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Senate vote on health care likely fodder for both parties

The U.S. Capitol dome is seen, Monday, July 9, 2018, in Washington.

Carolyn Kaster / AP

Last Updated Oct 11, 2018 12:13 PM EDT

Days after ending a turbulent Supreme Court confirmation fight, the Senate turned back to health care — with a battle squarely aimed at coloring next month's crucial elections for control of Congress. On Wednesday the Senate rejected a Democratic attempt to stop President Trump from expanding access to short-term health care plans, which offer lower costs but skimpier coverage. It was clear from the outset that Democrats would lose, and even if the measure had managed to get through the Senate, it would certainly have died in the Republican-run House.

Still, Democrats succeeded in forcing Republicans to cast a health care vote that Democrats would be able to utilize in campaign ads for next month's midterm elections, in which they hope to topple the GOP's 51-49 Senate majority. The vote was also aimed at refocusing people away from the Senate's nasty battle over confirming Brett Kavanaugh to the Supreme Court.

Wednesday's vote was about showing whether Congress will "allow insurance companies to scam Americans with cut-rate health insurance," said Senate Minority Leader Chuck Schumer, D-New York. "I wouldn't want to be on the wrong side of that vote."

Republican Sen. Cory Gardner of Colorado insisted it was actually the Democrats who had done themselves no favors with the vote.

"Look, if they want to take away people's health insurance and that's what they're campaigning on for the next several weeks, I think it's a losing strategy," said Gardner, who heads the Senate GOP's campaign organization.

Using regulations, Mr. Trump has moved to let people buy short-term insurance that could last one year — and up to three years if renewed. President Obama's health care law, which Mr. Trump and Republicans have weakened but failed to repeal, created more limited versions of those plans, lasting up to just three months. The policies are for people who don't get coverage at work.

The administration says premiums for the new short-term plans will be about one-third the cost of comprehensive coverage that Obama's law requires. Mr. Trump on Wednesday told Fox News that his White House would be coming with alternatives to the ACA that are "just as good and in some cases may be even better."

"We've been able to keep the premiums down much lower than they had previously during the Obama administration. And that's good. And that was -- that's really through good management of health care. And we have things happening on health care that are going to be very, very exciting," he added. 

Republicans have promoted them as a low-cost option for strapped consumers after years of steadily rising premiums, which they blame on Obama's law, and GOP candidates will be happy to use Wednesday's vote to make that point.

"It's not surprising that Senate Democrats are fighting to take away people's choices on health care, to drive up premiums," said Sen. Ted Cruz, R-Texas, who's facing a robust re-election challenge from Democratic Rep. Beto O'Rourke.

However, unlike coverage under Obama's statute, the new policies don't require coverage for people with pre-existing conditions. The government has estimated those people number from 50 million to 130 million, making them a potent political talking point for Democrats. The short-term insurance also doesn't have to cover a menu of services like prescription drugs and could cap beneficiaries' benefits. Democrats call the plans "junk insurance" because, they say, the policies will leave unwary consumers purchasing dangerously meager packages.

"Anyone who supports coverage for people with pre-existing conditions should oppose Mr. Trump's "expansion of these junk insurance plans," said Sen. Tammy Baldwin, D-Wisconsin, who is running for re-election and introduced the Democratic measure.

On its face, Wednesday's fight was over repealing Mr. Trump's new rules. But practically speaking, it served to bring attention back to the overall issue of health care, which, according to several polls, ranks at the top of the public's priorities and has been a major concern for voters for over a decade.

It also comes as campaign operatives assess whether the Kavanaugh battle will overshadow what has been shaping up as a voters' referendum on Mr. Trump, colored by candidates' views on health care and the economy. Virginia Sen. Tim Kaine thinks voters are moving on from the acrimonious Kavanaugh confirmation process.

"Kavanaugh's in the rear-view mirror," said Sen. Tim Kaine, D-Virginia, who spends weekends campaigning and is expected to be easily re-elected next month. "What people are asking me about is health care."

Consultants for both Republicans and Democrats have said initial polling has shown newfound enthusiasm among conservatives, who until the court fight were far less excited about voting than their liberal, anti-Trump counterparts. 

"Whatever difference in enthusiasm Republican voters may have had going into the fall elections has been eliminated," Senate Majority Leader Mitch McConnell, R-Kentucky, told reporters.  

But it's difficult to say whether conservative enthusiasm will last until Nov. 6 or fade, leaving Republicans subject to a historic pattern of midterm congressional losses by the party holding the White House and the prevailing controversies under Mr. Trump.

The Democratic effort to block Trump's short-term plans lost 50-50, with legislation needing a majority to pass. They forced the vote under a seldom-used procedure that makes it easier for lawmakers to try repealing recent federal regulations.

Sen. Susan Collins, R-Maine, the only lawmaker to join the other side in the vote, complained that the plans could deny coverage to people with pre-existing conditions. Sen. Lisa Murkowski, R-Alaska, voted against the Democratic proposal, saying people in her high-cost state could benefit from the low-cost option.

Last year, Collins and Murkowski helped defeat Trump's effort to repeal the Affordable Care Act.

Mr. Trump, however, insisted the new plans would continue to cover pre-existing conditions.  

"We are 100 percent for pre-existing and covering people with pre-existing conditions. And actually, if you look at my last, you know, for many months, speeches,...I say we will cover pre-existing conditions," Mr. Trump told Fox. 

He added, "The difference is that Democrats won't be able to do it because it doesn't fit in their plans and it doesn't work monetarily. They will never be able to do it."