Right Out of the Gate, AHCA not Winning Fans as ACA ReplacementCalifornia is a state where discussions of universal healthcare are taken so seriously that there’s a measure before the state Senate. Currently, around four million Californians have health insurance thanks to the Medi-Cal expansion under the Affordable Care Act (ACA). Considering those facts, you’d think it would be tough to find state legislators actively trying to pull the plug on the ACA. However, you’d be wrong.

After last week’s surprising defeat of the GOP attempt to repeal the ACA on the Senate floor just before recess, California Democrats may have been more excited to return home and greet their constituents than their colleagues on the opposite side of the aisle. The Golden State has 14 Republicans in the House, and more than half of them are up for reelection next year. Democrats predict those GOP healthcare votes will hurt Republicans where it counts: at the polls.

Indeed, Democrats are counting on public backlash over the healthcare votes as a means for winning back enough seats to shift House control back to their party.

ACA has never been more popular

Voters across the country have overwhelmingly expressed opposition to yanking the ACA without a viable replacement that ensures basic healthcare rights, such as guaranteeing coverage for individuals with pre-existing conditions and doing away with coverage limits. And yet the GOP seemed singularly determined to make good on their seven-year promise to repeal the ACA by carving up the country’s healthcare law until it looked nothing like it does today, which would serve to kick tens of millions of people off insurance rosters, some immediately, and some over time.

Judging by their last-minute votes, some of California’s House Republicans were hesitant to vote for the House plan that would have stripped an estimated one out of three state residents of healthcare. However, trepidation aside, they all voted for the American Health Care Act (AHCA) in May.

Democrats predict a haunting … for GOP Reps seeking reelection

Lest the public have a short memory, the Democratic party released statements after last week’s vote reminding representatives that they “can’t turn back time and undo the damaging vote they took to kick 23 million Americans off their health insurance and jack up premiums for millions more. … [They] own the Republican health care disaster and it will haunt them in 2018.”

And yet, despite the Democratic spin that says that Republicans would change their votes if they could hop on a time travel machine, GOP legislators are not expressing that desire. At least not publicly.

Many Republican legislators have not kept their dissatisfaction over GOP repeal/replace bills a secret. Senator Lindsey Graham of South Carolina, for instance, referred to the last-ditch “skinny repeal” as a “disaster” and a “fraud,” but cast a vote for it anyway, because he said he believed House Speaker Paul Ryan’s (R-Wi.) assurance that it would not automatically become law, but would serve as the means for the real work on healthcare to begin.

For example, Rep. Darrell Issa…

Similarly, in the House, Rep. Darrell Issa of Vista admitted that the AHCA had room for improvement, and therefore he wasn’t sure how he’d vote out of the gate. He said that his belief that the Senate would return an improved measure is what allowed him to vote for it.

Although this “pass it now, fix it later” approach might be hard to understand, Issa and Graham weren’t alone in sanctioning it, perhaps because Republicans felt pressure (including an unusual brand of public pressure from the president) to pass something after so many years’ of promising a healthcare trick up their sleeve superior to the ACA.

And one can’t overlook personal political goals when it comes to voting strategy. Issa narrowly won his seat in 2016 (by around 2,000 votes), and he’s already got opponents poised to challenge him next year. It’s not easy to vote against the party (as Senators McCain (Az.), Murkowski (Ak.), and Collins (Me.) did on Friday).

Issa stamps ACA with “failing” diagnosis

In a statement after Friday’s vote, Issa noted that he’d twice asked Senate leaders to think about making federal employee healthcare plans available to more (or all) Americans. And he said he won’t abandon that idea.

“It’s disappointing, but we can’t give up now,” Issa said. “Obamacare is still failing and we must bring young adults, families, small business and all Americans relief. We need to keep up the fight.”


This blog post is provided for educational purposes only and is not offered as, and should not be relied on as, legal advice. Any individual or entity reading this information should consult an attorney for their particular situation. For more information/questions regarding any legal matters, please email info@nelsonhardiman.com or call 310.203.2800.