Health insurance costs in Washington state are about to soar for people who are covered under the Affordable Care Act, sparking bitter pre-election campaign fights around the state over who’s to blame.
After two years of big price jumps, people in most states are expected to see declines or small increases in premiums for plans covered under the ACA, also called Obamacare.
But Washingtonians who buy the standard ACA plan on the open market will pay 12 percent more in 2019, one of the largest increases in the country.
And they’ll start to see higher costs just days before voting, since open enrollment for 2019 health care plans starts five days before the Nov. 6 election.
Candidates for Washington’s three competitive House of Representative seats have made rising insurance costs and access to health care centerpieces of their campaigns.
“You will see Republicans blaming health care cost increases on the Affordable Care Act,” said Liz Hamel, director of the public opinion and survey research team at the Kaiser Family Foundation, a non-partisan health care research organization. “You’ll see Democrats blaming cost increases on the Trump administration’s actions on health care.”
The issue is so complex that most voters struggle to determine what the real reasons are, she said.
This much is clear: In Washington, insurance companies last year spent more money paying for people’s health care than insurers wanted, leaving companies with less profit than the nationwide average, according to Cynthia Cox, KFF director for the study of health reform and private insurance.
The Affordable Care Act required insurers to cover people with pre-existing health conditions, which raised companies’ costs and decreased their profits, Cox said. Companies eventually adjusted, in most cases raising premiums.
But the insurance market was rocked again after President Donald Trump and Congress began chipping away at the ACA and repealed a mandate that required nearly everyone to purchase insurance, Cox said.
In 2017, the “political uncertainty scared some insurers away and others factored in higher rates just to cover themselves in case the individual mandate ended up not being enforced,” she said.
Carolyn Long, a Democrat running for the House in Washington’s Third Congressional District, doesn’t see the potential rate increase as evidence that Obamacare is flawed. She said Trump’s administration should be blamed for fiddling with the law.
In her campaign advertisements, Long ties her opponent, Republican Rep. Jaime Herrera Beutler, to the effort to repeal Obamacare.
The “Trump administration is repeatedly undermining the Affordable Care Act that provides insurance to 20 million people,” Long says in one ad. “How did (Herrera Beutler) vote? She voted 40 times to repeal it.”
Herrera Beutler proudly admits to attempting to end Obamacare, which she said has been a “failure.” People in her district on Medicaid and Obamacare plans trying to see primary care doctors are waiting for long periods of time, she said, a problem that didn’t exist before the ACA.
“When you can’t see your pediatrician, that’s not good enough,” Herrera Beutler said.
She said people who attribute rising premium costs to the Trump administration’s effort to undermine the ACA are wrong.
“(That) premise would be true if we had been successful in changing the law,” she said. “We haven’t.”
If Trump was responsible for rising costs, Herrera Beutler argues, then why did health insurance get more expensive in the early years of Obamacare, before he was elected?
In past elections, Republicans used the unpopular law as a battering ram against Democrats, often successfully. But when the GOP gained control of Congress and nearly repealed Obamacare in 2017, a majority of people decided for the first time that they liked the ACA.
“Health care has been an animating issue in midterms and certainly benefited Republicans,” said Kyle Kondik, the managing editor of Sabato’s Crystal Ball, which studies election trends. “Maybe this is the time where Democrats can turn the table on that sort of issue, and they’re very much trying.”
In Washington, 72 percent of all House and Senate ads broadcast in September mentioned health care, and 8 percent specifically mentioned the ACA or GOP health reform efforts, according to the Wesleyan Media Project, which analyzes election advertisements. Nationally, 50 percent of pro-Democratic ads referenced health care, compared to 28 percent of pro-Republican ads.
In eastern Washington, Democrat Lisa Brown, who is vying for a House seat in the Fifth Congressional District, has slammed Republican Rep. Cathy McMorris Rodgers for voting for the American Health Care Act, which would have repealed Obamacare last year. McMorris Rodgers was the only Washington House member to vote for the bill.
“You have someone who voted to take health care away from millions of people,” an advertisement targeting McMorris Rodgers says. “She told us she wouldn’t vote to repeal until there was a replacement, and then she went ahead and did it (anyway).”
Other health care plans have been used as campaign ammunition. Democrat Kim Schrier, running against Republican Dino Rossi for the open House seat in Washington’s Eighth Congressional District, was recently targeted by a Republican ad that quotes Schrier endorsing Medicare for All, a controversial universal health care proposal that could cost $32 trillion.
“Kim Schrier’s plan will put your health care in the hands of government bureaucrats and require historic tax increase for Washington families,” the ad says.
PolitiFact rated the claim “mostly false,” since it takes her quote out of context and doesn’t acknowledge that Schrier thinks the plan is unrealistic now. Rossi was also the target of a misleading health care ad.
Kellen Browning, 202-383-6102, @kellen_browning