As voters cast their ballots in the Atlanta suburbs on Tuesday, they’ll do so against the backdrop of a national health care debate that has energized Democrats and emerged as a top issue for constituents.
Georgia voters will vote Tuesday in the special House election to replace now-Health and Human Services Secretary Tom Price. A Democratic upset could send a threatening signal to Republicans for the 2018 midterms after their plans to deliver on Obamacare repeal stalled.
Democrats also hope next year’s open governor seat will be ripe for the picking in the Peach State, with Republican Gov. Nathan Deal term-limited. Georgia is one of a swath of Southern states where Hillary Clinton improved on President Obama’s reelection-campaign results. And Democrats have noticed: Georgia House Democratic Leader Stacey Abrams has already grown her caucus’s supporter list by thousands, two years before the next statewide election, thanks to dissatisfaction with President Trump.
“Georgia Democrats have seen a tremendous increase in engagement around the issue of health care,” Abrams said through a spokesperson Monday, “with the potential repeal of the Affordable Care Act and energy catalyzed by opposition to the Trump agenda drawing hundreds to town halls across the state.”
Price won a seventh term handily in 2016, while Trump carried the district by only 1 point. But that was before House Republicans’ efforts to repeal Obamacare came to a halt.
Robert Blendon, a professor of health policy and political analysis at Harvard University, said this has no doubt energized Democratic voters and a win would be a big warning for Republicans in 2018 elections.
“Having issues that you said you would fix and not doing anything about them is not a way to get your own voters excited,” Blendon said.
Democrats hope to make the race in part a referendum on Price. The lone major Democratic candidate in the race, Jon Ossoff, promised in one ad to “find common ground to fix Obamacare while keeping what works,” saying that “repealing it makes no sense.”
Polling recently conducted by SurveyUSA showed voters in the district agreeing with that preference. MoveOn.org Political Action, a progressive activist group, released its own polling earlier this month by Lake Research Partners showing health care as “the top issue in this district.”
“As these numbers show, Republicans will pay a steep political price in even conservative districts like GA-6 for their reckless health care plans,” MoveOn Political Action’s executive director, Ilya Sheyman, said in a statement.
The policy stakes are high in Georgia, which U.S. News and World Report ranked as one of the worst states for health care access. The fate of Obamacare’s insurance exchanges, in Georgia as well as other states, will be closely watched as insurers await a decision on whether cost-sharing reduction payments will continue.
While the marketplaces in large metro areas like Atlanta are healthier with more competitors, large areas of the state have only one available insurer, said William Custer, director of the Center for Health Services Research at Georgia State University. He added that, in the rural areas, there is adverse selection and the population is not large enough to “spread risk in a real way.”
The counties in Price’s former district have between two and four insurers participating this year, according to the Kaiser Family Foundation.
Sen. David Perdue has reportedly expressed the need to work with Democrats on the health care overhaul, while the administration has recently blasted Democrats for not contacting them to help save Obamacare.
Georgia Republicans have shown a desire to engage on the issue. Soon after Republicans pulled legislation that would have repealed substantial portions of the Affordable Care Act, Deal reportedly said he is eyeing changes to the Medicaid program, potentially including changes to “mandated minimum coverage” provisions. (Trump, for his part, doesn’t seem to mind. While meeting with first responders to the I-85 bridge collapse on Thursday, he called Deal, a former congressman, “a terrific guy” who he knows “very well.”)
“We are exploring a variety of solutions that bring Georgians greater flexibility and access to care,” spokeswoman Jen Talaber Ryan said when asked about the governor’s plans for Medicaid. “No specific proposals have been decided upon, but he will continue working with members of the General Assembly to evaluate all options.”
Lt. Gov. Casey Cagle, who last week filed to run to replace Deal, said earlier this year that 14 percent of Georgians don’t have health care, “ranking our uninsured among the highest levels in the nation.” Cagle launched the Health Care Reform Task Force to partner with the new administration on changes to the health care system.
“We can position our state to explore full flexibility with block-grant funding in order to give patients better care at more affordable costs,” he said in a speech in January.
Nick Ayers, an aide to former Gov. Sonny Perdue and a political adviser to a pro-Trump super PAC, America First Policies, is also reportedly considering running for governor. Ayers has been a confidant to Vice President Mike Pence, Trump’s apparent liaison to conservative Republicans on the Hill as they seek an Obamacare overhaul. Perdue himself is expected to enter the Trump administration, pending his confirmation as secretary of Agriculture.
One thing Republican gubernatorial hopefuls are not doing is publicly signing on to any plans to expand Medicaid. A spokesman for Secretary of State Brian Kemp, the other major Republican in the race, did not respond to a request for comment.
“For a Republican candidate to survive a Georgia primary, … to be for Medicaid expansion would probably be a killer,” Republican political consultant Seth Weathers said. “I can’t imagine a candidate surviving that.”