This year, health care and health insurance aren’t the dominant campaign issues they were in 2018, when candidates’ support for the Affordable Care Act helped determine winners, especially in the suburbs.
But the issues still have resonance, placing second in a recent MinnPost poll when voters were asked to list the issues that most factor in their vote. As such, it has again been the topic of negative campaign mailers, especially those created by the DFL and DFL-leaning activist groups working against incumbent GOP members of the state Senate. Flipping just two seats would give the DFL control of that chamber.
One such mailer has been used in Senate District 26, a Rochester-area district where Sen. Carla Nelson is being challenged by Aleta Borrud.
But while incumbents take hundreds of votes, some of which are unpopular with some groups of voters, so much so that they’re frequently cited in negative mailers, the mailer against Nelson doesn’t actually reference a Senate vote. Instead, it cites a tweet.
“Politicians like Carla Nelson supported a plan that would make our health care more expensive, they … supported a plan to eliminate protections for people with pre-existing conditions, including cancer, heart disease, Alzheimer’s, diabetes, and even pregnancy — and now we’re in a pandemic,” reads the mailer from Everytown for Gun Safety, a national gun-control group funded predominantly by former New York mayor Michael Bloomberg.
A footnote takes a voter to a box titled “Follow the Facts” that asserts the proof for that claim against Nelson can be found at “Twitter, @MNGOP, 3/14/17.”
The tweet in question, sent by the Republican Party of Minnesota, says: “It’s Time To Repeal & Replace #Obamacare So That Minnesotans Have More Choice, Increased Access, Lower Costs, & Better Healthcare.”
A related tweet provided by Everytown to support the first tweet reads: “Thank you @RepTomEmmer @RepJasonLewis @RepErikPaulsen for voting in favor of the AHCA today!” That was sent by the state GOP on May 4, 2017.
AHCA stands for the American Health Care Act. Passed by the U.S. House in 2017, the bill engendered broad disagreement as to how it would cover pre-existing conditions, and 20 House Republicans voted against the measure. It did not pass the Senate.
Finding a tweet that is 3½ years old is possible — but it’s not easy. But even if the tweets could be found by an average voter, is that enough to say Nelson supported the elimination of pre-existing condition coverage? Did she actually take that position, or was it only “politicians like Nelson?” Or is that just a way to remind voters that the incumbent is, in fact, a “politician”?
When asked to support the claim, Everytown for Gun Safety provided two quotes it attributed directly to Nelson. One, from the Albert Lea Tribune on Nov. 13, 2017, said: “Obamacare is a disaster, and if I am elected, I will stand with President Trump to repeal Obamacare.” That was said while she was a candidate for Congress, eventually losing the GOP primary to Jim Hagedorn.
The second quote came from the podcast “Up and At ‘Em,” on Aug. 28, 2017, said Everytown for Gun Safety: “So it’s critical that the misnamed Affordable Care Act be fixed because it is causing significant problems,” Nelson said.
Neither of these quotes was used on the mailer itself to justify the assertion, however. And supporting repeal of the Affordable Care Act doesn’t necessarily mean support for an end to covering pre-existing conditions, one aspect of Obamacare that is very popular with the public.
The lack of a replacement passed by both the U.S. House and Senate has allowed Democrats to say that the provision would be eliminated. Also, a lawsuit before the U.S. Supreme Court brought by a group of Republican state attorneys general seeks to have the law tossed out, a move that — if successful — would eliminate the pre-existing conditions mandate.
But the Minnesota Legislature didn’t vote on either the Affordable Care Act or the American Health Care Act. It did, however, vote to implement the Affordable Care Act with a state marketplace for individuals to buy policies, which Nelson voted against. And they voted on a GOP measure to provide health insurance companies with help covering the claims of the most expensive insured people, which Nelson supported.
Republicans in the state Legislature who oppose Obamacare often point to an earlier state program to assure health insurance for those with pre-existing conditions. The Minnesota Comprehensive Health Association was established in 1976 by the Minnesota Legislature to provide health insurance for people turned down for other coverage. Sometimes called an “assigned risk pool,” the plan provided policies to anyone who needed one (though usually at a higher cost, and much more than under the current system).
That program went away when the state created the individual insurance marketplace, where residents without employer-provided insurance and who aren’t eligible for Medicaid or Medicare could buy policies. Pre-existing conditions could not be a reason for denial and could also not cause higher premiums for those people versus someone without pre-existing conditions.
While the individual market has stabilized, the first few years were volatile with fewer than hoped providers and higher than hoped premiums, leading Republicans in the Legislature to create a reinsurance program with a governmental subsidy. That was meant to cover the highest insurance claims as a way of bringing more providers into the market and keeping basic premiums lower. Democrats opposed it when it was created, but then-Gov. Mark Dayton allowed it to become law without his signature.
“MNCHA was the Minnesota high risk pool that provided insurance for any Minnesotan denied coverage due to pre-existing conditions,” Nelson told MinnPost. “Furthermore, the premiums were held down by state subsidies. I have always supported coverage for pre-existing conditions and always will.”
Everytown for Gun Safety says it stands by the allegation. “Time and again she’s called for repeal of the Affordable Care Act, and said she’d stand with President Trump to end it, which would eliminate protections for Minnesotans with pre-existing conditions,” said Andrew Zucker, a spokesperson for the group.
Walker Orenstein contributed to this report.