June 25, 2020 

Trump Administration Asks U.S. Supreme Court to Overturn the Affordable Care Act

With health care for some 20 million Americans at stake, in the midst of the pandemic, opposition by President Trump and Republicans to the Affordable Care Act (ACA or Obamacare) and moves to undercut it are not popular.  Democrats have and will continue to raise this issue trhoughout the election year (see below).

On June 25, 2020 the Solicitor General filed an 82-page brief in Texas v. California, the Supreme Court case which will decide the fate of the Affordable Care Act (ACA).  The Administration seeks to overturn the ACA. 

Recall that in 2012 a divided U.S. Supreme Court ruled the individual mandate which undergirds the ACA is effectively a tax.  However, in 2017 the Republican Congress passed the Tax Cuts and Jobs Act which included provisions eliminating the "tax" (penalty for noncompliance). 

The crux of the Administration's argument is that, "The individual mandate no longer can be construed and upheld as a valid exercise of Congress’s taxing power because Congress eliminated the tax," and that the mandate cannot be separated from the rest of the Act (severability).  The Administration argues, "If this Court concludes that...Congress’s statutory findings tie the invalid mandate to the guaranteed-issue and community-rating provisions, then it necessarily follows that the rest of the ACA must also fall." 

Oral arguments are scheduled for Fall.  Although there will not be a decision before the Nov. 3 election, the arguments will thrust the issue to the forefront at the peak of the election campaign. 

Timothy S. Jost.  "The Supreme Court Will Decide the fate of the Affordable Care Act—Again."  The Commonwealth Fund, March 3, 2020.
MaryBeth Musumeci.  "Explaining Texas v. U.S.: A Guide to the Case Challenging the ACA."  Henry Kaiser Family Foundation, March 10, 2020.

Biden for President
June 25, 2020

Remarks as Prepared for Delivery by Vice President Joe Biden on the Affordable Care Act in Lancaster, Pennsylvania

Good afternoon.

Today, in the middle of the worst global health crisis in living memory, Donald Trump will file a brief in the Supreme Court to attempt to strip health coverage away from tens of millions of families, and to strip the peace of mind away from more than 100 million people with pre-existing conditions.

If he succeeds, more than 23 million Americans could lose their coverage outright— including nearly a million Pennsylvanians.

Insurers could once again discriminate, or deny services, or drop coverage for people living with preexisting conditions like asthma, diabetes, and cancer.

And perhaps most cruelly of all, if Donald Trump has his way, complications from COVID-19 could become a new pre-existing condition. 
Some survivors will experience lasting health impacts — like lung scarring and heart damage.
And if Donald Trump prevails in court, insurers would be allowed to strip away coverage or jack up premiums — simply because of their battle with the coronavirus.
Those survivors, having struggled and won the fight of their lives, would have their peace of mind stolen away at the moment they need it most.
They would live their lives caught in a vise between Donald Trump’s twin legacies: his failure to protect the American people from the coronavirus, and his heartless crusade to take health care protections away from American families.

I have called on Donald Trump many times to withdraw his lawsuit. Today, I am renewing that call.

Mr. President, drop the lawsuit. Stop trying to take away people's health care.

Now more than ever, stop trying to steal their peace of mind. I cannot comprehend the cruelty that is driving him to inflict this pain on the very people he is supposed to serve.

One of the families the Affordable Care Act has delivered peace of mind to is the Ritters—who live not far from here in Manheim, Pennsylvania.

Jan and Madeline Ritter were just four years old when their mom, Stacie, heard some of the most devastating words that a parent can ever hear. Both of her twins had been diagnosed with leukemia.

I promise you — that news — it stops your heart. It wrenches your entire world off of its axis. And the very last thing on your mind — the very last thing that should be on your mind— is whether you can afford treatment.

But when Stacie’s twins got sick, there was no Affordable Care Act.

So, after the draining days and the endless nights, the harrowing stem-cell transplants, the fickle waves of hope and fear, after enduring more than any parent should have to endure, the Ritters still faced a future where their twins could be denied coverage
for the rest of their lives.

The Affordable Care Act was created to put a stop to that inhumanity — to ensure that people like Stacie, thrust into the worst nightmare of their lives, could focus on the fight that matters.

Stacie’s twins won their fight. They beat cancer — and now, they’re 22 years old. Jan is studying early education at Elizabethtown College. Madeline just graduated from Arcadia University with a degree in international studies. And because of the law, insurance companies can no longer deny them coverage because they’re survivors of cancer.

I'm proud of the Affordable Care Act.

In addition to protecting people with pre-existing conditions, this is a law that delivered vital coverage to more than 20 million Americans.

It’s a law that bars insurance companies from capping Americans’ benefits— and from charging women more simply because they are women.

It's a law that reduced prescription drug costs for nearly 12 million seniors, who would see their those costs spike — because the Medicare ‘donut hole’would have suddenly reopened.

It’s a law that saves lives.

But now, in the middle of the worst public health crisis in modern history, Donald Trump is suing to take the Ritters and millions more Americans — back to the way things were. 

It’s cruel, it’s heartless, and it’s callous. 

And it’s all because he can’t abide the thought of letting stand one of President Obama’s greatest achievements.

We’ve seen that same callousness in his handling of the coronavirus.

Just over three months ago, as most Americans were first coming to grips with the unprecedented scale and danger of the pandemic, President Trump publicly claimed that, “Anybody that wants a test can get a test.”

That wasn’t true. And he knew it.

Then, five days ago, at his campaign gathering in Tulsa, he admitted telling his people to, slow the testing down, please.” At first, his spokespeople tried to say he was joking. But then Trump himself said he wasn’t joking. 

He called testing, “a double-edged sword.” Let’s be crystal clear about what he means by that. 
Testing unequivocally saves lives, and widespread testing is the key to opening up our economy again — so that’s one edge of the sword. 
The other edge: that he thinks finding out that more Americans are sick will make him look bad.
And that’s what he’s worried about. He’s worried about looking bad.

Well, Donald Trump needs to stop caring about how he looks and start caring about
what’s really happening in America.

The number of cases is increasing in 29 states. We are going to be dealing with this for a long time. Trump can’t wish it away. He can’t bend it to meet his political wishes. There are no miracles coming.

We are going to have to step up as Americans — all of us — and do both the simple things — and the hard things — to keep our families and neighbors safe, to re-open our economy, and to eventually put the pandemic behind us.

And sadly — we are going to have to do it without responsible leadership from the White House. So it is up to us. All of us.  

We’re going to have to wear masks. And I know as Americans it’s not something we’re used to. But it matters. All the evidence from all over the world tells us it just might be the most effective thing we can do. 

We’re going to have to socially distance. It’s not easy. It seems so strange to us. Not as Americans, but as human beings. We’re built to talk, to laugh, to hug, to gather with other people. I know I am. I know you are. But for now, we have to socially distance. It matters.

We’re going to have to find a way to keep our economy running as we bring the number of cases down. The president wants you to believe this is a choice between the economy and the public’s health. He still hasn’t grasped the most basic fact of this crisis: to fix our economy, we have to get control of the virus. 

He’s like a child who just can’t believe this has happened to him. It’s all whining and self-pity. This pandemic didn’t happen to him. It happened to all of us. 

And his job isn’t to whine about it. His job is to do something about it. 

If I have the honor of becoming President, I promise you I will lead.

I will do everything I can to take responsibility  and ease that burden on you and your families. I will put your family first. And that will begin with a dramatic expansion of health coverage and bold steps to lower health care costs.

We need a public option now more than ever — especially at a time when more than 20 million people are unemployed.

That public option will allow every American— regardless of their employment status —  the choice to get a Medicare-like plan.

It will force private insurers to keep premiums low and offer better coverage because, for the first time, they’ll have to compete for your business against a public insurer that doesn’t have a profit motive.

We’re going to lower premiums for people buying coverage on their own by guaranteeing that no American ever has to spend more than 8.5 percent of their income on health insurance — and that number will be lower for lower-income families.

We’re also going to further reduce costs by making it less expensive for Americans to choose plans with lower deductibles and out-of-pocket expenses by lowering prescription drug prices and by ending the practice called “surprise billing,” which can leave you with an unexpectedly high bill after you leave a hospital.

Here’s the bottom line: my plan lowers health care costs and gets us to universal coverage quickly when Americans desperately need it.

Families are reeling right now — enduring illnesses, forced into risky choices, losing their employer plans in droves.

They need a lifeline now. That’s what the families here today deserve. That’s what families all across this nation deserve.

They don’t need a president going into court to deny them health care. They need a president going into the White House who will fight for the health care they need.

If Donald Trump refuses to end his senseless crusade against health coverage, I look forward to ending it for him. And working quickly with Congress to dramatically ramp up protections, get America to universal coverage, and lower health care costs as soon as humanly possible.

This is my promise to you. When I am President, I will take care of your health coverage the same way I would for my own family. This is personal to me.

I was sworn into the United States Senate next to a hospital bed. My wife and daughter had been killed in a car crash— and lying in that bed were my two surviving little boys.

I couldn’t imagine what it would have been like if we didn’t have the health care we needed immediately.

Forty years later, one of those little boys, my son Beau, was diagnosed with terminal cancer and given only months to live.

I couldn’t imagine an insurance company coming in and saying, “for the last six months of your life, you’re on your own” — which is exactly what happened to so many families before the Affordable Care Act.

So Amy, I understand.

And when I say I’ll take care of your health coverage the same way I would for my family — there is nothing I take more seriously.

That’s my promise to Stacie and Victoria and Amy and to every American.

That’s what the presidency is — a duty to care.

A duty to care for everyone.

Not just those who voted for us.

For all of us.

And no trust is more sacred, no responsibility is more solemn, no purpose is more fundamental, than for a President to do absolutely everything he or she can to protect American lives.

So I want every single American to know: if you’re sick, if you’re struggling, if you’re worried about how you’re going to get through the day — I will not abandon you.

I will not leave you to face these challenges alone.

We are going to get through this — together.

And we are going to build our health care system, our economy, and our country back better than it has ever been before.

Thank you. God bless you, and God protect our troops.


Biden for President
June 25, 2020


In Lancaster Speech, Joe Biden Slams Donald Trump for Pushing to Dismantle Americans’ Health Care Access During Pandemic

Yesterday, Joe Biden delivered a forceful speech in Lancaster, Pennsylvania slamming President Trump for his push to take away health insurance coverage from 23 million Americans as well as critical protections for people with pre-existing conditions -- all in the midst of a pandemic that has left over 120,000 Americans dead.
Vice President Biden also highlighted the need to protect and build on the ACA while the Trump Administration filed a brief with the Supreme Court last night in favor of invalidating the landmark law in its entirety.
Prior to delivering his remarks, Vice President Biden met with families who have benefited from the Affordable Care Act, including parents of children with cancer and other chronic diseases.
Harrisburg Patriot-News: Joe Biden makes campaign stop in Lancaster, Pa., promising to provide health care for all
[By Ron Southwick, 6/25/20]
Biden also said it was “cruel” and “callous” trying to upend the Affordable Care Act during the coronavirus pandemic, which has led to more than 120,000 deaths nationwide.
He also directly attacked the president for his coronavirus response and for not pushing for more aggressive testing of COVID-19.
“Widespread testing is the key to opening our economy again,” Biden said.
“He thinks finding out that more Americans are sick will make him look bad,” Biden said. “And that’s what he’s worried about. He’s worried about looking bad.”
WGAL: Only on News 8: One-on-one with presumptive Democratic presidential nominee Joe Biden
[By Janelle Stelson, 6/25/20]
Biden also reacted to President Donald Trump blaming the Obama administration for the severity of the coronavirus pandemic.
“The president is bizarre. We left behind a pandemic office. As early as January, middle of January, I was saying, a pandemic is coming. We should be prepared. Why don’t you use the legislation, the act that’s available -- the Defense Production Act -- to make companies move and build the things they need to build. Provide the protective gear. Build hospitals. What did he do? He waited and waited,” Biden said.
NBC News: Biden ties COVID-19 to Trump's 'callous' Obamacare assault: 'A new pre-existing condition'
[By Adam Edelman, 6/25/20]
Joe Biden on Thursday warned that President Donald Trump’s attempts to dismantle the Affordable Care Act will have disastrous consequences on Americans who become infected with the coronavirus, demanding in a fiery speech that the "callous" president end a lawsuit that is seeking to terminate the landmark health care law.
"He’s like a child who just can’t believe this has happened to him. It’s all whining and self-pity," Biden said of Trump's coronavirus response during a speech in Lancaster, Pennsylvania. "This pandemic didn’t happen to him. It happened to all of us."
Addressing Trump directly at another point, Biden said, "Mr. President, drop the lawsuit. Stop trying to take away people’s health care and their peace of mind."
New York Times: Biden Hits Trump’s Coronavirus Response: ‘He’s Worried About Looking Bad’
[By Reid J. Epstein, 6/25/20]
WASHINGTON — Former Vice President Joseph R. Biden Jr. on Thursday laced into President Trump, condemning him for saying he ordered a slowdown of coronavirus testing and comparing the sitting president to a whiny child.
“He admitted telling people, and I quote, ‘You have to slow the testing down, slow it down please,’” said Mr. Biden, the presumptive Democratic presidential nominee. “He thinks that finding out that more Americans are sick will make him look bad. That’s what he’s worried about, he’s worried about looking bad.”
Mr. Biden’s speech, delivered at a gymnasium in Lancaster, Pa., was intended to focus attention on his call to expand protections under the Affordable Care Act. Mr. Biden warned that insurance companies, if freed from the federal mandate to cover pre-existing conditions, could deny coverage to people who had recovered from the coronavirus. And he called the Trump administration’s legal efforts to overturn the 2010 health care law “cruel.”

Biden for President
June 25, 2020


Jill Biden Hosts Virtual Affordable Care Act Event in Florida with Congressman Charlie Crist

Today, Jill Biden held a virtual event on the Affordable Care Act with Congressman Charlie Crist in Tampa, Florida. Members of the Tampa community shared their stories about the ways the ACA has helped improve their lives and the importance of having a president who will treat health care as a fundamental right.
“Health care is more than doctors and hospitals and medicine, it’s about receiving the support and services we need to remain safe in our homes and communities,” said Karen Clay, Chair of the Florida Democratic Disability Caucus. “We don’t want to go back to the days where we aren’t treated because of a preexisting condition, lifetime caps, or waiting lists. We cannot go back.”
“Our country is reeling in anguish as we face three simultaneous crises at once,” said Congressman Charlie Crist. “A crisis that has killed nearly 120,000 Americans, an economic crisis that has left 20 million unemployed, and a crisis of systemic racism whose ugly head has risen again. This moment has been a wake up call for so many, but unfortunately not for Donald Trump. It’s clear: Americans need health insurance now, more than ever. But instead of trying to expand life-saving care, the President is in court trying to overturn the Affordable Care Act and strip millions of Americans from their coverage in the middle of a deadly pandemic. Tens of millions of  American depend on Obamacare for insurance and Latinos and African Americans benefited the most from the law. The law protects over 100 million with pre-existing conditions, and not to mention those that may develop a condition through COVID-19. [Trump] must drop this lawsuit now. In stark contrast, our friend Joe Biden will not only protect the Affordable Care Act, but would expand on it to make health care more affordable for every single American.”
“We all know that the ability to take care of our health is the foundation of a good life,” said Jill Biden. “But these past few months have shown it’s so much more than that. It’s the foundation of our communities and our economy. If we want Americans to contribute to our communities, then we need to make sure they get care. If we want children to succeed in school, then they need to be able to get check ups when they need them. If we want our businesses to thrive, then workers need to be able to invest in their health. The ACA was a huge step forward, but it was always meant to be a starting point. And with millions of Americans counting on the ACA to stay covered during this pandemic, we have to protect and keep building on it - and that’s Joe’s plan. Like you said Charlie, Joe understands health care is a right, not a privilege. It won’t be easy to do. But neither was the ACA.”

Democratic National Committee

TO: Interested Parties
FROM: DNC War Room
DATE: Thursday, June 25, 2o20
RE: Trump Moves Forward With Health Care Repeal Case That Would Take Health Care Away From Millions During A Pandemic

Today, Trump’s Department of Justice and Republican attorneys general will submit briefs in California v. Texas to invalidate the Affordable Care Act. During the worst health crisis of our time, Trump and Republicans are fighting to strip protections from as many as 133 million Americans with preexisting conditions and take health care away from 20 million Americans.

Americans are relying on our health care system now more than ever before, and the ACA is one of our most critical tools to protect Americans from the consequences of the coronavirus. Now, as more than 20 million Americans are unemployed, Trump and Republicans are moving full steam ahead with their lawsuit.

The ACA is more popular than ever for one simple reason: it works. The ACA has significantly reduced the ranks of the uninsured; it’s helped Americans get the health care they need and helped keep them from being bankrupted just because they get sick. But even as Trump quietly relies on key provisions in the ACA to fight the spread of the virus, he and Republicans will stop at nothing to take the entire law away. 

In the midst of a global pandemic, the ACA is one of our most critical tools.

Comprehensive Coverage: The ACA established what are known as “essential health benefits,” mandating coverage of services like prescription drugs and hospitalization. Coronavirus testing and treatment are essential health benefits and must be covered by all ACA-compliant plans.

Access To Critical Vaccinations Without Cost Sharing: Once a coronavirus vaccine is developed, the Affordable Care Act will almost certainly cover the coronavirus vaccine without cost-sharing, because it requires plans to cover all vaccinations recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP).

Protections For As Many As 133 Million Americans With Preexisting Conditions: Under the ACA, insurance companies are not allowed to discriminate against those with preexisting conditions by denying them coverage or charging higher rates.

Coverage for 20+ Million People: Because of the ACA, more than 20 million Americans gained health coverage. People with insurance are much more likely to see a doctor when they are sick and to get the treatment they need.

Increased CDC Funding: The Affordable Care Act established the CDC Prevention and Public Health Fund, which helps states prepare for disease outbreaks.

Medicaid Expansion: Because of the ACA, states can get additional federal money to expand Medicaid to vulnerable populations. More than 17 million Americans now have coverage through Medicaid expansion. Importantly, Medicaid’s funding structure allows funds to increase in response to a public health emergency like coronavirus.

Key Support For Rural Hospitals: The ACA significantly reduced uncompensated care costs. Between 2013 and 2015, hospitals’ uncompensated care costs decreased by $12 billion, or roughly 30 percent. As hospitals face an influx in coronavirus patients, it is critical that they are paid for the treatment they provide.

Even as he tries to destroy the law, Trump has been forced to rely on key provisions of the ACA to fight the spread of coronavirus.

Essential Health Benefits: The Trump administration urged health insurers to make testing free by considering it an “essential health benefit,” despite simultaneously arguing in court to overturn this protection of the ACA.

Medicaid Expansion: Trump championed cuts that would kick millions of people from its rolls, the Trump administration is now playing catch-up and has approved state waivers making it easier for poor Americans to get care through Medicaid. But the administration’s coronavirus response is weakening Medicaid by skimping on aid for Medicaid providers to the benefit of large medical systems.

Nursing Home Inspections: The Trump administration announced new initiatives to protect nursing homes but has continued pushing forward with rolling back regulations aimed at preventing infections from spreading in nursing homes.

Trump will keep lying to Americans about protecting their health care — but he has already broken his biggest health care promises.

Fewer Americans Covered: Trump promised that whoever “wanted health care” would have it under his administration, but the Trump-backed lawsuit could cause more than 20 million Americans to lose their insurance.

Rising Health Care Costs: Trump promised he would put a stop to rising health care costs and even reduce them — but his lawsuit would raise out-of-pocket costs for premiums and prescription drugs.

No Preexisting Condition Protections: Trump promised to support preexisting condition protections and said that costs for people with preexisting conditions would be “much lower” under his leadership — but his lawsuit would end these vital protections.

Gutting Medicaid Access: Trump promised to protect Medicaid — but his lawsuit would end access to Medicaid for millions of Americans enrolled through the ACA’s expansion program.

Democratic National Committee
June 25, 2020

In The Battlegrounds: Democrats Slam Trump’s Broken Promises As Republicans Continue ACA Lawsuit

Today, as Donald Trump and Republican-led states filed briefs at the U.S. Supreme Court to strike down the Affordable Care Act, Democrats across the battlegrounds slammed Trump and the GOP for pushing a toxic health care agenda that threatens coverage, spikes costs, and jeopardizes protections for Americans with pre-existing conditions — even in the midst of a global pandemic. Take a look:

AZ Dems:  “The Affordable Care Act has been a critical lifeline for Arizona families who have been left reeling from Donald Trump’s catastrophic coronavirus response. But instead of working to deliver relief to our communities, Trump and the GOP are hellbent on ripping away health care coverage from Arizona families in the midst of a global pandemic. Arizonans deserve leaders who will keep their promises and fight to expand coverage, lower costs, and secure protections for pre-existing conditions  — not wage attacks on our health care when we need it most.”

CO Dems: “Today, with the support of Senator Cory Gardner, the Trump Administration and the GOP will submit briefs recklessly urging the U.S. Supreme Court to overturn the Affordable Care Act (ACA), which would rip care away from an estimated 470,000 Coloradans, endanger protections for 2.4 million Coloradans with pre-existing conditions, and undermine the nation’s public health response to coronavirus.”

FL Dems: “‘While Floridians are trying to stay afloat during the dual health and economic crisis born of the coronavirus pandemic, Donald Trump is still forging ahead with his lawsuit to strip millions of Americans of their health care,’ said FDP Chair Terrie Rizzo, ‘Today is a reminder of just how important it is for Floridians to elect Joe Biden in November -- we need a president who will treat health care as a right, not a privilege and work tirelessly to make that a reality for all Floridians.’”

GA Dems: “During the worst health crisis Georgians have faced in our lifetimes, it is unconscionable that Donald Trump and Republicans including Chris Carr are moving forward with their cruel lawsuit to overturn the Affordable Care Act. Tens of thousands of Georgians have lost their jobs and health insurance because of Trump’s chaotic, failed pandemic response.”

MI Dems: “‘Even a global pandemic can’t stop Donald Trump’s relentless fight to strip health care from over 700,000 Michiganders,’ said Michigan Democratic Party spokesman Christian Slater. ‘His latest attack is a shameful continuation of a war on health care that will devastate working families in our state.’”

NC Dems: “Today’s filing by the Republicans and the Trump administration is a purely partisan attempt to undo years of progress when it comes to accessible health insurance. Millions of North Carolinians depend on the protections of the ACA, and Republicans have made it clear that they will never stop their assault on these benefits. This is an attack on working families in our state, and come November, we’ll remind Donald Trump and his allies that they can’t get away with it.”

NH Dems: “Today, Trump is continuing his lawsuit to destroy the #AffordableCareAct. Yes, in the middle of a pandemic! Trump knows if his lawsuit is successful, 23 million Americans will lose their health care. And he doesn't care. We cannot let Trump get away with this.”

NV Dems: “It’s the same old tired playbook with Trump and Republicans--despite Americans favoring the ACA and repeated failed attempts to repeal the law, they will stop at nothing to ensure hundreds of thousands of Nevadans lose their care.”

OH Dems: “Yesterday the U.S. had its highest single-day total of new coronavirus cases reported since the crisis began. Today the Trump administration is trying to convince the U.S. Supreme Court to throw out the Affordable Care Act. [...] Here in Ohio, this lawsuit would have devastating consequences if Trump and the GOP are successful. The Center for American Progress estimates that more than 860,000 Ohioans could lose their health coverage.”

PA Dems: “Access to health care has never been more critical, but Trump and his allies just don’t get it. Democrats in Congress are working on new legislation to lower costs, expand coverage, and strengthen protections for pre-existing conditions. The contrast has never been more clear: while Republicans are working to rip away health care, Democrats are fighting to make access easier and expand coverage. Voters have a choice in November and they’ll choose the side that cares about the health and well-being of their families.”

TX Dems: “In the middle of a global pandemic, Texas Trump Republicans, like indicted Attorney General Ken Paxton, continue their attacks on the Affordable Care Act. For millions of Texans, the law has never been as important as it is now. If Republicans are successful, nearly 2 million Texans will lose healthcare coverage. That is unacceptable and flat out wrong. [...] We should be fighting to protect and expand healthcare for all, not cutting off access for millions of people.”

VA Dems: “741,000 Virginians stand to lose their health care if the ACA is repealed. Drop the lawsuit.”

WI Dems: “What's more is Trump is continuing his callous crusade to repeal the ACA, which would strip millions of Wisconsinites of their health insurance, threaten protections for people with pre-existing conditions, and eliminate an affordable option for those who lost their employer-based health care during this pandemic. This is nothing more than a cheap ploy that Wisconsinites will see through as they plan to vote for Joe Biden come November.”


May 19, 2020


To: Interested Parties

From: DNC Chair Tom Perez, DSCC Chair Catherine Cortez Masto, DCCC Chair Cheri Bustos, DGA Chair Phil Murphy, DAGA Co-Chairs Maura Healey and Ellen Rosenblum, DLCC Chair Andrea Stewart-Cousins

Date: May 19, 2020

Subject: Health Care Is On Every Ballot, From Top To Bottom
“Sadly, not even a global pandemic can stop Republicans from fighting to take health care coverage away from millions of Americans. It is the worst possible time to try to dismantle our health care system. But Republicans at every level of the ballot are fighting in court to take away people’s health care – or blocking millions of working families from life-saving Medicaid coverage. Voters know that Democrats are the party of health care. We’re going to keep reminding them of that through November.”

Democrats experienced tremendous electoral success in ’17, ‘18, and ‘19 by running on health care. Democrats flipped 435 state legislative seats, 4 state AG seats, 9 governors’ seats, 3 Senate seats, and 40 seats in the US House, as well as control of the Speaker’s gavel by promising to work to lower health care and prescription drug costs, expand access, and oppose Republican attacks on Americans’ health care. Since those wins, Democrats at all levels of government have kept those promises, using their offices to expand Medicaid, work to lower health care and prescription drug costs, defend the Affordable Care Act (ACA) in court, and stand firmly against Republican efforts to eliminate protections for Americans with pre-existing conditions.

Health care remains top of mind for voters in the 2020 elections
, and Democrats have continued to focus on this defining issue this cycle. The COVID-19 epidemic underscores the urgency of our efforts to protect Americans’ access to affordable health care.

The Republican Attorneys General lawsuit to eliminate the ACA, 
including pre-existing conditions coverage and other benefits, makes this issue of life and death even more stark as we face a public health crisis.

Their reckless lawsuit puts in jeopardy the ACA’s protections for the newly jobless, Medicaid recipients, and Americans battling COVID-19. The lawsuit risks eliminating cost-sharing for vaccinations, essential health benefits, and other protections that doctors, hospitals, and public health experts have deemed essential to combating the epidemic. On schedule to be heard by the Supreme Court in the Fall of 2020, this lawsuit threatens dismantling our health care system amidst a pandemic that has already killed over 90,000 Americans and infected over 1 million more.

Republican Attorneys General (several of whom ran for governor or U.S. Senate 2018 and four of whom are running for re-election this November) filed the litigation in Texas v. Azar – now called California v. Texas. The Trump Administration joined their cause, and House Republicans repeatedly voted in favor of the Trump Administration’s efforts. In fact, the House and Senate Republicans’ vote for the GOP tax law made the entire lawsuit possible. Then, Republicans doubled down on their efforts to undermine the Affordable Care Act, even as it became undeniable that the law is critical tool for combating the virus.

Republicans at all levels own this lawsuit’s attack on Americans’ health care.
 They will be held responsible for their party-wide obsession with throwing our health care system into chaos and stripping health care from 20 million Americans during a global pandemic. Republican governors and state legislators haven’t waited for the Supreme Court to issue a decision in California v. Texas, either. Their opposition to expanding Medicaid already endangers health care access for millions of Americans during this crisis.


While Trump and Republican Attorneys General refuse to back out of the ACA repeal lawsuit, several high-profile Republicans have come to realize the trouble their attacks on health care have created for them politically. Though none have said it quite as explicitly as the senior Republican strategist who told CNN in May that, “Republicans can’t afford to litigate health care for the second election in a row,” some have come close.

U.S. Attorney General William Barr warned the Trump Administration before its deadline for filing its briefing in California v. Texas that seeking to repeal the entire Affordable Care Act would hurt Republicans in the November elections. Similarly, retiring Republican Senator and Senate, Health, Education, Labor and Pensions Chairman Lamar Alexander voiced his frustration about the lawsuit during a May appearance on Meet The Press. Endangered House Republican Rodney Davis changed his position on whether to open the ACA’s health insurance marketplace depending upon who was interviewing him. In early April, he repeatedly stated he would defer to the Trump Administration’s judgment, but after being dogged by media outlets for weeks,

Davis suggested the exact opposite position to an interviewer later that month. Republican gubernatorial candidates have attempted to have it both ways on this issue – in Montana, Greg Gianforte has said he would continue to vote to dismantle the ACA, piece by piece,  while pretending Montana’s popular Medicaid expansion doesn’t rely on the ACA’s existence. Republican Attorneys General in swing states like Ohio and Montana even chose to file briefs in support of parts of the law.

Publicly available polling on health care is stark for Republicans. In January, multiple outlets reported that the President berated Health and Human Services Secretary Azar over the President’s abysmal health care approval ratings. On May 11, Navigator Polling found that 53 percent of registered voters disapprove of the President’s handling of health care and that voters trust Democrats in Congress to improve the health care system over the President by a 14-point margin. Similarly, a late April DCCC poll of 41 Trump-won districts and 23 Clinton-won districts found that Republicans are most vulnerable on health care – with 62 percent of likely general election voters souring on Republicans after hearing they are still attacking health care amidst the COVID-19 pandemic. Morning Consult/Politico polling found that the majority of Americans disapproved of the President’s decision to keep the health insurance marketplaces closed. NBC/Wall Street Journal polling in March measured ACA approval at its highest point in ten years of polling with a +7 favorability rating amongst voters. Democratic governors, working closely with public health experts, have also received higher approval ratings for their leadership during this crisis than their Republican counterparts.

We only need to turn to the story of Medicaid expansion to see how this will play out for Republicans this Fall. After years of fighting and losing this health care battle, the former head of the RGA declared: “The battle has been fought and lost on Medicaid expansion.” The message may not have reached every Republican however: in North Carolina, where Democratic Governor Roy Cooper has navigated the state through the crisis, his Republican opponent still opposes Medicaid expansion and has refused to oppose the ACA lawsuit which would undermine the health care of millions.

It’s too late for Republicans to walk back their years of attacks on the Affordable Care Act and the lifeline it provides to millions of Americans. For more than a decade, Republicans have been the architects of countless votes to repeal, lawsuits, electoral blockades, and executive intransigence that continue to threaten access to affordable health care for millions while the nation battles a deadly virus.

In the presidential campaign
, the DNC is holding Trump accountable each day by responding to his false claims about protecting American’s health care, highlighting how he is trying to take health care away from millions during a pandemic, and holding events in key battleground states with state leaders, surrogates, and everyday Americans who can localize and define Trump’s disastrous health care agenda.

At the U.S. Senate level,
 vulnerable Republican incumbents are being held accountable for voting repeatedly to dismantle the health care law, enabling the dangerous Republican lawsuit against the ACA with their tax scam, confirming a slew of anti-health care judges, and defending ‘junk’ insurance plans. Most importantly, GOP senators have to own their records of voting to gut protections for their constituents with pre-existing conditions. Flipping the Senate will mean protecting the progress we’ve made on health care, bringing down costs, and expanding access to coverage.

At the congressional level
, Democrats will continue to hold Republicans accountable for their votes to repeal the ACA and their continued support of the Republican lawsuit. Republicans lost the majority in 2018 in part because of their votes to eliminate protections for Americans battling pre-existing conditions. In 2020, they’ll have to defend their votes to let insurance companies discriminate against patients battling COVID-19. House Republicans twice voted to support the Republican ACA lawsuit – and Republican challengers have continued to support repealing the ACA. House Democrats will continue to remind voters that our majority is the firewall against Washington Republican efforts to take away their health care during this pandemic.

At the gubernatorial level, 
Democratic governors will continue to fight for Medicaid expansion and hold Republican nominees and governors accountable for the human cost of opposing expanded access to health care. In gubernatorial races in 11 states this year, Democrats will make the case for evidence-based policymaking that protects lives and livelihoods. The DGA will also hold Republicans accountable for opposing widely popular and life-saving policies like Medicaid expansion, targeted restrictions during the COVID-19 pandemic, and commonsense safety nets that would protect Americans from the fallout of unforeseeable emergencies.

At the state attorney general level, 
Democratic Attorneys General will continue to fight to save the ACA and health care for millions of Americans. DAGA will continue to put access to affordable health care front and center this election cycle. Access to affordable, lifesaving health care is on the line, and there’s no clearer distinction for voters than Democratic Attorneys General on one side of the Supreme Court case defending health care and Republican Attorneys General on the other side trying to take that health care away. All four of the Republican Attorneys General incumbents running for re-election this year are part of the GOP coalition in the ACA repeal case – Indiana AG Curtis Hill, Missouri AG Eric Schmitt, Utah AG Sean Reyes, and West Virginia AG Patrick Morrisey. Additionally, Republican AG candidates running for the open seat in Montana, and the ones challenging Democratic incumbents in North Carolina and Pennsylvania are on the record supporting the repeal of the ACA. It is hard to imagine how these GOP incumbents and candidates will explain the heightened risks to our entire health care system and our families’ health during a global pandemic. DAGA will pressure Republican Attorneys General and candidates for an explanation and be sure to remind voters where these candidates really stand on this top voting issue.

At the state legislative level, 
Democrats will spotlight the Republican failure to expand Medicaid and their efforts to undermine the ACA. GOP legislators have governed in lockstep with the Trump Administration’s continued attacks on health care. Our Democratic legislators and candidates are laser-focused on the need to protect and expand health care in their states.

Republicans can’t afford another cycle of Democratic attacks on their health care policy. But even more so, the American people can’t afford two more years of Republican attacks on their health care.