It's not just Donald Trump -- the health care debate weighs on Karen Handel, too

President Donald Trump now hangs around Karen Handel's neck like an albatross, turning an easy GOP claim on the Sixth District into a nail-biter. There is simply no disputing the situation.

With a standard-issue president in the White House, Handel might still be in a runoff, but it would be with another, lesser Republican, or a penniless Democrat whose name wouldn’t be Jon Ossoff.

Yet Trump isn’t the only burden the former secretary of state carries as the contest heads into its final days. The other weight around her neck is the American Health Care Act of 2017 – the House Republican effort to repeal and replace Obamacare.

After a failed effort to pass it months earlier, House Republicans on May 4 passed the bill over the objections of not just every House Democrat, but virtually every national medical and health organization of note.

Immediately, misgivings were rampant, even among Republicans. The very next day, Handel was pressed for her opinion on the legislation. Strategically, she did the smart thing. She split the difference.

“Obamacare is collapsing. It is important that we not let the perfect be the enemy of the good. Today’s vote is the first step in a long process,” the congressional candidate said in a statement released by her campaign.”

She didn’t betray her base. She didn’t retreat from her call to erase the Affordable Care Act. Yet in a backhanded way, Handel also acknowledged that the work just produced by her would-be colleagues in Congress was flawed. That’s what “first step in a long process” means.

A spokesman for her campaign assures me that this has been her standard response on the matter. As recently as Tuesday, Handel acknowledged that “the House bill is not perfect – it’s a first step. But something had to happen in order for the debate to happen, to continue.”

But last week, in that televised debate on WSB-TV, Ossoff claimed that the House bill would "gut protections for those with pre-existing conditions."

In doing so, he maneuvered Handel into a new role: She became a defender of the House bill.

Handel invoked the case of her sister, who was born without an esophagus. “For you to suggest that I would do anything that I would do anything that would negatively affect her is absolutely outrageous,” she argued – and then said this: “[The House bill] provides more protection for people with pre-existing conditions.”

Bill Custer, director of the Center for Health Services Research at Georgia State University, helped me sort things out.

The House bill would shift more responsibility for health care and its funding to the states, he noted. In doing so, states would be able to grant waivers to insurance companies, allowing them to attach higher prices to those with pre-existing conditions.

The House bill would protect those already insured from being bumped off, but lapses in coverage — or new policies — would be a green light to charge higher rates to those with poor health histories. States would be encouraged to set up pools to help those with pre-existing conditions to purchase insurance.

“The bill provides some, but very little money to do it,” Custer said. He estimates that eventually, 60,000 people in the Sixth District would lose coverage. (On Tuesday, Handel said she would like to see more federal cash allotted for insurance pools to cover those with pre-existing conditions.)

Handel’s pickle is that this is a contest to replace Tom Price, who is now the man in charge of this nation’s health care system. His wife, Betty Price is also a physician – and a member of the state House whose district lies wholly within the Sixth.

Geographically, Betty Price’s political base aligns with Handel’s. She was on the host committee of a Roswell fundraiser for Handel just last week. The Prices are bastions of support for the AHCA, which would make it hard for Handel to distance herself completely from the House bill – even if she wanted to.

On the other hand, last week’s poll by The Atlanta Journal-Constitution, only 25 percent of likely voters in the survey favored the House effort to repeal and replace Obamacare. Nearly the whole of Ossoff’s support (92 percent) lines up against the AHCA.

The issue fractures Handel’s supporters. Fifty percent rate the AHCA favorably, but 29 percent oppose it. That’s an obstacle for a candidate in need of full-throated enthusiasm.

The topic may matter more in the Sixth than anywhere else in Georgia. By strict numbers, the Fifth District of U.S. Rep. John Lewis, D-Atlanta, has the most health care jobs of any congressional district in the state: 25,268.

But the Sixth District is next, with 14,311 workers spread across six hospitals, including Northside and Children’s Healthcare of Atlanta. And you have to wonder how many health care employees work in Lewis’ Fifth – but vote in the Sixth.

The AHCA is now in the hands of the Senate, Republicans are hammering out a rewrite in secret. It just so happened that some of the authors were among the 15 GOP senators with whom President Trump lunched on Tuesday.

Many of us are beginning to suspect that consistency isn’t Trump’s strong suit.

The president referred to the House effort to replace Obamacare — the bill whose passage he celebrated in the Rose Garden, the bill that Handel defended last week – as "mean." Trump asked the senators to "improve" the bill significantly.

There’s no law that says two albatrosses can’t work together.