Rep. Mimi Walters of California vowed to protect patients with pre-existing conditions<\/b>
\nWASHINGTON \u2014 Days after President Trump\u2019s inauguration, Rep. Mimi Walters of California vowed to protect patients with pre-existing conditions in any plan to replace the Affordable Care Act.
On Wednesday she cast a vote for a plan allows insurance companies to discriminate against people with cancer, diabetes and other common preexisting conditions \u2014 even pregnancy.
It\u2019s a moment that could have significant consequences for the Republican Party, particularly House lawmakers like Walters. Her Orange County district is among a couple dozen that have just become more competitive for Democrats due to a vote on a Republican health care plan passed without a single Democratic vote, according to the nonpartisan Cook Political Report.
There\u2019s no way GOP leaders could have gotten the bill approved without the support of vulnerable lawmakers like Walters, who sits in a district that Democrat Hillary Clinton won by six points in November. Republicans say the plan will eventually lower health care premiums, even if it results in fewer Americans being insured than under the current health system.
\u201cIt\u2019s called spending your political capital, \u201d said David Wasserman, House editor of the nonpartisan Cook Political Report. \u201cElections have consequences and majorities tend to use their majority to do things that are unpopular, \u201d said Wasserman, who told USA TODAY he is changing ratings on close to two dozen races to reflect the increased political liability.
\u201cIt gives Democrats a really big vote to attack, \u201d he said, citing members like Walters as well as fellow Californians Ed Royce and Dana Rohrabacher. Even before the vote, there were regular demonstrations outside all of their district offices.
In January, Walters tweeted that she is \u201ccommitted to protecting patients w\/ pre-existing conditions.\u201d
In a statement following the vote, she didn\u2019 t mention pre-existing conditions. \u201cI gave the people of Orange County my word that I would work to ensure all Americans have access to an affordable, patient-centered healthcare system, \u201d she said.
\u201cThe Affordable Care Act has clearly failed the American people through unaffordable premiums and deductibles, massive tax burdens on small businesses, and collapsing healthcare exchanges, \u201d said Walters.
The imperative of protecting sick Americans from the whims of a more capitalist, free market health care system was a key talking point for Democrats as well as Trump throughout the 2016 election. As recently as a few days ago, Trump even insisted such protections were part of his plan to replace the Affordable Care Act.
Even so, the GOP vow to repeal and replace Obamacare was so central \u2014 both to Trump\u2019s campaign and throughout the past seven years of Republican control of the House \u2014 that Republicans made a bet that doing nothing could be more costly if their base voters rebelled. Republicans say the legislation would bring down the price of premiums and stimulate more competition among insurers who are currently withdrawing from certain markets.
\u201cDonald Trump was elected president on the promise to repeal and replace Obamacare, \u201d said Rep. Chris Collins, a Republican representing New York\u2019s 27th district. \u201cIf we weren\u2019 t able to repeal and replace Obamacare, it would have been a bad midterm for us. I think we will at least hold our own, if not pick up seats, \u201d he said.
Indeed, conservative groups known for spending against Republicans who fail to back their agenda, including the Club for Growth, lauded the bill. \u201cRepublicans owe a debt of gratitude to conservatives for greatly improving the AHCA, \u201d said Club for Growth president David McIntosh.
The legislation is unlikely to go anywhere in the Senate in its current form, with critical moderate Republicans, including Nevada\u2019s Dean Heller, registering their disapproval within minutes after the vote. Yet members including Walters are now on the record supporting it going into the 2018 election cycle. It \u201cis a serious problem for Republicans who come from Clinton districts who voted for this, \u201d said Wasserman.
In all, there are 23 Republicans representing districts Democratic nominee Hillary Clinton won, and 14 of them supported the bill. Democrats need 24 seats to retake the House.
Yet the danger isn\u2019 t limited to these districts. According to an analysis by the New York Times\u2019 Upshot, voters in districts that voted for Trump have the most to lose if the legislation were to become law. Those eligible for at least $5,000 less in tax credits supported Trump by a margin of 59% to 36%, according to the analysis based on the previous version of the bill.
At the same time, taxpayers in counties that backed Trump would see less of a gain in tax relief (about $6.6 billion) compared to counties that backed Clinton (about $21.9 billion) , according to a Bloomberg analysis based on the initial bill.
Moments after the vote, the Democrats\u2019 official campaign organization blasted out an email announcing a digital ad campaign in 30 Republican-held districts, including those of some of the most vulnerable Republicans who were initially skeptical of the bill but supported it after a new amendment was added, including Reps. David Valadao and Jeff Denham of California. The amendment worth $8 billion was intended to offset some of the costs of high-risk patients.
The big question is whether the GOP health plan will be as big a liability for the party as Obamacare was for Democrats in 2010, when they lost control of the House. According to a Kaiser Family Foundation tracking poll, the number of Americans viewing Obamacare favorably was up to 48% by late April.
Democrats say they are targeting even vulnerable Republicans like Virginia\u2019s Barbara Comstock who voted against the bill. \u201cEvery single House Republican owns this, \u201d said Tyler Law, a Democratic Congressional Campaign Committee spokesman.
The House bill would not fully repeal the 2010 Affordable Care Act, but it would kill major elements of that Democratic law. It would prune taxes, subsidies and mandates under the law and trim Medicaid. Current tax credits, which are based on income and the cost of health insurance in their local market, would be replaced with less generous tax credits based on age. It would create pools for high-risk patients but also allow insurance companies to opt out of „essential benefits“ including maternity and emergency care. Prior to the Affordable Care Act, the majority of states did not have such coverage protections.
Democrats say allowing insurance companies to discriminate will inevitably hurt the sickest, oldest and most vulnerable. They cite opposition by major groups representing doctors, nurses, hospitals and seniors, including the AARP and the American Medical Association. The bill effectively creates an \u201cage tax\u201d on old Americans, Democrats say, and it will actually raise premiums in short term, according to CBO.
Republicans including Tim Walberg of Michigan cited a lot of \u201cmyths that are being spun, \u201d citing a number of markets where insurers are withdrawing from Obamacare’s individual exchange markets and arguing that more competition among insurance companies will bring down premiums. \u201cWe tried the Obamacare way. It is failing remarkably and the American people are demanding a change, \u201d said Rep. Kevin McCarthy of California, the House majority leader.
Yet Republicans did not receive a score for the legislation from the nonpartisan Congressional Budget Office after a final amendment was added to draw more moderate Republican support. The amendment threw an extra $8 billion intended to offset the costs of high-risk patients.
The prior version would have resulted in 24 million losing insurance, according to CBO. The Center for American Progress estimated on Tuesday that the version the House voted on underfunds high-risk pools by $200 billion over 10 years.
Walters is among the Republicans already under significant pressure from her constituents, a number of whom have created a group called the California 45th Town Hall Group to pressure her to meet face-to-face with constituents.
According to the group, it was formed because constituents have made \u201crepeated, formal\u201d requests for an open format town hall. She has declined and earlier told a radio station that the \u201cwhole goal is to try to get me to say something that they could use against me.\u201d
That pressure is only likely to intensify over a congressional break that starts this weekend.
\u201cYou have every provision of this bill tattooed on your forehead. You will glow in the dark, “ said Rep. Nancy Pelosi, the top Democrat in the House.<\/p>\n

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