Need or nightmare?: Democrats want the midterms to be a referendum on Obamacare

In the shadow of palm trees on Venice Beach in Los Angeles, a group of about 50 progressives gathered for a midterm campaign event to talk tax reform and health-care policy. Democratic House minority leader Nancy Pelosi was the rally's headliner, but the unlikely star at the podium was 10-year-old Myka Eilers.

"I'm just like everyone else except I have a special heart and I go to special doctors," Eilers said, reading from enormous cue cards.

According to Myka's mother, Angela, those "special doctors" have cost more than $500,000 US, which has mostly been covered by the health insurance they obtained through the Affordable Care Act (ACA).

Also known as Obamacare, the 2010 health-care reform bill made it so insurance companies could no longer deny someone coverage due to a pre-existing condition.

Since Donald Trump was elected president, Republicans have been chipping away at the ACA. Last Wednesday, Senate majority leader Mitch McConnell said Republicans could try again to repeal Obamacare if they win enough seats on Nov. 6.

Now many progressives like Angela Eilers are trying to turn the midterms into a referendum on health care.

"That's why I'm here today," she said, "because I don't have a choice: I need to protect my child and I need to keep her health care intact."

Many polls have suggested voters rank health care at the top of midterm issues. And polls have shown the ACA is the most popular it's been since it was signed into law eight years ago.

In the 2010 midterms, Democrats lost 63 seats in the House and six seats in the Senate, in part because the Republicans ran so effectively against the ACA. They used their "repeal and replace" mantra to warn voters that Obamacare would deny them their choice of doctor and hike the cost of insurance.

It was so effective that in the 2014 midterms, many Democrats shied away from defending the law.

Four years later, Democrats are running on a promise to protect it.

According to several surveys of political advertising, nearly half of Democratic ads mention health care, compared to only 21 per cent of Republican ads, and Democrats have spent more than $80 million through September on those health-care ads, more than on any other issue.

In one TV spot, Senate Democrat Joe Manchin of West Virginia, dressed in hunting clothes, claims his opponent supports a lawsuit that would take away health care from people with pre-existing conditions. Manchin then shoulders his shotgun, aims at a paper copy of the lawsuit mounted on a target, and blows a hole in it.

But this battle isn't just being waged on the airwaves. It's part of a sustained ground war led by party activists and voters alike. In the waning days of the campaign, evangelists on both sides of the debate are doing what they can to swing votes, driven by their own experiences of being saved — or ruined — by Obamacare.

'More than our house payment'

In the affluent enclave of Rancho Cucamonga, 60 kilometres east of Los Angeles, Susie Jacobson sat shuffling her medical bills like playing cards.

"It is very depressing that most of my money is going into health care," she said. "This is not the way I had planned to spend my life when I retire."

Like Myka Eilers, Jacobson has a congenital heart condition that requires frequent hospital visits and expensive medication. After Obamacare was passed, the insurance premiums for her family of four quintupled, she said.

"We were paying $2,500 a month just in the premium. That didn't include co-pays or deductibles," she said. "It was more than our house payment."  

So with election day around the corner, she's been blogging and writing in to local newspapers to expose what she calls the myths of Obamacare.

"I know other people are suffering and that's why I'm doing this: I want the truth out there," Jacobson said. "Obamacare is falling apart. I'm living the nightmare I read about."

Dr. Rick LeMoine says he's seen plenty of patients like Jacobson who've struggled with rising premiums. The Cape Breton native is the chief medical information officer at Sharp HealthCare, San Diego County's largest regional health-care delivery system, which comprises seven hospitals and more than 2,500 physicians.

In the years before the ACA, the uninsured rate was as high as 18 per cent. After the law was passed, the rate plunged to around 10 per cent. But according to several surveys, it's begun to creep back up.

"A lot of people who drop off the [insurance] rolls, that's the reason they gave: 'I just can't afford these premiums,'" said LeMoine.

Marrying for health coverage?

ACA defender Terri Carlson admits the system has flaws, but says "Obamacare is better than 'I don't care,' which is what we had."

She pointed to the bones of the new house she's building on a hill outside San Diego. "This is the American dream right there. I have this dream because of Obamacare."

Ten years ago, she feared she might end up homeless, bankrupted by her rising medical bills.

"I went to try to find health insurance and nobody would insure me due to a genetic defect that I was born with," Carlson said.

The American people do not want Obamacare. I'm being their voice.- Susie Jacobson, Rancho Cucamonga, Calif.

She suffers from a rare genetic disorder similar to lupus, and when she got divorced and lost access to her husband's health plan, a friend suggested she re-marry to get coverage.

"And I sat there, I thought … you know what? That's not a bad idea."

Her "Will marry for health insurance" website went viral, generating more than 35,000 proposals from men and women.

She says her real goal wasn't to find an insured partner but to make a political point: "Nobody in the U.S. should have to consider marriage as their only way to get health insurance."

Luckily for Carlson, her pre-existing condition was eventually covered by the ACA. She has since become a health-care advocate, working tirelessly to lobby for Canadian-style universal coverage. Now, in the election's final days, Carlson says it's her mission to help Democrats preserve the vestiges of Obamacare.

"This is my life's work and I get e-mails every day — the fear is just unbelievable," she said. "No one should have to worry that one illness will put you on the streets."

Health care 'squished in the middle'

But some health-care experts say whichever party wins control of Congress, Americans on both sides of the issue may still end up losing. 

At the annual gathering of the American College of Emergency Physicians in San Diego, a debate called "Obamacare versus Trumpcare" pitted Dr. Anthony Cirillo of Rhode Island against Dr. Steven Stack of Kentucky. 

"Nobody agrees on where the hell we're going," Stack said. "So we are on a journey with no shared agreement on the destination and no clear way to get there."

On this, they both agree: the expensive and divisive health-care system can't be fixed if Washington remains broken.

"The polarization that exists will prevent anything good from happening in terms of legislation," said Cirillo. 

Stack described health care as a "casualty" of the ideological divide in the nation. 

"When those two tensions hit each other, health care sort of gets squished in the middle."