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The 2014 election was bad for Democrats, but there was *some* good news for healthcare

2014 midterm voters

There’s really no sugar-coating it: the election yesterday was a bad one for supporters of universal health care. Margot Sanger-Katz, writing on The New York Times Upshot blog, reports:

Arkansas, Kentucky and West Virginia — states that saw substantial drops in the proportion of their residents without insurance — all elected Republican Senate candidates who oppose the Affordable Care Act. Control of the West Virginia state House of Delegates flipped from Democrats to Republicans. And Arkansas elected Republican supermajorities to both houses of its legislature along with a Republican governor, a situation that could imperil the Medicaid expansion that helped more than 200,000 of its poorest residents get health insurance.

Meanwhile, vulnerable Republican governors in Georgia, Maine, Kansas, Wisconsin, and Alaska who refused to expand Medicaid under Obamacare, and Florida governor Rick Scott who only tepidly supported expansion, all cruised to reelection. And, in what might be the night’s biggest surprise, Vermont’s Democratic governor Peter Shumlin, who had been working toward implementing a single-payer health system in his state, was nearly unseated.

However, it wasn’t all bad news for healthcare yesterday. Here are some bright spots.  

Florida (really!)

Democratic gubernatorial candidate Charlie Crist didn’t win his race, but he lost by just one percentage point on a night that heavily favored Republican candidates– and polls indicate that Obamacare wasn’t the reason he lost. The Week’s Marc Ambinder explains why this is good news for Obamacare supporters:

Democrat Charlie Crist supported President Obama’s health care policies to the letter. And of those voters who believed that health care was the most important issue, three-fourths supported Crist. I don’t doubt that the word “ObamaCare” helps keep some GOPers motivated. It remains unpopular in reliably Republican states.

But results in Florida (and elsewhere) suggest that ObamaCare in reality is not a sinker issue, which, if you think about it a second, is probably the biggest underreported political development of the cycle, given how universally loathed it was just a year ago. The enormous bugbear of ObamaCare is no longer an albatross. Democrats in 2016 can run on ObamaCare in places they thought they could not in 2014. Also, and more meaningfully, these results could convince some recalcitrant Republican governors to change their policies on ObamaCare in the next two years, which might increase the program’s efficacy.

Even in deep red states where anything with Obama’s name attached is a dirty word, opposition to Obamacare isn’t nearly as fierce as it once was. As we pointed out in a recent post, Republican candidates in Arkansas and Kentucky wouldn’t give straight answers to questions about how repeal would affect the exchanges or the Medicaid expansion– provisions that are quite popular in those states. The fact that an honest answer– the exchanges and Medicaid expansion would go away– would be pretty unpopular, even in those red states, shows just how hard it would be for Republicans to repeal Obamacare, even if they were in a position to do it.

Exit Polls

According to an exit poll from CNN, 47% of voters said that Obamacare went too far in its reforms, while 48% said it was just about right or didn’t go far enough. Keeping in mind how relatively old and conservative leaning this year’s electorate was, the fact that more voters said they support reform than oppose it shows that Obamacare repeal may be good for rallying the GOP base, but it’s not a position the majority of Americans support.

Pennsylvania

Democrats in other states underperformed relative to the polls, but in Pennsylvania, Democratic candidate Tom Wolf crushed the incumbent Republican, Tom Corbett, as expected.

Rather than joining the ACA’s Medicaid expansion, Corbett had spent the first year of Obamacare negotiating for the ability to charge premiums and higher copays to new recipients and to cut benefits for existing enrollees (you can read all about his plan in our earlier post here). Wolf has said that he’d pursue the standard Medicaid expansion, which would mean more people receiving better coverage.

“Personhood” amendments went down

Voters in Colorado and North Dakota rejected amendments to their state constitutions that would have recognized unborn fetuses as “persons”– amendments that would basically outlaw abortion, and allow for the criminal prosecution of doctors that provide them. Opponents have pointed out that these amendments could outlaw not just abortion, but also in vitro fertilization and some methods of birth control. The amendments were both soundly defeated.

Closing an Obamacare loophole

This is something that wasn’t on the ballot, but it was announced yesterday, so we’ll include it.

Some employers had discovered that they could provide workers with extremely skimpy plans that don’t cover hospitalizations, and they still wouldn’t have to pay the employer mandate penalty, because technically these plans still counted as providing “minimum value” according to an online calculator on the Treasury Department’s website. On top of that, workers who were offered these plans would be ineligible for subsidies to purchase better plans on the exchanges.

On Tuesday, the Obama administration announced that it would be issuing regulations saying that plans without “substantial coverage for in-patient hospitalization services” do not meet the law’s “minimum value” threshold. It also said that “in no event” will workers given an employer plan without hospital coverage be disqualified from the subsidies.

It’s a small change, but it illustrates something important. Even with control of both the House and Senate, Republicans still can’t repeal Obamacare and they can’t do more to obstruct changes to the law than they’ve already been doing. But as long as Democrats control the White House they have at least some power to keep improving the law so that it works for more people.

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