Health Care

Health care was a big reason Calif. Democrats won. But don’t expect major changes

The promise of better health care options was a big reason Democrats did so well in California, and they’re pledging to move quickly to vote on major legislation.

But they’re going to have a hard time fulfilling all of their promises.

The Democrats flipped seven Republican-held congressional districts in California, and every Democratic candidate made health care an important part of the campaign, if not the central issue. Drew Godinich, spokesman for the Democratic Congressional Campaign Committee, said health care will continue to be a major issue in 2020 campaigns.

But while Democratic plans should do well in the Democratic-run House next year, they are likely to be easily thwarted in the Senate, where Republicans will control 53 of the 100 seats.

There is one initiative Democrats can plan without the Senate: A House vote to intervene in the Texas lawsuit trying to dismantle the Affordable Care Act, including coverage protections for pre-existing conditions.

That can be approved by a majority vote in the House, without approval from the Senate or the president. Democrats are expected to control 235 of the House’s 435 seats next year.

The vote would authorize House counsel to devote resources to defending the Affordable Care Act in court. It’s similar to how House Republicans intervened in the lawsuit against the Defense of Marriage Act, which outlawed same-sex marriage, when the Obama administration declined to defend the law in court. The Supreme Court ruled against House Republicans in that case.

“The new Democratic House majority will move swiftly,” said Henry Connelly, a spokesman for presumptive Speaker of the House Nancy Pelosi, D-California.

Democrats see themselves working in some areas with Senate Republicans and President Donald Trump, such as passing bills allowing negotiating prices on prescription drugs and increasing availability of generic drugs.

But in other areas, House Democratic leaders are eager to pass some legislation even if it won’t have a chance in the Senate — both to show voters what Democrats could get done without Republicans in control and to make House Republicans take votes that could put them in a politically perilous position.

Pelosi has made it clear she wants to focus on legislation to help lower health care costs.

There is talk of trying to make incremental changes, such as expanding Medicare to include dental and vision coverage.

Democrats also want to reverse Trump’s executive actions regarding the Affordable Care Act, such as his cuts to funding for those who help individuals buy health care coverage using markets established by the Act.

None of those Democratic cost-related plans, though, are likely to get far in the Senate. But Democrats see the ability to make a strong political statement.

“Democrats will be focusing on ways we can expand affordable coverage, including strengthening Medicaid and Medicare and undoing the Trump administration and Congressional Republicans’ health care sabotage,” said Rep. Ben Ray Luján, D-New Mexico, outgoing DCCC Chairman and assistant Democratic leader in the next Congress.

“The American people made it clear this past election that they want Congress to make health care more affordable and accessible, so it would be incumbent on Republicans to come to the table and work with us on passing legislation,” he said.

Democrats also want to have more conversations on how to move towards universal coverage, though senior House Democratic aides cautioned it’s unclear at this point specifically how such a plan would work.

Some members of Congress, including newly-elected freshman, have campaigned on working for Medicare for all.

The importance of the issue was obvious in the campaign for California’s 21st district, where Republicans saw their incumbent Rep. David Valadao as safe.

He’d consistently won the district by a large margin, even in 2016, when Democratic presidential nominee Hillary Clinton won by 15 over Trump.

But Thursday, Valadao conceded to Democratic challenger TJ Cox as it became clear Cox would win by less than a thousand votes.

Cox, like many other Democrats, pointed out Valadao’s votes to repeal Obamacare — the Republican House voted to repeal the legislation 67 times over six years.

Cox also had a personal edge on health care. He’d given funding through his investment business to five health clinics in the area, which he has said provided 26,000 Central Valley residents with health care. His wife, Dr. Kathleen Murphy, is also a pediatric intensive care physician.

Cox sees his election is a mandate from his constituents to continue to find progress on making health care more affordable.

“The Affordable Care Act was the first step and first glimpse towards quality, affordable health care for all,” Cox said. “Seeing Republicans trying to take that away — there was an obvious backlash.”

Kate Irby is based in Washington, D.C. and reports on issues important to McClatchy’s California newspapers, including the Sacramento Bee, Fresno Bee and Modesto Bee. She previously reported on breaking news in D.C., politics in Florida for the Bradenton Herald and politics in Ohio for the Cleveland Plain Dealer.