How the Vulnerables Voted on Health Care

Over half of the nearly two-dozen Republicans in districts that Hillary Clinton won last year voted to scrap Obamacare.

Rep. Darrell Issa
AP Photo/Susan Walsh
Ally Mutnick
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Ally Mutnick
May 4, 2017, 5:58 p.m.

Some the most en­dangered GOP mem­bers may have just be­come more vul­ner­able.

Of the 23 Re­pub­lic­ans sit­ting in dis­tricts that went for Hil­lary Clin­ton in 2016, 14 voted Thursday af­ter­noon in fa­vor of the GOP’s Obama­care re­peal—an is­sue which Demo­crats have prom­ised to make a fo­cal point of midterm elec­tions.

Mem­bers like Reps. Car­los Cur­belo of Flor­ida and Dav­id Valadao of Cali­for­nia—whose dis­tricts both backed Clin­ton by double-di­gits—voted with House lead­er­ship on their second at­tempt to pass the Amer­ic­an Health Care Act. Oth­er “yes” votes from mem­bers sit­ting atop Demo­crats’ 2018 tar­get list: Reps. Dar­rell Issa of Cali­for­nia, Erik Paulsen of Min­nesota, and Martha Mc­Sally of Ari­zona.

Few of the Clin­ton-dis­trict GOP in­cum­bents had pub­licly signaled sup­port for the bill as House lead­er­ship raced to fi­nal­ize the whip count. But mem­bers who voted “aye” were quick to put out state­ments de­scrib­ing their votes as the ful­fill­ment of a ma­jor cam­paign prom­ise.

“Today’s vote gives a voice to the vic­tims of Obama­care, the mil­lions of Amer­ic­ans who are pay­ing high­er premi­ums, re­ceiv­ing less cov­er­age and for whom the status quo offered no end in sight,” Issa said in a re­lease.

Re­pub­lic­an Rep. Kev­in Yo­der, whose Kan­sas City-area dis­trict Clin­ton won by a point, struck a sim­il­ar tone, not­ing his “yes” vote chooses “mar­kets over man­dates, in­nov­a­tion over reg­u­la­tion, and pa­tients over bur­eau­crats.” And Cur­belo re­leased a three-minute You­Tube video tout­ing the parts of Obama­care that re­main in the new plan.

All sev­en mem­bers of the Cali­for­nia del­eg­a­tion who hold Clin­ton-won dis­tricts backed the bill. Valadao and Reps. Jeff Den­ham and Steve Knight, whose dis­tricts Trump lost by 3 and 7 points, re­spect­ively, had been pub­licly un­de­cided as of Thursday morn­ing. But they signaled that they would be likely “yes” votes after they signed on as co­spon­sors to an amend­ment from Rep. Fred Up­ton of Michigan that would provide an ad­di­tion­al $8 bil­lion to cov­er those with preex­ist­ing con­di­tions.

Yet, after sev­en years of mak­ing the re­peal a party ral­ly­ing cry, 20 Re­pub­lic­ans still voted against it, many cit­ing con­cerns over its lack of pro­tec­tion for those with preex­ist­ing con­di­tions, even with Up­ton’s amend­ment.

Nearly half of the GOP nays, such as Reps. Bar­bara Com­stock of Vir­gin­ia and Will Hurd of Texas, came from dis­tricts that Trump didn’t carry, though many of those in­cum­bents in­sisted the midterm elec­tions didn’t factor in­to their mo­tiv­a­tions.

“I’m not look­ing for polit­ic­al cov­er. It was just the right vote for my dis­trict,” said Rep. John Katko, who won his up­state New York dis­trict by 22 points even as Clin­ton won by 4. “That’s all I’m con­cerned about.”

But even some mem­bers who didn’t back the bill ac­know­ledged the vote was still polit­ic­ally dif­fi­cult.

“I come from a dis­trict that—part of it’s in the Seattle met­ro­pol­it­an area and the oth­er piece is over the Cas­cade moun­tains, so there’s a lot of vari­ety of opin­ion,” said Rep. Dave Reich­ert of Wash­ing­ton as he left the House Cham­ber on Thursday, not­ing that he hoped the Sen­ate ad­dressed his con­cerns over preex­ist­ing-con­di­tion cov­er­age.

Demo­crats in­sisted Thursday that the ex­tra money al­loc­ated in Up­ton’s amend­ment would be in­ad­equate to cov­er the health costs of Amer­ic­ans with preex­ist­ing con­di­tions, and they sug­ges­ted it would play a ma­jor part in their midterm strategy.

“Which part of a com­pletely ob­jec­tion­able bill is the most ob­jec­tion­able?” said Rep. Denny Heck, the Demo­crat­ic Con­gres­sion­al Cam­paign Com­mit­tee re­cruit­ment chair, spec­u­lat­ing on what might be the most ef­fect­ive parts to high­light in 2018 ads and mes­saging.

An up­dated Con­gres­sion­al Budget Of­fice score for the new bill was not avail­able at the time of the vote—something Rep. Mike Coff­man of Col­or­ado cited as a reas­on for vot­ing against it. A bi­en­ni­al Demo­crat­ic tar­get, Coff­man holds a sub­urb­an Den­ver dis­trict that Clin­ton car­ried by 9 points.

House Demo­crats have already be­gun hit­ting the 14 GOP mem­bers who sent the bill out of com­mit­tees, launch­ing a five-fig­ure di­git­al-ad buy after Re­pub­lic­an lead­er­ship pulled the ini­tial ver­sion of the bill in March. Four of those mem­bers voted against the re­peal on Thursday.

Still, his­tory shows a “no” vote doesn’t al­ways provide enough polit­ic­al pro­tec­tion, es­pe­cially in wave-like con­di­tions. Of the 34 House Demo­crats who es­chewed the 2010 Af­ford­able Care Act, ex­actly half lost reelec­tion any­way as the GOP won a whop­ping 63 seats.

Even Blue Dog Demo­crats like Rep. Ike Skelton of Mis­souri, who spent 34 years cast­ing so­cially con­ser­vat­ive votes, couldn’t con­vince voters to send him back to Con­gress des­pite his vote against Obama­care.

The DCCC seems to be hop­ing for a sim­il­ar res­ult for Re­pub­lic­ans in 2018. It un­veiled its new di­git­al-ad cam­paign just minutes after the vote was fi­nal, blast­ing Re­pub­lic­ans in 30 tar­get dis­tricts, in­clud­ing six who voted against the bill.

“No mat­ter how I vote there’s po­ten­tial rami­fic­a­tions,” said Re­pub­lic­an Rep. Ry­an Cos­tello, a “nay” vote whose sub­urb­an Phil­adelphia dis­trict Clin­ton nar­rowly won last year.

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