Where Michigan candidates for Senate, Congress stand on health care, ACA

If you have a television and live in Michigan, then you’ve almost certainly seen campaign ads about health care — and are likely tired of them.

In Michigan’s tight U.S. Senate race, Republican John James and incumbent Democrat Gary Peters have aired dueling ads about health insurance for months. Same goes for Republican Peter Meijer and Democrat Hillary Scholten in the 3rd congressional district to represent west Michigan, or numerous other races statewide.

Democrats (like Peters) accuse Republicans (like James) of jeopardizing protections for 4.1 million Michiganders with pre-existing conditions by advocating for the repeal of the Affordable Care Act. 

Republicans (like Meijer) accuse Democrats (like Scholten) of pushing massive health care plans that could raise taxes, close hospitals and separate patients from doctors.

This election season, Bridge Michigan has seen so many of the ads, framed in such familiar ways, that fact-checking each political advertisement would be redundant.

Instead, Bridge is laying out the facts in one place, compiling a list of where each of the candidates in key federal races across the state stand on health care, how they have voted while they have held office, and what they plan to do if they are in office in 2021.

Here’s what you need to know about the health care debate.

The Plans

The Affordable Care Act, or “Obamacare,” was approved in 2010. It expanded Medicaid, gave  subsidies to those within 400 percent of the federal poverty level, made it illegal for health insurance providers to discriminate against people with pre-existing conditions, banned lifetime caps on health insurance coverage and allowed those under 26 to remain on their parents’  plans. It also instituted an individual mandate that made those without health insurance pay a tax penalty.

Within the first five years, 1.2 million Michiganders gained health care access due to the ACA, which lowered the state’s uninsured rate by 53 percent. The law was funded by the individual mandate, and a 3.8 percent tax increase on investment income for households with over $250,000 in income, and individuals with over $200,000 in income. 

The individual mandate was repealed in 2017, but a repeal of the rest of the law failed. The ACA is the only U.S. law that protects citizens with pre-existing conditions.

The American Health Care Act was Republicans’ failed effort to replace the ACA. Introduced in 2017, it would have repealed the Medicaid expansion, drastically cut spending and eligibility, eliminated tax credits for health care costs and abolished taxes for higher earners. 

But the bill would have kept popular provisions of the ACA, such as the bans on denying coverage to those with pre-existing conditions and lifetime coverage caps, and the rule allowing children to stay on parents’ plans until 26. 

A Public Option is a plan favored by many Democrats including presidential nominee Joe Biden that would keep the ACA and allow people to buy government-controlled health plans to compete with private plans.

Different plans come with different levels of coverage and different ways to pay for them, but Biden’s plan will cover an estimated 97 percent of Americans while raising taxes on Americans with an income of $400,000 or more.

Medicare for All is a plan favored by liberal Democrats that would abolish the private health care market and offer universal coverage for all Americans. It would cost some $3 trillion per year, require a significant tax increase (likely on high-income earners and on capital gains tax) but would provide universal coverage with no cost to consumers. 

Abolishing the private health care market may cause massive job losses, though some studies dispute that point.

President

Donald Trump, Republican

• Trump favors repealing the Affordable Care Act. Replacing the ACA was a key part of his platform when he ran for president in 2016. In early 2017, Trump led the charge to repeal the law and replace it with the ACHA.
• While he has yet to lay out a replacement health care plan, he has stated that he wants to continue protections for those with pre-existing conditions. 

Joe Biden, Democrat

• Biden was vice president when the Affordable Care Act became law, and he said he’d protect it under his presidency. 
• He plans to expand Medicaid and increase tax credits given to low-income individuals who purchase health care plans. Biden also plans to give tax credits based on the amount of a family's insurance premiums. 
• Biden plans to end “surprise billing,” a practice in which patients are met with large hospital bills for reasons outside of their control. For example, an emergency room visit where a patient is incapacitated, or a patient at an in-network hospital being treated by an out-of-network doctor.
• The candidate plans to lower drug prices by repealing a law that restricts Medicare from negotiating drug prices with manufacturers, limiting drug price increases, limiting the launch price of low competition drugs, increasing the production of generic drugs and allowing consumers to purchase drugs from overseas.

Senate

Gary Peters, Democrat

• Peters supports the ACA and voted in favor of it when he was in the U.S. House in 2010.
• His website states that he will “continue supporting bipartisan, commonsense efforts to improve the law to make quality health care more affordable and accessible for Michiganders.”
• Peters is not in favor of Medicare for All. He was asked on WDIV’s Flashpoint on Oct. 18 as to why he does not, and he did not answer the question. He supports expanding Medicare, though, as he introduced a bill that would allow Americans as young as 50 to buy into Medicare.
• He supports measures to repeal the law that prevents Medicare from negotiating drug prices. Peters also co-sponsored the Affordable Insulin Approvals Now Act and the Creating and Restoring Equal Access to Equivalent Samples Act, both of which helped decrease drug prices once they went into law. 

John James, Republican

• James favors of repealing the ACA, though he has said that he would not support a repeal without an alternative plan in place. On Sept. 28 he told WZZM-TV that he opposed a lawsuit heading to the Supreme Court that would declare the ACA unconstitutional.
• He reiterated his support for protecting pre-existing condition protections during an appearance on WDIV’s Flashpoint on Oct. 18, but refused to elaborate on how he would provide them if the ACA is repealed. 
• James supports expanding preventative care such as “wellness coverage including trauma, addiction, nutrition and fitness,” according to his website. 
• While he does not explicitly support an existing plan, any plan he would support will contain “must include tort reform and regulatory reform,” per his website.

1st Congressional District

The sprawling district includes much of the northern Lower Peninsula and entire Upper Peninsula. It has been represented by Republicans since 2011, and was represented by the Democratic party for the 78 years before then. 

Jack Bergman, Republican, took office in 2017

• Bergman supports repealing the ACA. 
• He voted in favor of the ACHA, and voted against the Protecting Americans with Preexisting Conditions Act of 2019.
• Voted against a law that would allow Medicare to negotiate drug prices.

Dana Ferguson, Democrat, a carpenter

• Ferguson supports single payer health care, per his campaign website.
• He compares his plans to two previous Medicare for All proposals.
• Ferguson proposes universal coverage, streamlined payment negotiations, and maintaining choice over doctors and coverage.
• He proposes paying for the system through monetary and tax reform.

2nd Congressional District

Covers much of western Michigan, including Lake, Muskegon, Newaygo, Oceana, and Ottawa counties and areas of Allegan, Kent, and Mason counties. Held by Republicans since 1967.

Bill Huizenga, Republican, took office in 2011

• Huizenga supported the 2017 repeal of the ACA, saying “Obamacare as it stands is failing and will soon collapse under its own weight, which is why we must leave behind this failed policy and promote solutions that empower patients and care providers,"
• He supports continuing protections for those with pre-existing conditions, and introduced the Protecting Patients with Pre-existing Conditions Act in 2019, a law that will continue protections even if the ACA is repealed.
• Voted against a law that would have allowed Medicare to negotiate drug prices with manufacturers. 

Bryan Berghoef, Democrat, a pastor and author

• Berghoef wants to “march toward universal coverage”, per his campaign website.
• He does not want to abolish private insurance with his universal plan, though, wanting to “move toward a system that allows a choice between private and public plans.”
• Berghoef wants to implement policy to control costs.

3rd Congressional District 

Covers Ionia, Barry, and Calhoun counties and portions of Kent and Montcalm counties, including the city of Grand Rapids. It is represented by Justin Amash, a former Republican turned Libertarian who is not seeking re-election.

Peter Meijer, Republican, a businessman

• Meijer pledged to work toward repealing ACA and said he would “oppose efforts to give the federal government more control of health care” when answering a survey with the Campaign for Liberty, a Libretarian organization.
• During a debate Oct. 1, he said he would not support a repeal of the ACA without a plan for pre-existing conditions in place. His campaign told Bridge that Meijer would not support an appeal of the ACA unless there was a plan that expands access, lowers costs and protects those with pre-existing conditions ready to replace.
• According to Meijer’s website, the candidate supports expanding the use of health savings accounts, which allow Americans to save money pre-taxes to be used in the case of a medical emergency.

Hillary Scholten, Democrat, immgiration attorney

• Scholten supports the ACA, saying “I will defend the Affordable Care Act and work every day to expand on it,” on her campaign website.
• She supports creating a public option.
• Her campaign website states she supports protections for those with pre-existing conditions, and will work to prevent insurance premiums and deductibles from rising.

4th Congressional District

Covers central Michigan,including  Clare, Clinton, Gladwin, Gratiot, Isabella, Mecosta, Midland, Missaukee, Ogemaw, Osceola, Roscommon, Shiawassee and Wexford counties and portions of Montcalm and Saginaw counties. The seat has been held by Republicans since 1935.

John Moolenaar, Republican, in office since 2015

• Moolenaar has voted to deregulate the medical industry, with votes for the 21st Century Cures Act, a vote to repeal the Medical Device Tax and voting in favor of Right-to-Try legislation, which allows patients to choose to use unapproved drugs.
• He voted to repeal the ACA in 2016, and again in 2017.
• Voted against allowing Medicare to negotiate drug prices with drug providers.

Jerry Hilliard, Democrat, former teacher 

• Hilliard supports Medicare for All, per his campaign website.

5th Congressional District

Covers the eastern Lower Peninsula, including Arenac, Bay, Genesee, and Iosco counties and parts of Saginaw and Tuscola counties. Democrats controlled the seat since 1993.

Dan Kildee, Democrat, in office since 2013

• Kildee supports protecting, and expanding, the ACA.
• He voted in favor of the Protecting Americans with Pre-Existing Conditions Act.
• The congressman has supported efforts to end surprise billing, allow Medicare to negotiate drug prices and increase the production of cheaper, generic drugs. 
• Kildee supports Medicare expansion. 
• Voted for a bill that would allow Medicare to negotiate drug prices with drug manufacturers.

Tim Kelly, Republican, former state House member

• He told Campaign for Liberty that he wanted to repeal the ACA.
• Kelly attacked his opponent on Twitter for voting to add Medicare for All to the official Democratic Party platform. 
• He told BallotPedia he would “support economic policies that will continue growth, make healthcare and prescription drugs less expensive.”

6th Congressional District

Covers southwest Michigan, including Van Buren, Kalamazoo, St. Joseph, Cass, and Berrien counties and a part of Allegan County. The seat has been held by Republicans for more than 30 years.

Fred Upton, Republican, in office since 1987

• Upton voted to repeal the ACA, and replace it with the ACHA.
• Upton voted against a bill that would allow Medicare to negotiate drug prices.
• He voted against the Protecting Americans with Preexisting Conditions Act of 2019.
• He introduced the 21st Century Cures act, which helped accelerate medical research and develop new, non-addictive, prescription drugs, and expedited the FDA approval processes for new drugs.
• He co-sponsored the Lower Costs, More Cures Act in 2019, a bill which worked to lower prescription drug prices.

Jon Hoadley, Democrat, state House member

• His website says that he will fight for “more affordable prescription drugs and letting the government negotiate prices for Medicare patients.”
• Hoadley also says “my first priorities will be reforming our healthcare system to provide quality long-term care solutions for seniors.”
• He stated his support for Medicare for All on Twitter. His campaign expressed support for Medicare for All on a BallotPedia survey as well.

7th Congressional District

Covers southern Michigan, including Branch, Eaton, Hillsdale, Jackson, Lenawee and Monroe counties and a portion of Washtenaw County.

Tim Walberg, Republican, in office since 2011

• He voted in favor of repealing the ACA and replacing it with the ACHA.
• Walberg voted in favor of The Lower Costs, More Cures Act to lower drug costs.
• He voted for three bills that would help more generic drugs hit the market, in the Pay for Delay Act, the CREATES Act, and the BLOCKING Act.
• Walberg voted against the Lower Drug Costs Now Act, which would allow Medicare to negotiate drug prices.
• Per his website, Walberg supports ending surprise billing.
• He is a co-sponsor of the Pre-existing Conditions Protection Act.

Gretchen Driskell, Democrat, former state House member

• She supports “universally accessible, affordable health care,” per her campaign website, and that includes an expansion of Medicaid. 
• Driskell supports expanding “comprehensive mental health coverage, and the requirement that all policies cover mental health care.”
• “Addressing the rising cost of prescription drugs will be a top priority,” her website states if she is elected.

8th Congressional District

Covers  central and eastern Michigan, including Livingston, Ingham and parts of Oakland counties. Republicans had controlled the district from 2001 to 2019.

Elissa Slotkin, Democrat, in office since 2019 

• Sloktin favors  “bipartisan reform of the Affordable Care Act” per her website.
• The candidate would “consider” plans that allow Americans to buy into Medicare.
• She plans to “reform standards on the prescription drug industry in order to bring down prescription drug costs.” She also voted in favor of allowing Medicare to negotiate drug prices with manufacturers.
• Slotkin voted in favor of the Protecting Americans with Preexisting Conditions Act of 2019.
• In October 2019 she introduced a bill to Congress that would add vision coverage to Medicare, and lower drug costs.
• In the same month she introduced the STABLE Act, which allows those with disabilities - or those caring for someone with disabilities - to access health savings accounts.

Paul Junge, Republican, former Trump administration official

• Junge favors repealing the ACA, though his campaign told Bridge he only would support the repeal if there is a replacement in place for protecting those with pre-existing conditions.
• Per his campaign’s official website, Junge believes Medicare for All to be “a threat to your health coverage,” and that he “will protect your work-provided health care.”
• Junge supports measures to “lower out-of-pocket-costs by increasing the availability of generics, speeding up the FDA approval process, and providing greater price transparency.”
• He is a supporter of expanding health savings accounts.

9th Congressional District

Covers parts of Oakland and Macomb counties. It has been represented by Democrats for 21 of the past 27 years. 

Andy Levin, Democrat, in office since 2019

• Levin supports Medicare for All, per his campaign website. He is a cosponsor of the Medicare for All act.
• He voted in favor of the Protect Americans With Pre-existing Conditions Act of 2019.
• Voted in favor of the Lower Drug Costs Now Act.

Charles Langworthy, Republican, Navy veteran

• Langworthy wants to reduce start up regulations for insurance providers so more insurance companies can open up. He also wants to allow for more tailored, less comprehensive, health care plans.
• He pledged to Campaign for Liberty that he would work to repeal the ACA.

10th Congressional District

Covers Michigan’s Thumb, including Huron, Lapeer, Sanilac, and St. Clair and parts of Macomb and Tuscola counties. Republicans have controlled the district since 2003. Incumbent Republican Paul Mitchell is not seeking re-election.

Lisa McClain, Republican, businesswoman

• The ACA “must be repealed as soon as possible and replaced with a free market approach to health care coverage that starts with individual responsibility,” her campaign website states.
• McClain supports expanding the use of health savings accounts.
• She supports allowing health care plans to be purchased across state lines to encourage competition. 

Kimberly Bizon, Democrat, climate activist

• Bizon wants to expand the ACA, according to her campaign website. 
• Bizon “supports a universal health care coverage solution that does not tie individuals to specific jobs or employers.”
• She “will fight for more affordable prescription pricing,” her website states.

11th Congressional District

Coves suburban Detroit, including parts of Oakland and Wayne counties. It had been represented by Republicans for six years before 2019. 

Haley Stevens, Democrat, in office since 2019

• Stevens website states that she wants to “fix the Affordable Care Act (ACA), not dismantle it,”. She condemned a 2018 lawsuit, Texas v. U.S., which argued the law is unconstitutional. 
• Oppose the repeal of protections for people with pre-existing conditions, and will attempt to lower healthcare costs.
• Stevens supports a public option, and is against Medicare for All, her campaign told Bridge.
• In 2019 Stevens introduced a bill to end surprise billing.
• Stevens introduced a bill last year to lower out of pocket drug costs for Medicare recipients. She also voted in favor of the Lower Drug Costs Now Act.
• She voted in favor of the Protecting Americans with Preexisting Conditions Act of 2019.

Eric Esshaki, Republican, former nursing home worker

• Esshaki supports a repeal of the ACA, per the survey by Campaign for Liberty. His official website states that he “believes that Obamacare has failed us. It eliminated choice and substantially increased insurance costs for millions of Americans.”
• He is “is 100 percent against government run healthcare,” per his website.
• Esshaki wants to lower costs and protect people with pre-existing conditions, his website says.
• “We need to have a healthcare policy focused on actually bringing those costs down, and there’s a handful of ways to do it. One is to have more free-market principles involved in health care, more competition based on cost,” Esshaki told The Jewish News.

12th Congressional District

Coves Detroit’s western suburbs, including parts of Wayne and Washtenaw counties. It has been a Democratic district for decades.

Debbie Dingell, Democrat, in office since 2015

• Dingell supports Medicare for All, per her campaign's official website. She is a cosponsor of the Medicare for All act, and a co-chair of the Medicare for All caucus. 
• She voted in favor of a bill that would allow Medicare to negotiate prescription drug prices. 
• Dingell supported amendments to a law that allowed for protections for the elderly against becoming impoverished due to medical costs.
• Voted in favor of the Protecting Americans with Preexisting Conditions Act of 2019.

Jeff Jones, Republican, former health Insurance executive

• Jones pledged to repeal the ACA and limit government involvement in health care to Campaign for Liberty.

13th Congressional District

Covers parts of Wayne County, including much of Detroit and western suburbs.  It has been represented by Democrats since 1949.

Rashida Tlaib, Democrat, in office since 2019

• Tlaib is a proponent of Medicare for All. She is a co-sponsor of the Medicare for All act.
• She supports the ACA, and believes it was a step in the right direction towards Medicare for All. Tlaib condemned a court decision to strike down the law.
• Tlaib voted in favor of the Lower Drug Costs Now Act.
• She voted in favor of Protecting Americans with Preexisting Conditions Act of 2019.

David Dudenhoefer, Republican, deputy state coordinator for the Campaign for Liberty

• He told Campaign for Liberty that he would work to repeal the ACA.
• “I am not for the government-forced One-size-fits-Medicare-for-all no-choice healthcare plans,” Dudenhoefer states on his campaign website.
• Dudenhoefer would “support legislation that gives nurses more autonomy.”
• He supports the expansion of health savings accounts.
• He supports allowing Americans to purchase health insurance across state lines. 
• Dudenhoefer was to provide Medicaid recipients with access to more specialized health care. 

14th Congressional District

Covers parts of Wayne and Oakland counties, including parts of  Detroit and northern suburbs up to Pontiac. It has been represented by Democrats since 1949.

Brenda Lawrence, Democrat, in office since 2015

• Lawrence is a cosponsor of the Medicare for All act.
• She voted in favor of the Lower Drug Costs Now Act in 2019.
• Lawrence voted in favor of the Protecting Americans with Preexisting Conditions Act of 2019.

Robert Vance Patrick, Republican, contractor

Patrick pledged to Campaign for Liberty that he would work to repeal the ACA and reduce government involvement in healthcare. Patrick reiterated the pledge to Bridge on Oct. 21.