Health care law casts long shadow ahead of pivotal election

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The uneven political imprint of the Affordable Care Act on Georgia’s elections could be found last week within a couple of tables in a diner in McDonough.

Phil Herrington is looking for the GOP U.S. Senate candidate who could best dismantle Obamacare. Chauni Morris praises the law for helping her.

Interviews with dozens of voters across Georgia and an exclusive Atlanta Journal-Constitution poll show just how long a shadow Obamacare casts ahead of Tuesday’s primary. The law still energizes the most fervent supporters in both parties, but it has a more nuanced effect among the swing voters who will likely decide the November election.

Tuesday’s primary will be the first statewide ballot since the law’s rocky rollout and the expansion of health insurance subsidies to millions across the country. Many who embrace the law want to see it altered. Many who oppose the law don’t want to scrap it entirely. And many are frustrated that few lawmakers are trying to broker a consensus solution.

“This is about our livelihoods, and it seems like everyone either wants to do away with it or continue with it. Everyone is just posturing, and it’s all a defensive strategy,” said John Sillen, a 29-year-old sales agent in Atlanta who views a candidate’s health care stance as paramount. “I don’t see anyone staking out a middle ground.”

A soft spot for Medicaid

The AJC poll shows an overwhelming majority of voters — 86 percent — view a candidate's stance on the health care law as a very important factor in their vote. About half say it makes them more likely to vote for a congressional candidate. And 61 percent of voters believe it needs major modifications or should be scrapped altogether.

But there's a soft spot in many Georgians' heart for the expansion of Medicaid under the Affordable Care Act, which would have provided as many as 650,000 low-income residents with health coverage thanks mostly to federal funding. Gov. Nathan Deal rejected the expansion because he said it would be too costly in the long run.

Only 13 percent of GOP voters said Deal’s stance made them more inclined to vote for the governor, but about 40 percent of voters said it made them less likely to cast a ballot for him. That includes 42 percent of voters who identify as independents — a right-leaning bloc crucial for both parties to win.

One of those hard-charging GOP voters is Trent Pippin, who said he specifically seeks out candidates at the ballot box who oppose Obamacare. The Conyers man, who owns a trucking firm, said he sees health insurance as too costly and doesn’t want to be forced to buy it.

“I don’t think that anybody has the right to tell me that I have to have anything,” Pippin said. “I’m 28 and I’m healthy and I can’t really afford it. But I still don’t think it’s the government’s place to tell me that I have to have it. And I don’t believe the country can afford it.”

Others are frustrated by Deal’s move to stymie the law, saying their votes were motivated in part by wanting to expand Medicaid.

“I have my own health insurance from my job,” said Shamika Norman, a 26-year-old from Stone Mountain. “But I’m more concerned with the other poor Georgians who do not.”

A harsh Obamacare lesson

The law has loomed over the races for governor, the U.S. Senate and the U.S. House as the candidates fight for their parties’ nominations in contested primaries across Georgia. Most Democrats promise to stand by the law, while a near-unanimous chorus of GOP candidates vows to scrap it.

In the acrimonious Republican Senate contest, which features three sitting congressmen and two other high-profile contenders, few will venture even a kind word about the overhaul for fear of being branded a supporter.

U.S. Rep. Jack Kingston learned that harsh lesson last year when he was called a heretic after he said that allowing the law to “fall to pieces on its own” is not the most responsible thing to do. The comments came amid an Obamacare funding dispute that led to a partial government shutdown, and Kingston quickly repeated that he wanted to repeal the law.

All seven Republicans running for the Senate want to repeal the law, though they differ on exactly how to replace it.

Two candidates seen as the most conservative, U.S. Reps. Phil Gingrey and Paul Broun, have used some of the toughest rhetoric. Gingrey vows to step down after a single term if he fails to help repeal Obamacare, while Broun warns that it's "going to destroy our economy and it's going to push us into a total economic collapse of America."

Former Georgia Secretary of State Karen Handel and businessman David Perdue also adamantly oppose the law, though they often use language a shade softer.

Senate Democratic front-runner Michelle Nunn, who faces three primary challengers of her own, said she supports the Affordable Care Act but wants to make big changes to it — including delaying the requirement that all individuals buy health insurance and make cheaper bare-bones insurance available on the law’s exchanges.

In the governor’s race, Deal’s stand against Medicaid doesn’t go far enough for his GOP challengers. Former Dalton Mayor David Pennington trumpets a pledge he signed to stop Obamacare while state Schools Superintendent John Barge will tap a committee to explore whether to set up a state health care exchange for low-income residents.

Awaiting the winner is Democrat Jason Carter, the grandson of a former president who said he sees Obamacare as a "mess" and that Obama and Congress should partner together and make needed fixes.

‘The magic word’

The fate of Obamacare plays an outsized role on the campaign trail. At an event for Handel’s campaign last week, attendees were itching to kill the law.

Richard Nasternak, a 65-year-old Roswell man who listened to the GOP candidate’s stump speech, said repeal has become something of a “magic word” to GOP audiences. Still, he had little hope of it working.

“I don’t think it’s all going to be repealed realistically, but they can make insurance competitive over state lines,” he said.

A scant 16 percent of voters polled in the AJC survey said Obamacare had helped their families, and about one-third said it had hurt them. The leading answer, though, was from the 53 percent of voters who said it had no effect. Many were Republicans who worried about its broader impact on the economy.

Robyn Blickhan said she doesn’t pay much attention to debate over the overhaul because she has health coverage through her job. But she said Deal’s opposition to the Medicaid expansion makes her more likely to support his re-election bid.

“I like Deal’s stance because I don’t like all the freebies,” said Blickhan, a 42-year-old analyst. “That makes the insurance go up. But I don’t care about all the other Obamacare stuff. We’ve been hearing about it for years.”

A fight for minimum wages

Still, as the fight over Obamacare rages on, other issues have risen to the forefront for some voters. Sharon Gilchrist, a retired educator in her 70s, said Obamacare has taken a back seat to the nascent push to raise the minimum wage.

“What can we do to get people out to vote? If we lose the Senate, minimum wage will never hit $10.10,” she said. “I am tired of supporting relatives who make minimum wage. The other party is sticking it to us here.”

And Mike McLendon, a 51-year-old from Metter, said finding a Christian conservative who takes a hard line on social issues is at the top of his list.

“Abortion, gay marriage, just basically all the moral issues,” he said of his top priorities. “I know money and Obamacare, taxes, are just going to be the same. It’s going to be hard to fight all that.”

A chord of consensus

Back at the Gritz diner in McDonough, Kingston worked the room, with the lunch crowd occasionally quizzing him on the health law. Herrington said he is still making up his mind how to vote, but he liked Kingston’s approach to the health law.

"He's saying he wants to get rid of Obamacare," said Herrington, who complained of rising health care costs at his advertising business. "I think he will."

At a nearby table, Morris had a drastically different take. She was laid off from her job three years ago, not long before her son’s father died. She went back to school for more training and is thankful she could get health care coverage for the first time in years when the law took effect.

She said she understands why some people are frustrated over rising costs associated with the plan. “However, on the flip side, for somebody like me, I’m grateful for it because it gives me the opportunity to finally have insurance,” she said.

For all the division, many voters simply want lawmakers to stop all the bickering.

“It would be great,” said Bob Cook of Kathleen, “if you can get a good compromise that works for everybody.”