For years Republicans have railed against broad public support for access to health care, triggering backlash and setbacks to their causes. If the past is prologue, 2024 will continue that trend.
In 2010, Obamacare, modeled after Massachusetts reform, passed. Republicans worked tirelessly to oppose it then to sideline it before it could take effect. Advocates knew that for the law to work it had to garner early support from more than half the states. Rural and red states were of concern. Importantly, Govs. Joe Manchin, of West Virginia, Andy Beshear, of Kentucky, and Republican Gov. Brian Sandoval, of Nevada, faced down political risks and joined the program. They determined they could not leave so many uninsured and so much federal funding on the table or deprive hospitals of essential revenue streams.
In February 2012, I sat next to Gov. Jan Brewer, of Arizona, at a dinner in Washington D.C. Brewer was among the most anti-immigration and pro-Second Amendment Republicans in the country. And yet we talked at length about Mitt Romney’s health reform in Massachusetts. I left dinner believing she would at some point expand health access.
The next day Brewer appeared on Meet the Press and endorsed Mitt Romney to lead the Republican presidential ticket. Less than a year later, she led Arizona into the Obamacare fold.
President Donald Trump staked enormous political capital to repeal Obamacare. Key votes were cast by Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, who determined to keep health care expansion. The decisive vote, undermining President Trump’s plan, was Sen. John McCain, R-Ariz. In so doing, he continued Gov. Brewer’s expansion of health care for Arizonans.
The more things change, the more they remain the same
For decades, a major platform of the Republican Party was to overturn Roe v. Wade. With public approval for Roe exceeding 60 percent, a constitutional amendment was simply not going to happen. President Trump campaigned on appointing justices who would reject the Supreme Court’s previous precedent. Given the opportunity to fill three vacancies, he did just that. Subsequently, the Dobbs decision found there was no constitutional right to abortion, leaving that decision to the states. That is exactly what the Republicans had called for. Yet many immediately proposed a constitutional amendment to outlaw abortion nationally. Others fashioned state statutes limiting abortions past 60 days of pregnancy with few or no exceptions.
The backlash was swift, including among red states where file ballot initiatives could be filed. In less than a year, Kansas, Kentucky, Montana, Ohio and Michigan passed state constitutional amendments ensuring rights like those previously guaranteed under Roe. Now, Michigan and Ohio Republicans are looking to deny their courts’ ability to interpret and effectively implement these amendments. This may slow things down, but it will likely fail, and will keep the issue front and center in 2024. This could prove a boon to Democratic Sen. Sherrod Brown’s reelection chances in Ohio as well as to President Joe Biden in affected swing states.
Abortion is a political tempest, and a perfect storm is brewing in Florida. Gov. Ron DeSantis signed a six-week abortion ban. Republican Sen. Rick Scott, who is up for reelection, supported that ban. A former health insurer CEO, he was forced to resign after his company incurred $1.7 billion in fines for Medicare fraud. As governor, Scott left 1.5 million Floridians uninsured by rejecting Obamacare. As senator, he suggested that Medicare and Social Security entitlements be up for review in five years. Republicans will work to scuttle a voter referendum. But, if one makes it to the ballot, it will draw new voters, particularly from among the state’s 9 million women of voting age, 60 percent of whom are Democrats or independents. This is not good for Scott, who has never won an election by more than 1 percent. With a referendum, a credible pro-choice Democratic nominee who gets competent support from the state and national democratic parties could win.
Also, consider President Donald Trump won Florida by only 3.3 percent. He or any other Republican nominee who has supported overturning Roe could lose in this climate. That would put the state’s 30 electors in play with broader ramifications.
William O’Leary, of Richmond, is the former Massachusetts Secretary of Health and Human Services.
