Mar 31, 2023 - Health

Obamacare ruling gives Democrats new political ammo

Illustration of a megaphone with a red cross in the center

Illustration: Annelise Capossela/Axios

Democrats may hate the substance of yesterday's court ruling striking down elements of the Affordable Care Act — this time, its requirement that employers cover certain preventative care services. But politically, it feeds right into the party's 2024 campaign narrative.

Why it matters: Defending the ACA has been a tried-and-true strategy for Democrats since the GOP tried to repeal it in 2017. Judicial threats to the law easily fold into messaging about right-wing extremist judges that the party has been building on since the Supreme Court overturned the federal right to abortion.

  • And while Republicans may still not be huge fans of the law, its preventative care provisions weren't exactly topping their list of grievances.

Driving the news: Yesterday's decision — written by the same federal judge in Texas who ruled the entire law invalid — essentially forces employers and insurers to decide whether to continue covering certain preventative benefits without cost-sharing.

  • America's Health Insurance Plans, insurers' top lobbying group, said in a statement that "Americans should have peace of mind there will be no immediate disruption in care or coverage."
  • "We fully expect that this matter will continue on appeal, and we await the federal government's next steps in the litigation, as well as any guidance from relevant federal agencies," AHIP added.

Between the lines: It's unclear how insurers would respond should the decision be upheld by higher courts, but even the threat of new patient costs for some cancer screenings, statins for heart disease or HIV prevention drugs presents an opportunity to rail on Republican extremism.

What they're saying: "Yet again, a Republican activist judge has issued a ruling based on MAGA ideology and not the law, that would decimate our healthcare system and is opposed by a vast majority of Americans," Senate Majority Leader Chuck Schumer said in a statement.

  • "This ruling is not only misguided, it is outright dangerous and could cost lives. Whether it is attacking laws like this, taking away a woman's right to choose or trying to gut Medicaid, Republicans must stop their non-stop onslaught on Americans' health care," he added.
  • Republicans were largely silent.

The big picture: A court ruling on eliminating nationwide access to a common abortion pill may be imminent. If FDA approval of the drug is overturned, Democrats would have even more fodder for their argument.

  • Protecting the ACA, known as Obamacare, was a key part of the party's messaging when it recaptured the House in 2018 and has played a role in every election since then. And the overturning of Roe last summer was widely viewed as a liability for Republicans in last year's elections.
  • All of this takes place against a backdrop of sustained messaging from Democrats and the White House about Republican attempts to cut Medicare, Medicaid and Social Security, even though the GOP hasn't formally proposed any such cuts this Congress.

The bottom line: The ruling puts Democrats in a familiar and comfortable position and will likely force Republicans to once again answer for a politically unpopular court decision.

  • "It's another real health care take-away threat that may actually be an unwelcome ruling in some Republican political circles," said Democratic strategist Chris Jennings.
  • "Democratic policymakers don't relish this by any means, but they certainly will highlight the fact that this is a frequently court-hopped judge that was appointed by President Trump whose rulings have been viewed as suspect by many court watchers of all stripes.”
Go deeper