Andy Slavitt, Opinion columnist
Published 3:15 a.m. ET Sept. 21, 2018
Republicans avoided constituents after trying to kill the Affordable Care Act and pre-existing condition protections. They bet on voter amnesia and lost.
Earlier this month, over a year after Republicans tried multiple times to repeal the Affordable Care Act, I asked people in the Twittersphere if their representatives in Congress had voted for repeal and, if so, if they held a town hall to explain their vote and put forward a better vision for health care. Within 24 hours, over 500 people had tweeted back their experiences.
The responses reflected not just people who disagreed with their member of Congress, but people who felt ignored by them. The list of those who chose to vote and disappear in 2017 is long, including many who now find themselves in highly contested races — among them Republicans Barbara Comstock of Virginia, Dana Rohrabacher and Mimi Walters of California, Peter Roskam and Mike Bost of Illinois, Steve Chabot and Steve Stivers of Ohio, and Bruce Poliquin of Maine.
Sensitive to criticism for avoiding their constituents, some lawmakers have taken to holding a “don’t call us, we’ll call you” style of constituent meetings. They often label them town halls, but in reality they are either paid events or telephone calls with limited capacity where only “random” questions are accepted. Few sound satisfied with these interactions. It’s certainly not representative democracy at its finest.
Unpopular votes, ignoring voters in off years
In fact this pattern of voting and ignoring their constituents is a decidedly odd-numbered year phenomenon. On Capitol Hill these odd-numbered years are referred to as off-years because they are non-election years for Congress. And, not surprisingly, they are when unpopular votes like ACA repeal often occur. Members can vote to end pre-existing condition protections and roll back health care coverage for 20 million Americans in an odd year, like 2017, and hope those votes will be forgotten by the time even years, like 2018, come along.
This year, that strategy is not only backfiring for Republican members, it has produced much of the energy and even some of the candidates to unseat them. Shireen Ghorbani in Utah responded on Twitter that her congressman, Chris Stewart voted for repeal and avoided a town hall. She added, “it’s the reason I’m running against him.” Same with Dr. Rob Davidson, an emergency physician in Michigan, who is running to take on Bill Huizenga. “I had to do something. So I decided to run against him,” he said.
Politician behavior in even-numbered years is a different story entirely. Erik Paulsen in a competitive race in Minnesota attracted special attention when he told a paying audience in mid-August that he prided himself on being “accessible.” This was despite avoiding town halls entirely during and after the ACA votes — and for almost seven years prior. A video clip showing the audience reacting with shocked laughter has gone viral. Voters seem to remember their member’s odd-year behavior.
The greatest dichotomy in odd year vs. even year behavior is the GOP’s approach to pre-existing conditions. These are protections that Republicans voted to repeal 70 times without a replacement. Republican-controlled states, with support from Trump, are now suing to eliminate pre-existing condition protections in a case currently before a judge in Texas.
But the same politicians who pushed so hard for ACA repeal in the odd numbered years, are suddenly “embracing” these protections in 2018. Guaranteeing coverage for people with pre-existing conditions, which affect 130 million Americans, is one of the great contributions of the ACA. And these protections are extremely popular.
So 10 Republican senators and28 GOP House members recently signed on to bills that claim to offer pre-existing condition protections. Spoiler alert: they don’t. The bills would, in fact, require insurance to be offered to people with pre-existing conditions. However, they wouldn’t require that insurance companies cover their actual pre-existing conditions. Consider it a classic even-year proposal — enough to campaign on, but nothing to govern with.
Republicans feign health care concern
Perhaps the most brazen of all even year cynics may be Gov. Scott Walker of Wisconsin. Walker was one of the leaders arguing for ACA repeal and in fact his state is now one of the states suing to nullify the ACA and its pre-existing condition protections. However, locked in a tough re-election bid, Walker recently declared himself a champion of such protections. His spokesman, Brian Reisinger, said that “if something were to change” and leave people with pre-existing conditions uninsured, “Walker would call a special session in a heartbeat” and fix it.
People living with cancer, or who have children with debilitating illnesses, or even who are considering job changes will need to decide whether to believe the odd-year Walker or the even-year Walker and all the others who voted to dismantle the ACA last year and have found election-year religion.
The November midterms are in part a referendum on whether taking unpopular votes while avoiding constituents in non-election years is a strategy that works. It’s a bet members of Congress make against how much attention their constituents pay, what they remember, and whether they show up to vote. Historically that may have been a good bet. But 2018 is a chance for Americans to get it right.
Andy Slavitt, a member of USA TODAY’s Board of Contributors, is a former health care industry executive who ran the Affordable Care Act and the Centers for Medicare and Medicaid Services from 2015 to 2017. Follow him on Twitter: @ASlavitt
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