As President Donald Trump called on a court to dismantle the Affordable Care Act, reassured Americans that congressional Republicans would quickly reassemble a plan to replace it and subsequently punted plans for health reform until after the 2020 election all within one week, a new Morning Consult/Politico poll finds most voters are bearish on the party’s ability to deliver on health care.
Asked how much trust they placed in Trump or congressional Republicans to protect or improve the health care system, nearly 3 in 5 voters said “not much” or “none at all,” according to the latest March 29-April 1 survey. By contrast, a 53 percent majority of the electorate said they had “a lot” or “some” trust in Democrats on the same question.
The poll, which surveyed 1,945 registered voters and has a margin of error of 2 percentage points, was conducted in the immediate aftermath of the Justice Department’s decision to support a federal judge’s ruling in a Texas-led lawsuit that calls for dismantling the entirety of the ACA -- including its popular protections for people with pre-existing conditions.
“Every smart House and Senate Republican has got to be horrified at this turn of events,” said Jim Manley, a Democratic strategist and former aide to former Senate Democratic Leader Harry Reid of Nevada. “The president had a good week last week, and now he’s gone ahead and blown any momentum he had by re-engaging in a health care debate, which is an absolute disaster for this party.”
Several congressional Republicans, including Senate Majority Leader Mitch McConnell (R-Ky.), have appeared less than enthused by the administration’s stance. In a conversation Monday, McConnell informed the president that his chamber has no intention of putting together a comprehensive health reform bill anytime before the 2020 election.
Though the ACA has never enjoyed overwhelming backing from the public -- net support totaled 8 points in the last poll -- it has undoubtedly become a fixture in the U.S. health care system, and not only for the 21 million Americans with coverage through plans on the ACA exchange.
The health law prohibited insurers from citing pre-existing conditions as a reason to charge more for coverage or deny it outright, and extended care to adults under age 26 as well as millions of Americans through state-level Medicaid expansion.
Michael Steel, a Republican strategist who served as press secretary for former House Speaker John Boehner (R-Ohio), said he was at an “utter loss” as to why Trump would reintroduce the option of striking down the ACA.
“I have no earthly idea what prompted him to bring the issue back on the table,” said Steel, now a partner at Hamilton Place Strategies. “There is no practical or political advantage.”
At the onset of the 115th Congress, voters placed their trust in Republicans over Democrats on health care by a 4-point margin -- a lead the GOP lost and never recovered following its unsuccessful attempts to repeal and replace former President Barack Obama’s signature 2010 health law. Democrats’ current 12-point lead is consistent with the average 10-point lead the party has held ever since.
The political backlash to overhauling Obamacare was most keenly felt by House Republicans, who helped pass a bill that did not protect coverage for people with pre-existing conditions, only to see it die in the Senate.
Voters’ trust in Democrats to protect people with pre-existing conditions likely flipped dozens of House seats in the November 2018 midterm elections, analysts said, after the Justice Department’s initial decision not to defend the ACA’s consumer protections in court. In the month preceding Election Day, Republicans trailed Democrats in voter trust on that issue by 18 points.
Six months of Republicans reiterating their commitment to protecting people with pre-existing conditions, despite their disapproval of the ACA, have not narrowed that gap. Democrats held a 2-to-1 lead over Republicans, by a margin of 40 percent to 19 percent, in the most recent poll.
In a series of tweets on Monday night, Trump extended the timeline for Republicans to become “the party of health care,” and said that a vote on a GOP health proposal can wait until after the 2020 presidential election, “when Republicans hold the Senate & win back the House” -- indicating no intention of working with House Democrats.
“He put the issue back in play, and then he quickly ran away from it, suggesting that he wasn’t going to deal with it until after the 2020 election,” Manley said.
Rather than playing into the hands of Democrats, enthralled by the possibility of once again running campaigns on the message that Republicans are aiming to gut Americans’ health care, Steel said the GOP should focus its energy on opposing “Medicare-for-all.”
Just over a quarter of voters -- 26 percent -- believe a single-payer system would be more disruptive to the health care system than overhauling the ACA (22 percent), while 18 percent said both would be equally as disruptive.
But it will be extraordinarily difficult for Republicans to recover now that the president has raised the potential of tearing down the ACA, Manley said, because the 2020 election is not just going to be about criticizing Trump: “We’ve got an issue to run on, as well.”