Health care advocate Laura Packard speaks at a Protect Our Care press conference Tuesday, Sept. 24. (Wisconsin Examiner photo)

Nearly 15 years after passage of the landmark federal law that expanded health care access across the country, health care remains a fixture on the ballot almost every November election.

This year is no exception. For advocates, health care is a central issue in both the national presidential campaign and in Wisconsin’s newly competitive contest for the state Legislature.

Sooner or later, virtually every American faces a struggle over how to pay for health care, Leslie Dach of Protect Our Care said during a visit to Madison Tuesday. Dach, a health advisor to President Barack Obama, founded Protect Our Care in 2017 to advocate for maintaining and strengthening federal health programs including the ACA.

“When you get sick, it takes over your life,” Dach said in an interview. “There’s no larger kitchen table issue in America. And it’s expensive, and a lot of people don’t have access to the care that they need, and so it’s a problem that affects really everybody — maybe not every day, but catches up with you at some point in your life.”

Besides being a personal issue, “it’s also a political issue now,” Dach added. The Affordable Care Act (ACA) remains under threat from Republican lawmakers. Some have also called for repealing all or part of the 2022 Inflation Reduction Act, including provisions making health insurance cheaper and allowing Medicare to negotiate the price of prescription drugs.

“The choices are very clear, and it’s both emotional and economic for people,” Dach said.

He was in Wisconsin for the second stop on the organization’s bus tour — a campaign to draw attention to the health care law’s increasing popularity and how it has been improved through laws such as the Inflation Reduction Act.

The Inflation Reduction Act extended tax credits that reduce the cost of health insurance policies that people buy on the ACA’s health insurance exchange through 2025.

Those credits have cut health insurance premiums by an average of $2,400 a year, said Joe Zepecki, Wisconsin representative for Protect Our Care, at a press conference outside the Protect Our Care campaign bus.

The 2022 law also capped insulin costs for Medicare patients at $35 a month and authorized Medicare to negotiate select drug prices. Starting in January, it will cap Medicare patients’ out-of-pocket drug costs at $2,000 a year.

“It is essential that everyone understands how they can benefit from these savings,” Zepecki said. “These policies are overwhelmingly popular. They touch nearly every household in America, whether you’re a senior or an individual struggling with a disability who’s having a hard time affording prescription drugs, a family purchasing your own health coverage, or a taxpayer who is sick and tired of lining the pockets of big drug companies.”

The Affordable Care Act also prevented insurers from rejecting patients or charging them higher premiums because of pre-existing health conditions — a practice that was routine until the ACA took effect.

“Insurance companies analyzed people with chronic conditions like cancer,” said Dr. Sophie Kramer, a Wisconsin physician for 35 years. “If you were born with a genetic heart condition or developed multiple sclerosis in your 30s, you were often out of luck.”

Prevention and protection

Without the ACA in place, “many people had to take the risk of no health insurance or opt for expensive, extremely high deductible plans,” Kramer said. Preventive care such as mammograms to detect breast cancer or colon cancer screenings are often treated as out-of-pocket costs until the ACA required coverage for a number of preventive health care measures, she added.

“The passage of the ACA changed this,” Kramer said. “Since 2014  … one in seven Americans and over 800,000 in Wisconsin have benefited from the ACA. This is tremendous progress.”

Despite that progress, she and others noted, Republican politicians have continued to bad-mouth the ACA and run on promises to repeal it.

“Donald Trump has talked about terminating the Affordable Care Act in this campaign,” said Wisconsin Attorney General Josh Kaul, who after first taking office in 2019 withdrew the state from a lawsuit to block the ACA and joined a friend of the court brief to support the health care law. “Let’s be clear, there’s no replacement plan for the Affordable Care Act.”

Kaul referred to Trump’s statement at the Sept. 10 debate with Vice President Kamala Harris, the Democratic candidate for president, about what he would do to replace the ACA after working to repeal it.

“Donald Trump recently said he has ‘concepts of a plan,’ after nearly a decade of his candidacy and as President,” Kaul said. “So there’s no plan to protect people with preexisting conditions. There’s no plan to ensure that costs remain low.”

Protections for people with preexisting conditions are at risk, he added, “and it’s clear that we’re facing further restrictions on access to safe and legal abortion.”

Laura Packard, a health care advocate taking part in the bus campaign who has supported the ACA for helping her survive and get treatment for a cancer diagnosis, said that after Trump’s statement about “concepts,” his running mate, Sen. J.D. Vance (R-Ohio) “laid out what some of those concepts are.”

A Vance proposal to replace preexisting condition protections with “high-risk pools” for those patients “would allow insurance companies to pick and choose their customers again,” Packard said. As one of 135 million Americans with a preexisting condition, she added, “if insurance companies had the choice, they would choose not to cover us. And we need health insurance to stay healthy and to stay alive.”

Zepecki said the Protect Our Care bus will travel 12,000 miles and visit 17 states “with a simple message — lower costs are here and we are not going back.”

Legislative endorsements

Advocating for the ACA is just one example of the way health care policy is on the political agenda this fall.

The Committee to Protect Health Care (a separate advocacy group) announced Tuesday a $500,000 ad buy and its endorsements in this fall’s Wisconsin Legislature races.

The committee consists of doctors, other health care professionals and other advocates. It is targeting a dozen Assembly and Senate races with digital video ads, direct mail and text messages directed at about 300,000 Wisconsin voters in the 12 districts.

The group’s health policy agenda includes expanding Medicaid, known as BadgerCare in Wisconsin, under the ACA and extending Medicaid coverage for new mothers for the first 12 months after they give  birth.

The committee’s priorities also include support for a state board empowered to reduce the cost of prescription drugs in Wisconsin, support for a paid family and medical leave program, and measures to ensure that decisions about reproductive care are made by  patients and medical providers. 

The group calls for repealing an 1849 law that caused abortion providers to cease practicing in Wisconsin for a year and a half, for fear of felony prosecution, until a judge ruled in 2023 that it did not pertain to abortion,  and enacting guarantees for access to contraception.

All of those measures have been proposed in the Wisconsin Legislature in one form or another by Democratic lawmakers but rejected by the Legislature’s Republican majority, the committee noted in its announcement.

Candidates supported by the ad campaign as well as the longer list of endorsed legislative candidates were selected for their support of the organization’s agenda, according to the committee.

“For too long, our state legislators have refused to expand BadgerCare and repeal our state’s archaic, harmful abortion ban,” said Dr. Ann Helms, a Committee to Protect Health Care Wisconsin leader and a neurologist. “These candidates have an opportunity to finally take action, granting health care access to tens of thousands of Wisconsinites and ensuring all women in the state can access the reproductive health care they need.”

GET THE MORNING HEADLINES.

SUBSCRIBE