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Advocacy Guide
July 2018

Midterm Elections: Six Key Questions for Congressional Candidates

Last year, Congress came within a few votes of repealing much of the Affordable Care Act (ACA) and making unprecedented cuts to Medicaid. Legislation that passed the House and nearly passed the Senate would have allowed insurers to deny coverage to people with preexisting conditions, increased health care costs for middle-class consumers, and cut more than 15 million people off of Medicaid coverage. Thankfully, Congress rejected this disastrous legislation. Yet the future of health care remains on the ballot box. Polls throughout the year have confirmed that health care is the most important priority for a majority of likely voters in the 2018 midterm elections. Depending on the outcome of the midterm elections, Congress could try again next year to repeal the ACA.  

As advocates engage with congressional candidates in the months leading up to the election in November, we urge them to ask candidates the following six questions on their commitment to protecting consumers’ access to health care.

Protections for People with Preexisting Conditions

Before enactment of the Affordable Care Act (ACA) in 2010, health insurers could legally discriminate against people with preexisting conditions, women, and older people. This discrimination could include increasing individuals’ premiums, denying coverage for certain conditions, or even denying insurance altogether. Thankfully, the ACA banned such discrimination. Yet, federal litigation, Trump administration actions, and active legislation all threaten access to coverage for people with preexisting conditions.

Will you commit to opposing legislation that would have the effect of harming people with preexisting conditions? If court decisions or administrative action allow health insurers to discriminate against people with preexisting conditions, will you support legislation to reinstate protections?

Action to Reduce Prescription Drug Prices

Recent years have seen scandalously high drug prices. Examples include EpiPens tripling in cost, a manufacturer boosting the price of a drug to treat malaria from $14 to $750 per dose, and another drug maker charging $750,000 for a drug to treat neuromuscular diseases. These pricing abuses impose tremendous hardships on millions of people, leaving many with no choice but to go without the medicine they desperately need. They are particularly shocking because drug manufacturers are some of the most profitable corporations in the world.

Will you support legislation to prohibit drug makers from charging unconscionably and unwarranted high prices for drugs?

Protecting Medicaid

Medicaid provides health care coverage to more than 70 million people in the country – more than half of whom are children or are disabled adults. Unlike Medicare, it also covers long-term services and supports for millions of seniors, with Medicaid paying for 60% of all nursing home care. Despite costing less per-capita than Medicare or private insurance, last year, congressional leaders attempted to gut the program, cutting its funding by nearly half a trillion dollars. These cuts would have eliminated coverage for millions of vulnerable and low-income people and seniors.

Will you commit to protecting Medicaid, rejecting legislation that slashes funding for or restructures this vital health care safety net?

Health Care Affordability

Health insurance premiums in the individual market are projected to increase by between 30-50 percent between 2017 and 2019, on average, across the country. While increased health care prices account for a portion of those rising premiums, various actions by the Trump administration to undermine health coverage, from slashing funding for consumer outreach and assistance, to allowing the sale of junk health insurance, are reducing coverage and driving up premiums.

What will you do to stop the administration from undermining health coverage and increasing health care costs for middle-class families?

Access to Oral Health

Nearly 60 million seniors and people with disabilities rely on Medicare for their health care, but it doesn’t cover part of the body that causes all kinds of health problems—the mouth. Accordingly, an estimated 70 percent of seniors lack or have limited dental insurance and fewer than half access dental care each year. Recent polling suggests that more than 85 percent of voters support including dental coverage as part of Medicare.

Would you support legislation to provide seniors with dental coverage under Medicare?

Ensuring Everyone Has Access to High-Quality Health Care

The United States spends more money on health per capita than any other country, yet we consistently rank last among them in access, equity, key health outcomes, and overall performance. Equally troubling is the fact that these poor outcomes disproportionately affect communities of color, those with low incomes, people with disabilities, and those living in distressed geographic areas.

What will you do to help ensure everyone in our country has access to high-quality health and health care regardless of their race, income, health status, or geographic location? How will you ensure that none of your constituents are left behind as the health care coverage and delivery systems continue to change rapidly due to technological improvements, economic changes, and policy updates?