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Will Texas Republicans Suffer for Their Obamacare Vote?

Nearly 700,000 Texans have ACA insurance in districts represented by Republicans who voted to curtail it.

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U.S. House Speaker Paul Ryan conducts a news conference with members the GOP caucus to discuss the AHCA.
Photograph by Tom Williams/AP

When Houston’s Astrodome first opened in 1965, the scoreboard had an electronic cartoon for when the opposing team’s pitcher got removed from the game. “Pitcher, to the showers,” a manager intoned with a thumb motion indicating the pitcher was a gone’er. The cartoon pitcher walked off the field, head down and dejected, to the showers. Suddenly, the shower filled with water and the pitcher drowned. The last you saw of him was his surprised eyes. In the cruelty of childhood, I thought that was pretty funny.

That image returned to my mind on Thursday as I saw the videos of U.S. House Democrats chanting, “Na, Na, Na, Na, Hey, Hey, Goodbye” at Republicans who had voted to repeal and replace the Affordable Care Act, also known as Obamacare. The Republicans had voted for the American Health Care Act, a health reform bill of dubious character. If the legislation gets through the Senate—which is a big if—millions of Americans will likely lose their health insurance or have to pay exorbitant prices in a high-risk pool. But, in this moment, once again the two major political parties that control the greatest legislative body on the planet demonstrated that to them this isn’t about improving the lives of most Americans, but rather a zero-sum game of political winners and losers. The Democrats were boisterously acting like fans who witnessed the opposing pitcher get knocked out of a game.

The point of the chant was that the health care vote will give Democrats a chance to retake the House majority by driving home the idea that Republicans want to deprive people of healthcare, particularly children. The ones especially at risk are the 23 Republicans who represent districts that Democrat Hillary Clinton carried in 2016. As I noted recently, a Clinton victory in a Republican district alone is not enough to make the case for an easy ouster. While Republican incumbents Pete Sessions of Dallas and John Culberson of Houston are in districts carried by Clinton, they also received substantially more votes in their districts than she did.

Among the Texas delegation, all the Democrats voted against the AHCA. Every Texas Republican voted for it except congressman Will Hurd of Helotes. He has one of the most competitive congressional districts in the nation and is on the national Democratic Party hit list for 2018. Clinton carried the district, and of the three she did in Texas, Hurd is the only candidate who received fewer raw votes than the Democratic presidential nominee.

Another metric by which we might measure these districts for political impact is by how many people have insurance under the ACA in each district. So I turned to The Henry J. Kaiser Family Foundation for some statistics. They have an excellent interactive map if you want to study this beyond what I’m offering you here. Looking at the Texas congressional delegation, there are 690,900 adults and children who have Affordable Care Act health insurance through the federal exchange and who live in districts where the member of Congress voted for the Republican health care bill. In fact, six of the top ten districts with people enrolled in Obamacare are represented by Republicans. All told, there are slightly more than one million Texans who were covered in 2016 by insurance purchased through the federal ACA exchange.

The district with the most enrollees is Democratic: District 16 represented by  Hurd’s carpool pal Beto O’Rourke of El Paso—not terribly surprising given the level of poverty along the border. Hurd’s district, which stretches from San Antonio to El Paso along the Rio Grande, is ranked 18th out of the state’s 36 congressional districts for the number of enrollees.

The district with the second-highest number of ACA enrollees, though, is Congressional District 22 represented by Republican Pete Olson. His district had 40,500 people insured by the ACA in 2016. Trump carried the district with 52 percent of the vote, while Clinton received 44 percent, slightly more than her statewide average. Olson received 59 percent of the vote in his reelection campaign. But Clinton carried the largest county in Olson’s district, Fort Bend—which accounts for 62 percent of the total population of Olson’s district—and she received about 12,000 more raw votes in the county than Olson. (I should note here that part of Fort Bend County also is in Democrat Al Green’s district. However, if you add Olson’s Fort Bend votes together with those of Green’s Republican opponent, Clinton still received more votes in the county.)

What’s difficult to take away from the Affordable Care Act numbers in Olson’s district is the fact almost half the Obamacare federal marketplace enrollees here had incomes too high to qualify for full federal financial assistance. That means they might just as easily be those people complaining about the premiums as those worried about losing their health insurance. Also, these numbers include adults and children, so you cannot instantly equate them with voters.

Here’s how to read the Kaiser Family Foundation numbers: The first row is the total number of people who enrolled in Obamacare in 2106 through a federal exchange; the second row is the number of those total enrollees who received a premium tax credit on their income taxes; and the third column is the number who received federal subsidies on their purchase of healthcare.

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  • SpiritofPearl

    The question is not whether Texans will be harmed by Trumpcare, but rather will they (1) realize they’ve been harmed, and (2) will they continue to vote against their own self interest if they do realize they’ve been harmed?

    • Lilredhead

      Yes, and No, Texas voters are mostly idiots.

      • anonyfool

        Ted Cruz is in the Senate but if he can get re-elected, anybody in the GOP can get re-elected in Texas. He scored points with the GOP with his performance in the Yates hearing with his persistent asking about Hillary Clinton emails when the committee is talking about Russian influence, but if GOP voters are stupid enough to fall for that, they will fall for anything.
        Not to mention Cruz’ epic flip flop from never supporting Trump to endorsing Trump and phone banking for him ( but that probably scored more points with the GOP than not).

        • BCinBCS

          I dunno, I watched the Yates interview and it appeared to me that she ate Cruz’s lunch. He, typically, cherry-picked the sections of the law that would prove that he “gotcha” but she was intelligent and informed enough to quote the remainder of those laws and superceding law that proved that she was right and Comrade Trump/Bannon and Cruz were wrong.

          • anonyfool

            If you are a conservative voter, you are very atypical! 🙂

          • BCinBCS

            Out of curiosity, why do you think that I am a conservative voter?

          • vjmassey

            lucky guess?

          • vjmassey

            Yep.

          • vjmassey

            Depends on your politics.

        • vjmassey

          Don’t be surprised if he doesn’t become a court nominee.

      • vjmassey

        As you said. Yes and No.

    • WUSRPH

      And even that will depend on when the impact hits…..The GOP is certain to make the main hit occur after 2018 and more likely not take full effect until after the 2020 elections……Some voters will be influenced by the numbers the CBO and many other groups will produce, but others will not pay attention until they actually loose their coverage. That will dilute the impact of the retaliation by the voters. Assuming that the final bill (if there is one) gives the states the power to limit Medicare coverage thru the :”block grants” the Texas Legislature will not be able to do it until 2019 unless Abbott were to call a special session…..which means none of the Texans who are more than likely going to be punished for being poor by having their coverage taken away or drastically limited will suffer before 2020 at the earliest.

      • SpiritofPearl

        Let’s see what happens in the midterms.

        • Jed

          i still have a hillary sticker on my car, and daily i still have big suburbans and expeditions swerving into my lane on the highway to try and intimidate me, and daily i see someone in another car point and laugh at my sticker.

          this is in austin.

          i don’t think texans are suffering from any buyers’ remorse, nor are they likely to.

          • vjmassey

            Probably right.

        • vjmassey

          I’m thinking not much. But who knows.

      • vjmassey

        You make some good points.

    • vjmassey

      Odds are no.

  • José

    Regarding the Dems serenading their GOP colleagues with “Na Na Na Na”, as petty and ill-advised as that stunt was, it was simply a payback for the Republicans doing the exact same thing after passage of the ACA. The original taunt was an extraordinary act of nastiness. Sort of like the AHCA passed by the House Republicans.

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    • vjmassey

      I agree.

  • dave in texas

    This piece by the indispensable Charles Pierce pretty much sums up my feelings about the passage of the AHCA.

    http://www.esquire.com/news-politics/politics/news/a54896/republican-healthcare-bill-pass/

    • SpiritofPearl

      And they celebrated with a truckload of Bud Light . . .

      • vjmassey

        lol

    • vjmassey

      very good.

  • Jed

    yep. mopac is like mini-dallas. half the city missed the memo on austin as liberal bastion.

    • WUSRPH

      I still have a Hillary sticker on my car….and a Hillary sign in my yard….but I’m in a neighborhood that votes for such people (altho there were a bunch of Bernies, too)… I plan to leave both where they are until the Democrats nominated someone in 2020 or Trump leaves office, whichever is first.

      But I have heard of incidents such as you have experienced….including of a woman friend whose car was forced off the road around Hillsboro….It had a definite effect on her. She now makes virtually ALL the anti-Trump rallies.

      • vjmassey

        A brave soul.

    • SpiritofPearl

      Over here on the eastside it’s quite different, although I know plenty of folks on the westside who are nominally “limosine liberals.”

      • vjmassey

        Good one.

    • vjmassey

      That’s funny.

  • vjmassey

    Not at all.

  • vjmassey

    I would think.