A new study from the non-partisan Kaiser Family Foundation suggests the uncertainty created by Republicans’ failed attempts to overhaul the Affordable Care Act – and President Trump’s repeated urgings for the Senate to keep trying – will play a part in expected premium hikes across the country in 2018, a development that could well hand Democrats just the sort of made-for-TV attack they need to take a real run at GOP Congressional majorities next November.
Of the 20 states – and DC – where preliminary 2018 premiums and insurer participation are available, premiums will rise in every location but one, according to the Kaiser analysis. The lone exception is in Rhode Island where premiums in Providence are expected to dip by 5% as compared to 2017. The premium increases range from 3% in Detroit, Michigan to 49% in Wilmington, Delaware. Fifteen of the locations are projected to see a premium increase of double digit percentages.
Those rate increases are, according to the Kaiser study, the direct result of the uncertainty around the law and its future. Here’s the key bit from Kaiser on that:
“In the 20 states and DC with detailed rate filings included in the previous sections of this analysis, the vast majority of insurers cite policy uncertainty in their rate filings. Some insurers make an explicit assumption about the individual mandate not being enforced or cost-sharing subsidies not being paid and specify how much each assumption contributes to the overall rate increase. Other insurers state that if they do not get clarity by the time rates must be finalized – which is August 16 for the federal marketplace – they may either increase their premiums further or withdraw from the market.”
It doesn’t – or shouldn’t – take a political genius to see how those numbers could translate into a political context. Close your eyes and imagine seeing this ad:
[images of sick, sad looking patients on screen]
Narrator: “Donald Trump and Republicans in Congress are gutting our health care. Premiums are spiking. And Trump? ‘Let Obamacare fail…I’m not going to own it.”
Add in a little localized factoid – “in Pennsylvania, premiums are surging by 25%” – and you have the makings of a devastatingly effective ad.
And, unlike, say the Russia investigation, which remains difficult to weaponize in a political context because of its abstractness and complexity, health care is a tremendously potent issue in a campaign.
It touches everyone on a daily, weekly or, at a minimum, monthly basis. It is not some pie-in-the-sky idea. It is a real-life struggle and challenge. It impacts lives. Those are the sorts of issues that really matter in politics – ones that speak to the heart more than the head.
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We’ve seen proof of health care’s power as an issue in both the 2010 and 2014 midterm elections. In 2010, conservative outrage at what they viewed as major overreach by the federal government into their health care fueled the Republican takeover of the House. In 2014, the broken promise of “If you like your health care plan, you’ll be able to keep your health care plan” led to the Republican takeover of the Senate.
This Kaiser study is the sort of thing that you will see in lots and lots of Democratic ads over the next 15 months. And it’s a line of attack Republicans – at least to this point – have no obvious answer to.