Source: New York Times
A tally by the Wesleyan Media Project found that the 2018 elections stand out not for how much Democrats talked about the tweeter in chief, but for how little. So what did the campaigns that led to a blue wave talk about? Above all, health care, which featured in more than half of Democrats’ ads.
Which raises the question: Now that Democrats have had their big House victory and a lot of success in state-level races, can they do anything to deliver on their key campaign issue? Yes, they can.
There won’t be any more legislative attempts to dismantle the Affordable Care Act (ACA). On the other hand, with Republicans still controlling the Senate and White House, major new federal legislation on health care isn’t going to happen. Democrats may debate about their future agenda, which seems likely to include offering some form of Medicare buy-in option for Americans under 65 — and it’s important that they have this debate. But for now, at least, Washington will be gridlocked. There can, however, be action at the state level.
States were encouraged to create their own health insurance marketplaces, although they had the option to use healthcare.gov, the federal site. A 2012 Supreme Court decision also let states opt out of Medicaid expansion, and many did choose to refuse federal dollars and deprive their own residents of health care. This has created a divergence in health care destinies.
Also, the importance of state-level action has only increased in the past two years, as the Trump administration and its congressional allies, unable to fully repeal the ACA, have nonetheless done all they can to sabotage it — eliminated the individual mandate and reinsurance that helped insurance companies manage their own risk; and cut back drastically on outreach. But states can, if they choose, fill the Trump-size hole.
The most dramatic example of how this can be done is New Jersey, where Democrats gained full control at the end of 2017 and promptly created state-level versions of both the mandate and reinsurance. The results were impressive: New Jersey’s premiums for 2019 are 9.3 percent lower than for 2018, and are now well below the national average. Undoing Trumpian sabotage seems to have saved the average buyer around $1,500 a year.
The point is that while the new House majority won’t be able to do much beyond defending Obamacare — at least for now — its allies in the states can do much more, and in the process deliver on the agenda the whole party ran on this year. As they say in New Jersey, you got a problem with that?
Source: New York Times