Obamacare Ruling Leaves Parties Searching for 2022 Pitches (1)

The end of the latest legal challenge against Obamacare weakens a message that has shaped and united Democratic campaigns in recent elections.

The U.S. Supreme Court upheld the Affordable Care Act in a decision Thursday, rejecting a challenge brought by Republican-controlled states and former President Donald Trump’s administration to a landmark law that provides health insurance to 20 million people. Those behind the case didn’t have the right to sue, the justices ruled.

“Let me say definitively: the Affordable Care Act has won,” Senate Majority Leader Chuck Schumer (D-N.Y.) said in floor remarks after the verdict’s release.

Republican opponents have been trying to scrap the Affordable Care Act since it was enacted under Democratic President Barack Obama in 2010, with the Supreme Court backing the law three times.

“It seems to me like the ACA has petered out as a major animating issue,” said Kyle Kondik, managing editor of Sabato’s Crystal Ball, an elections forecaster and newsletter at the University of Virginia. “Health care itself is always going to be an important issue, but it may be that future political battles are more about things other than the ACA.”

Democrats used Republicans’ unsuccessful efforts to overturn the ACA to help them win control of both chambers of Congress in 2020. Now, instead of promising to defend the ACA, Democrats will have to show a new health-care message to voters, one they may struggle to agree on. Their caucuses hold slim majorities in both chambers of Congress and are facing tough midterm battles in 2022.

Andrew Harrer/Bloomberg via Getty Images

A family practice physician examines a patient with a stethoscope at a CCI Health and Wellness Services center in Gaithersburg, Md., on April 18, 2017.

Progressive Democrats say their party needs to deliver on the promise to lower drug prices and expand Medicare to include more benefits and more Americans. Moderates, on the other hand, are focused on ways to expand health access while avoiding charges of “socialism” that fueled several of their colleagues’ election defeats in 2020.

Republicans, meanwhile, see 2022 as a time to offer a competing vision for health policy.

U.S. Supreme Court Upholds Affordable Care Act in 7-2 Vote

Always in Peril?

Some Democrats say the high court’s ruling changes little, and they expect those who gained coverage under the ACA to find the issue motivating for years to come.

“It’s always going to be in peril,” Sen. Chris Murphy (D-Conn.) said of the ACA ahead of the ruling. “Republicans are always going to run races asking people to put them in office to take health care away from millions of Americans. It’s our job to say we won’t let that happen.”

More than a decade after its passage, views on the ACA remain partisan: most Democrats—85%—support former President Barack Obama’s signature law, while 77% of Republicans view it unfavorably, a June 3 poll by the Kaiser Family Foundation found.

Fate of Obamacare in Limbo: Fight of Supreme Court Explained

Democrats have focused much of their health agenda in 2021 on building on the health law. This year, they temporarily expanded the tax subsidies for people on the individual marketplace, and created incentives for states to expand their Medicaid programs.

However, those efforts are largely unknown among the public. The Kaiser poll found 81% of those eligible for expanded tax credits were unsure they could get them, and 11% of those eligible said they didn’t think they could. Less than one in ten (7%) are aware of the increased financial assistance, according to the Kaiser poll.

‘Golden Opportunity’

Republicans say Americans are frustrated with the health system as it operates now, particularly their insurance coverage. Some want the party to go into the 2022 elections by promising better coverage options instead of pushing to repeal the ACA.

“Republicans have a golden opportunity, and ought to be on offense on health care,” said Rep. Chip Roy (Texas), who sits on the Republican Study Committee’s health care task force.

Roy said that agenda should focus on allowing Americans to pick their own doctors and find cheaper insurance plans.

“We don’t have to start with an assault on what Democrats have passed,” Roy said. “Start with giving them more options.”

The case is California v. Texas, 19-840.

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bgov.com

To contact the editors responsible for this story: Robin Meszoly at rmeszoly@bgov.com; Anna Yukhananov at ayukhananov@bloombergindustry.com; Sarah Babbage at sbabbage@bgov.com