Ongoing challenge to Affordable Care Act could add to risks for Collins

Republicans are facing a self-inflicted calamity with a lawsuit that puts at risk the health care coverage for millions of Americans.

And they are doing it just in time for a contentious US Senate race in Maine and a presidential election.

On Tuesday, the US Court of Appeals for the 5th Circuit – a conservative court for sure – heard oral arguments in Texas v. US, which is reviewing a lower court ruling that would end the Affordable Care Act.

The Kaiser Family Foundation provides an excellent explainer on the implications of the case: “The trial court’s decision has not yet been implemented. However, if the decision does take effect, it will have complex and far-reaching consequences for the nation’s health care system, affecting nearly everyone in some way. A host of ACA provisions would be eliminated, including: protections for people with pre-existing conditions, subsidies to make individual health insurance more affordable, expanded eligibility for Medicaid, coverage of young adults up to age 26 under their parents’ insurance policies, coverage of preventive care with no patient cost-sharing, closing of the doughnut hole under Medicare’s drug benefit, and a series of tax increases to fund the new benefits.”

In short, there would health care chaos and real harm to millions of people who would no longer be able to afford health care coverage. While Mainers are protected against several of the most ominous rollbacks through state law, an estimated 70,000 people in the state could lose access to the subsidies that make insurance affordable.

Republicans, including President Donald Trump, have promised time and time again to replace the Affordable Care Act, but they have failed to develop a real alternative.

The reason is simple: Fundamentally, they believe that the government should have as little role in providing health care to people as possible. They have tried to cut Medicare and Medicaid, privatize health care for veterans and remove the guardrails that protect consumers from insurance companies.

Depending on the outcome of the appeal, Texas v. US is likely headed to the US Supreme Court, where the conservative majority will decide the outcome, next year – while candidates up and down the ticket are vying for election.

And that’s when the calamity could come home to roost for Republicans, including US Sen. Susan Collins, who will face a spirited, well-funded opposition in her race for re-election.

Collins, a hero of the Affordable Care Act for her vote to protect the law, turned around and voted for the GOP tax scheme in 2017. That law put the ACA at risk.

She also voted to confirm Justice Brett Kavanaugh, pushing the US Supreme Court to the right and further jeopardizing the ACA, as well as putting at risk access to abortion and non-discrimination protections for LGBTQ Americans.

In 2018, health care was one of the biggest issues motivating voters. That year, Democrats surged back in Maine and around the country, capturing the both houses of the Legislature and the Blaine House here and the US House of Representatives in Washington.

Thanks to the Trump administration’s inept handling of the health care policy, a radical swing in the make up of the Supreme Court and the GOP’s limitless desire to rollback social policies, Collins could find herself in a storm of regressive efforts to take our country back to the 1950s.

Collins is weaker electorally than she has ever been, but she should be favored to win re-election even in a race that could exceed $60 million in spending by the campaigns and outside groups.
But she might be running against more than just her Democratic opponent.

A strong undertow from the presidential campaign and an unpopular Trump and a national policy lurch to the far right – fueled by a Collins-approved Supreme Court – including the loss of health care for tens of thousands of Mainers would significantly undermine her case for re-election.
Health care mattered in 2018. It looks like it could be the issue again in 2020, and that’s bad news for Republicans.

David Farmer is a public affairs, political and media consultant in Portland, where he lives with his wife and two children. He was senior adviser to Democrat Mike Michaud’s 2014 campaign for governor.