Virginia Republican Nick Freitas has called the Affordable Care Act, or Obamacare, a “cancer.” The libertarian-leaning state delegate has promised to help repeal it if he unseats freshman Rep. Abigail Spanberger (D-Va.) and joins Congress next year.
But in the midst of a global pandemic, Freitas and other Republicans are campaigning on a key piece of the legislation: preserving coverage for pre-existing conditions. Freitas is among a handful of GOP candidates in swing districts running TV ads promising those protections will remain in place if they are elected.
“Yes, I want to see Obamacare gone,” Freitas said in an interview. “In the interim, as we're moving from one approach to a different one, I want to make sure that vulnerable populations are covered.”
It’s a stance that many health experts say is untenable. Democrats like Spanberger say is it's also disingenuous. In 2018, the former CIA officer flipped a GOP-held seat with a heavy focus on healthcare.
“I find it unbelievable,” Spanberger said in an interview. “The ACA is currently the only law that protects people's pre-existing conditions. And if [Freitas] wants to propose something new, I welcome him to do that.”
The stakes are higher after the passing of Justice Ruth Bader Ginsburg. On November 10 -- a week after Election Day -- the Supreme Court will hear arguments in a lawsuit backed by 18 states and President Donald Trump which seeks to strike down the ACA. Trump’s pick to replace Ginsburg, Judge Amy Coney Barrett, has criticized a prior Supreme Court verdict that upheld the law.
Larry Sabato, director of the University of Virginia’s Center for Politics, said the ACA is now in jeopardy.
“Obamacare may well be on its way out,” Sabato said.
Freitas points to a Republican bill in the House of Representatives that would protect pre-existing conditions if the ACA is repealed. Health care experts say that approach would create unaffordable plans unless Congress passed additional subsidies and a broader health care overhaul.
Polls conducted by the Kaiser Family Foundation show roughly half of those surveyed support the ACA, with over 40% opposed. A larger percentage -- 57% -- oppose the Trump administration’s court case against the law.
There was some coverage for pre-existing conditions before the law passed in 2010, but only for people who got health insurance through their job. Karen Pollitz, a senior fellow with the nonprofit Kaiser Family Foundation, compared the system to a game of musical chairs.
“When the music stops, if you're between jobs, the individual market wouldn't catch you,” she said.
The ACA covered those people. It also created larger pools of insured people so that those with expensive conditions were balanced out by those who were healthier.
If the health law is struck down, Pollitz says the costs of plans would skyrocket. Medicaid expansion could be threatened. A trade group representing major insurers have warned the courts that repealing the ACA would “wreak havoc” on the U.S. healthcare system. Roughly 20 million people could lose coverage.
Sabato said Republicans are banking that voters won’t investigate the ads they see on TV.
“Call it a scam if you want,” Sabato said. “It doesn't matter if it's completely untrue. Because by the time that truth catches up, Election Day will have long passed.”
Freitas is known in the House of Delegates for staking sometimes lonely positions that his supporters take as a proof of his scruples and detractors see as evidence of callousness. The former Green Beret did not join a handful of GOP colleagues to pass Medicaid expansion in Virginia, which has insured over 450,000 people. He voted against GOP-sponsored bills that mandated coverage for children’s hearing aids and required coverage for the treatment of autism; Freitas argued the proposals would drive up costs for everyone else.
In the long run, Freitas said he wants to see a broader overhaul that focuses on building a larger supply of doctors and clinics and moves away from insurance paying for all costs, which he argued is “not an efficient model.” In his weekly podcast, Freitas also floated the possibility of giving doctors the ability to vary their rates if they were treating, for example, a friend, “without having to worry about the red tape that they might potentially violate.”
Elsie Cimorelli, a 78 year-old Freitas supporter who stopped by a recent rally to pick up a couple yard signs, said she likes the GOP approach. She was unhappy with insurance her son got through the ACA to treat a disability and trusts Republicans to come up with something better.
“Trump is working on something,” Cimorelli said. “So I'm gonna stick with that. I'm sure it's gonna be good.”
President Trump says he has a plan “ all ready” -- a claim he’s made repeatedly since 2016.
