pre-Existing Conditions Heats Up As Midterms Near


Now to the fast-approaching midterm elections, where health care has been the dominant issue. Democrats have been aggressively attacking Republicans for trying to repeal Obamacare. But as Election Day approaches, Republicans are fighting back. NPR's Danielle Kurtzleben has more.

DANIELLE KURTZLEBEN, BYLINE: Democrat Antonio Delgado has put up more than a dozen ads on his YouTube page since the start of October. And the overwhelming majority - all but one - mention health care.


ANTONIO DELGADO: Everywhere in this district, folks tell me, we've got to fix health care.

UNIDENTIFIED PERSON: I'm a three-year cancer survivor. I'm so happy you're going to fight the fight for us.

KURTZLEBEN: He's in a tight race in New York's 19th Congressional District, and his strategy is one Democrats nationwide have embraced. In fact, more than half of pro-Democratic TV ads in the homestretch to Election Day have mentioned health care, compared to around one-third of Republican ads. That's according to the Wesleyan Media Project.

Margie Omero is a Democratic pollster.

MARGIE OMERO: Democrats have a very clear advantage on health care. And not only that, it's one of the top issues that voters say matter to them, that they think is a, you know, big issue facing them personally and facing the country.

KURTZLEBEN: That's a big change from the 2010 and 2014 midterms. When Republicans slammed Obamacare, Democrats barely touched the topic. But since 2016, Republicans have tried and failed to repeal Obamacare, and the law has gained popularity.

Now, Republicans have ramped up their own messaging. Among the new ads that popped up in recent weeks, one from Republican John Faso, whom Delgado is trying to unseat. The ad features Faso's wife, a cancer survivor.


MARY FRANCES FASO: John knows firsthand how important health care is for families. The truth is he voted to guarantee coverage for people with pre-existing conditions.

KURTZLEBEN: This is one of a recent crop of ads where GOP candidates promise to protect people with pre-existing conditions. President Trump has been saying the same thing. But then, the Republican Obamacare repeal bill would likely have made it harder for many sick people to get coverage. That's according to the Kaiser Family Foundation's Larry Levitt.

LARRY LEVITT: Insurers would have still had to guarantee insurance to people with pre-existing conditions. But for people who were uninsured and had a pre-existing condition, they might have faced prohibitively high premiums, which would've put coverage effectively out of reach.

KURTZLEBEN: According to a September poll from Kaiser, even a majority of Republicans supported keeping these protections. However, Levitt points out a flip side to the policy.

LEVITT: When the ACA guaranteed insurance to people with pre-existing conditions, premiums did go up, especially for people who are healthy.

KURTZLEBEN: And this has long been part of the Republican argument - that Obamacare raised premiums for too many people and, furthermore, forced people to get insurance they didn't want. However, there aren't dozens of Republican ads explaining, for example, the finer points of pre-existing conditions. And there's a good reason for that.

MICHAEL STEELE: There's a truism in politics that if you're explaining, you're losing.

KURTZLEBEN: Michael Steele is a Republican strategist. It's not that Republicans have been dodging health care this year. Rather, they have other lines of attack. Perhaps the biggest - single-payer healthcare, often known as “Medicare-for-all.”

STEELE: I think Republicans feel that the growing support for “Medicare-for-all” without a realistic plan to pay for it also, you know, provides an opportunity, you know, when talking to a lot of voters who are trying to make up their minds right now.

KURTZLEBEN: While these arguments are being used to motivate voters to turn out on Election Day, the reality is that the election probably won't do much to settle the debate. Danielle Kurtzleben, NPR News. Transcript provided by NPR, Copyright NPR.

Danielle Kurtzleben is a political correspondent assigned to NPR's Washington Desk. She appears on NPR shows, writes for the web, and is a regular on The NPR Politics Podcast. She is covering the 2020 presidential election, with particular focuses on on economic policy and gender politics.