Mark Wilson / Getty Images on a proposed protection plan for people with pre-existing health conditions
Obamacare – as the Affordable Care Act is well known – will not be on the ballot next month. But the fate of the eight-year old health bill could determine which party would gain control of Congress in November.
"Medicare for All" – the progressive alternative to Obamacare – also wins or loses ground.
And the Trump government will look for a green light to further change their healthcare.
Republican strategist Karl Rove wrote about what is at stake in a recent Wall Street Journal column. The headline described health care as the "threshold problem" of the 2018 midterm elections.
Republican Lou Hendricks agrees. The Kansas City retiree told pollsters that health care is high on his list as he ponders his interim vote.
"One of the great concerns we have as a family is ensuring that continued reporting on past conditions, said Hendricks.
Sen. Claire McCaskill, D-Mo., In a tough fight for reelection McCaskill describes her own fight against breast cancer in a new campaign.
"I do not talk much about it," she says of a video showing the senatorial meeting with other women. "Those who facing cancer and many other diseases have a precondition when it comes to health insurance. "
McCaskill bombs her Republican opponent, Missouri Attorney General Josh Hawley, for joining a lawsuit seeking to lift Obamacare and its demands Insurance companies offer cover regardless of a person's medical history.Republicans insist that they include patients with pre-existing ones n diseases, even though they vaguely said how to do it.
Democrats across the country have adopted this problem. Health care dominates campaigns that outperform jobs, taxes and immigration.
"The Democrats have laser focus on health care this year," said Erika Franklin Fowler, who follows campaign ads for the Wesleyan Media Project.
It is a reflection of past electoral cycles as Republicans launched a blitzkrieg with ads attacking Obamacare while Democrats largely remained silent.
"Regardless of how Americans think about the Affordable Care Act, there are provisions that are very popular," Franklin said. "Once it has become clear that these provisions are in trouble, that has changed the way politicians talk about it in this cycle."
Democrats are determined to protect these popular provisions if they win one or both houses of Congress in November. On the other hand, if the Republicans stay in control, they could take another run on the lifting of Obamacare.
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"Many Republicans want the ability to finish the job," said Jessica Anderson, vice president of the conservative group Heritage Action. "They've been campaigning for over eight years."
Anderson said that even if Republicans lost in November, they could make one last attempt to pick up Obamacare during the Lame-Duck meeting. The late Senator John McCain (R-Ariz.), Who had supported the campaign's final lifting, has now been replaced by Jon Kyl, a more reliable GOP poll.
No matter which party controls Congress next year, the Trump administration will likely try to blow away Obamacare. For example, the administration has already relaxed regulations to allow for reduced insurance with reduced coverage.
"The President will still be in office, and his government will still be active," Anderson said.
But if the Democrats gain control of both chambers, they might be able to slow down those efforts
"What you're likely to see is much bigger and even fierce oversight over the administration's efforts to change – and many would say undermining the Affordable Care Act, "said Drew Altman, president of the Kaiser Family Foundation, a health research organization.
Hendricks described himself in Kansas City as a fan of the Affordable Care Act. But more and more he tends to adopt a single-payer insurance system that progressive advocates like to refer to as "Medicare for All."
"It makes it easier and easier for everyone," Hendricks said, "with the exception of Aetna, Blue Cross / Blue Shield, join the health insurance here."
President Trump has gone on the offensive, claiming without proof that Medicare expansion will be at the expense of today's seniors.
Democrats will not have the power to pass "Medicare for All" through a presidential veto, but they could start the talks in two years before the next election.