Trump's push to end the ACA could roil politics in Miami, Obamacare capital of the U.S.

Jun. 26--A renewed effort by the White House to overturn the Affordable Care Act is stirring campaign politics in battleground Florida, a must-win state for President Donald Trump that is home to nearly 2 million Obamacare consumers -- most in the nation.

In a brief filed before the U.S. Supreme Court late Thursday, Solicitor General Noel J. Francisco argued that the signature achievement of Trump's predecessor was rendered unconstitutional when Congress effectively ended Obamacare's individual mandate, the provision requiring all Americans to obtain health insurance or pay a fine. Francisco wrote "the entire ACA ... must fall with the individual mandate."

The brief -- joining Republican state attorneys general, including Florida's Ashley Moody -- was not unexpected. But with more than 11 million Obamacare consumers nationwide, and roughly 850,000 in Broward, Miami-Dade and Palm Beach counties, the Trump administration's push was quickly condemned by Democrats.

Miami Rep. Donna Shalala, a former Health and Human Services secretary under former President Bill Clinton, called the effort "immoral." She said there are 100,000 people in her district alone relying on Obamacare. No county in the U.S. has more people signed up for 2020 Obamacare coverage than Miami-Dade's 457,000, according to data from the Centers for Medicare and Medicaid Services, which manages the federal insurance exchange at healthcare.gov.

Meanwhile, COVID-19 hospitalizations are on the rise in Miami-Dade County, and the Florida Department of Health reported 8,942 new confirmed cases of the disease Friday, smashing a previous high.

"The idea in the middle of COVID-19 to eliminate health insurance from 100,000 people in my district is a new disaster," Shalala said, noting that Florida hasn't expanded Medicaid, leaving more than 400,000 Floridians currently uninsured. "It would create a huge gap. More importantly just think of individual people who suddenly lose their health insurance, and we're in the middle of a pandemic."

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Trump, who claims full-time residence in Florida, has not backed away from his efforts to eradicate his predecessor's signature legislative achievement. Just Tuesday, the president touted Republican efforts to overturn the Affordable Care Act during a speech to young Republicans at a Phoenix church. "We eliminated Obamacare's unfair individual mandate, which punished young Americans, like you, for the privilege of not buying bad health insurance," he said.

But federal data shows many Floridians are receiving their coverage through the health law, which was adopted in 2010.

The average monthly premium for Floridians with ACA coverage in 2020 is $597. But more than 1.78 million of the 1.9 Floridians enrolled in the ACA marketplace this year received a federal tax credit to make their insurance premiums more affordable, with those qualifying paying an average of $98 a month for coverage.

More than 11.3 million Americans signed up for ACA coverage in 2020, according to CMS enrollment data. An additional 12.4 million Americans have gained Medicaid coverage in Washington, D.C., and the 36 states that have expanded eligibility for the program as allowed for under the health law, according to the Medicaid and CHIP Payment and Access Commission, a legislative agency that provides policy recommendations to Congress. Florida is one of 14 states that have refused to expand eligibility for Medicaid.

Trump promised during his Arizona speech to protect coverage for people with pre-existing conditions -- a key achievement of the Affordable Care Act -- but Republicans have not yet agreed on a proposal to accomplish that should the high court strike down Obamacare.

Democrats oppose the move

Democrats, who took back the House of Representatives two years ago while making healthcare a signature campaign issue, quickly highlighted the legal briefing. U.S. Rep. Debbie Mucarsel-Powell, a freshman Democrat facing a likely challenge in Florida's 26th congressional district from Republican Miami-Dade Mayor Carlos Gimenez, said late Thursday that "voters will blame Carlos Gimenez, the party that is backing his run for Congress, and the president who has swapped endorsements with him" if the high court overturns the Affordable Care Act.

Gimenez responded to the ruling through a campaign spokeswoman, saying he supports "the right of states to challenge federal laws," and called on Congress to pass a healthcare compromise.

"This lawsuit, which was already in progress, is not about the plaintiffs or their supporters but about the impact on people," Gimenez said. "Instead of fighting this out in the courts, Congress should instead work together to create meaningful, bipartisan healthcare reform for all Americans."

Republican Rep. Mario Diaz-Balart, who represents the five zip codes with the most Obamacare enrollees in the country, said Obamacare "has failed to deliver on its promises."

"I've often expressed that I am willing to work in a bipartisan, bicameral manner on a reform that will lower costs for families and small businesses, increase access to affordable, high-quality care, and strengthen the doctor-patient relationship," Diaz-Balart, who will not face a reelection opponent this year, said in a statement. "The American people deserve access to the care they need, from the doctors they choose, and at a price they can afford."

Emma Vaugh, a spokeswoman for the Trump campaign in Florida, said "President Trump has prioritized fixing our broken healthcare system and worked with Congress to implement a system that works for all Floridians."

Recent polls have found that Florida voters count healthcare or the coronavirus pandemic among the most important issues this campaign season. This week, several found that Floridians trust Trump to effectively respond to the coronavirus pandemic less than his likely opponent in November, former Vice President Joe Biden.

A New York Times/Sienna poll of registered voters published Wednesday found that most Floridians (52%) disapprove of Trump's response to the coronavirus. A FOX News poll published Thursday found that almost half of voters (49%) trust Biden on the pandemic, versus 36% who trust Trump. That same poll found that Biden has a nine-point lead over Trump in the state, falling outside the poll's margin of error.

Kevin Muñoz, a spokesman for Biden's campaign in Florida, said "the last thing the president and [Attorney General] Moody should be doing is trying to take away Floridians' healthcare" during a spike in COVID-19 cases, which he mostly blamed on Trump and Florida Gov. Ron DeSantis. "As president, Joe Biden will strengthen and build on the ACA so that every Floridian can access the care they need."

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