Obamacare Returns as Galvanizing Issue After Ginsburg Death, Barrett Nomination

Democrats are intent on using the A.C.A. to gain advantage in Senate races across the country, especially against vulnerable Republican incumbents like Thom Tillis in North Carolina, Martha McSally in Arizona and Cory Gardner in Colorado — who has run an ad promising to protect pre-existing conditions even though he voted in 2017 to repeal the Affordable Care Act. Protect Our Care, a liberal advocacy group focused on preserving the health law, is preparing to run television ads in all three incumbents’ states warning that they want “to rush a justice onto the court who will repeal our health care,” after digital ads this week.

Similar ads are running against Republican senators in tighter-than-expected races in Alaska, Iowa, Georgia, Montana, South Carolina and Texas. Winning both the White House and the Senate, where Republicans currently hold a three-seat majority, could allow Democrats to fix the law in a way that might help save it from being overturned by the Supreme Court, by reinstating a financial penalty for people who go without health insurance. The crux of the legal case is that when Congress zeroed out the penalty in 2017, the law’s requirement that most Americans have insurance became unconstitutional, and that without that mandate the rest of the law could not stand.

The issue of the health law aside, Joel White, a Republican strategist, said he thought the court vacancy would actually help Republicans in tight Senate races “where their base is looking for a reason to be excited,” and in conservative states like Georgia and Montana, “by motivating partisans.” More important, he said, the vacancy could galvanize evangelical voters who may otherwise have been reluctant to vote for Mr. Trump.

James DiPaolo, an independent voter in Jacksonville, Fla., said he had been considering voting for Mr. Biden — even though he dislikes the Affordable Care Act’s requirement that insurance plans offer comprehensive coverage, which can make them more expensive — because Mr. Trump “says things that are atrocious.” But the court vacancy he said, has changed his calculation because he is a devout Catholic and “big fan” of Judge Barrett.

“Her being a woman of faith, that’s important to me,” Mr. DiPaolo, 36, said of Judge Barrett, who is also Catholic.

Mr. DiPaolo did point to one piece of the health law that he strongly supports: its protections for people with pre-existing conditions. His grandfather had diabetes, as does his father, he said, adding, “I’m hoping it skips me but I don’t know, so I think protections for that are key.”

He did not connect a vote for Mr. Trump with the possibility of losing those protections.

“I don’t see him getting rid of that,” he said.

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