Politics

Why Some House Republicans Could be Taking a Risk on Obamacare Repeal

The 11 GOP members who have the most constituents on Obamacare

These 11 members of Congress represent the Republican districts with the greatest percentage of constituents enrolled in government insurance exchanges. They are (clockwise from upper left): Ileana Ros-Lehtinen, R-Fla., Carlos Curbelo, R-Fla., Mario Diaz-Balart, R-Fla., Brian Mast, R-Fla., Francis Rooney, R-Fla., Vern Buchanan, R-Fla., Jason Chaffetz, R-Utah, Gus Bilirakis, R-Fla., Bill Posey, R-Fla., Ron DeSantis, R-Fla., Rob Woodall, R-Ga.

As House Republicans rolled out their plan to replace the Affordable Care Act this week, some members of the conference found themselves stuck between their constituents and their colleagues.

Eleven House Republicans, who will be expected by party leadership and the White House to support their party’s replacement plan, represent districts where at least 6 percent of their constituents are enrolled in government insurance exchanges set up by the 2010 health care law, according to a CQ Roll Call analysis of Kaiser Family Health Foundation and Census Bureau data. 

Almost all of these exchange customers in the 11 districts receive some type of income-based federal subsidy, which the new health care plan would change to an age-based system. There is no official count of how many people would be priced out of insurance if the GOP plan is passed and signed by the president, though the Congressional Budget Office will likely release its estimate next week.

Nine of the 11 House members representing these districts are from Florida, which had one of the highest uninsured rates of any state in the country before the 2010 health care law went into effect, according to Census Bureau statistics. Florida now uses the federal insurance exchange run through healthcare.gov to register patients.

Kaiser Family Health foundation used county-level data provided by Health and Human Services to estimate the number of exchange enrollees in each congressional district. Counts for Florida, which was redistricted in 2015, relied on state data.

1. Ileana Ros-Lehtinen, R-Fla.

Constituents in health care exchange: 13.7 percent

Exchange customers receiving federal subsidy: 96.8 percent

What she has said: “I have already voted 30 times in Congress to defund, fully repeal or do away with parts of ObamaCare and I will vote that way again.” —June 28, 2012 statement after Supreme Court upheld the ACA

2018 race rating: Solid Republican

2. Carlos Curbelo, R-Fla.

Constituents in health care exchange: 13.2 percent

Exchange customers receiving federal subsidy: 96.6 percent

What he has said: “I prefer to use the word ‘replace’ or ‘substitute’ Obamacare because to just say ‘repeal’ implies that there is no need for health care reform. But yes, if we replace or substitute Obamacare, that means it would no longer exist.” —2014 interview with Florida PolitiFact

Race rating: Tilt Republican

3. Mario Diaz-Balart, R-Fla.

Constituents in health care exchange: 11.9 percent

Exchange customers receiving federal subsidy: 96 percent

What he has said: “It is crucial that by the time the repeal takes place that we have the replacement already in law.” —Jan. 4 interview with the Florida Naples Daily News

Race rating: Solid Republican

4. Brian Mast, R-Fla.

Constituents in health care exchange: 8.6 percent

Exchange customers receiving federal subsidy: 92.8 percent

What he has said: “You’re going to see a big push for us expanding the market for people to purchase their health care. And I’m sure you’ve heard a lot of that, purchasing health care across state lines. ... Making sure that there are risk pools out there for people so that we can maintain that coverage for people with pre-existing conditions.” —Jan. 8 interview with NPR

Race rating: Solid Republican

5. Francis Rooney, R-Fla.

Constituents in health care exchange: 7.2 percent

Exchange customers receiving federal subsidy: 93.6 percent

What he has said: “While on the campaign trail, a common theme from Southwest Florida constituents was how harmful Obamacare has been.” —Jan. 14 Op-Ed in the Florida News-Press

Race rating: Solid Republican

6. Rob Woodall, R-Ga.

Constituents in health care exchange: 7.2 percent

Exchange customers receiving federal subsidy: 91 percent

What he has said: “We must instead focus on common-sense reforms, like modifying our medical liability laws, expanding access and use of consumer-driven products like Health Savings Accounts, and dealing with the challenge of Medicare physician reimbursements.” —Statement on websiteRace rating: Solid Republican

7. Ron DeSantis, R-Fla.

Constituents in health care exchange: 7 percent

Exchange customers receiving federal subsidy: 92.4 percent

What he has said: “There are pluses and minuses (in the AHCA), but I think that almost everyone is committed to answering the call of the people that sent us here and to doing a bill that removes the burdens from Obamacare and starts to answer some patient-centered reforms into the system.” —March 8 story on Newsmax.com

Race rating: Solid Republican

8. Bill Posey, R-Fla.

Constituents in health care exchange: 6.3 percent

Exchange customers receiving federal subsidy: 92.2 percent

What he has said: “I have heard from thousands of residents across the 8th District who have been adversely impacted by the president’s health care law. Some have said they wanted to keep the coverage they had but couldn’t. Others are being forced to pay more for less coverage, have lost their jobs or have had their hours cut due to mandates in the health care law.” —2015 statement on website

Race rating: Solid Republican

9. Gus Bilirakis, R-Fla.

Constituents in health care exchange: 6.2 percent

Exchange customers receiving federal subsidy: 91.4 percent

What he has said: “The American Health Care Act reflects what I’ve heard from patients, families, doctors, and many others over the past eight years.” —March 8 story by Sunshine State News

Race rating: Solid Republican

10. Jason Chaffetz, R-Utah

Constituents in health care exchange: 6.2 percent

Exchange customers receiving federal subsidy: 89 percent

What he has said: “Well, we’re getting rid of the individual mandate. We’re getting rid of those things that people said that they don’t want. Americans have choices, and they’ve got to make a choice. So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own health care.” —March 7 interview with CNN

Race rating: Solid Republican

11. Vern Buchanan, R-Fla.

Constituents in health care exchange: 6.1 percent

Exchange customers receiving federal subsidy: 90 percent

What he has said: The individual mandate “is failing to stabilize the health insurance marketplace.” —Jan. 25 Bloomberg story

Race rating: Solid Republican

— Larry Nista contributed to this report. Get breaking news alerts and more from Roll Call on your iPhone or your Android.