US Sen. Saxby Chambliss, R-Ga, center. (AP Photo/Gregory Smith)
Even before President Obama signed the Affordable Care Act into law, Republicans were vowing to repeal it. It’s no wonder, because polls showed that the basic elements of the ACA were quite popular, and there was a real danger that it would become more so as people found out that the plan denounced as a “monstrosity” by the National Republican Senatorial Committee would not trample on their liberties so much as help protect their health. Desperate to avoid this, the GOP-controlled House has voted no fewer than thirty-seven times to repeal Obamacare in the three years since it was enacted.
Now letters produced by a Freedom of Information Act request reveal that many of these same anti-Obamacare Republicans have solicited grants from the very program they claim to despise. This is evidence not merely of shameless hypocrisy but of the fact that the ACA bestows tangible benefits that even Congress’s most extreme right-wing ideologues are hard-pressed to deny to their constituents.
As I reported here last September, Congressman Paul Ryan, who as Mitt Romney’s running mate in 2012 called for its repeal, sent a letter requesting ACA money for health clinics in his district two years earlier. The Nation has obtained documents revealing that at least twenty other Obamacare-bashing GOP lawmakers have similarly pleaded for ACA funds on behalf of constituents. Among them are Kristi Noem, a Republican lawmaker from South Dakota likely to run for the Senate next year, as well as Ohio Senator Rob Portman, who has been touted as a potential GOP presidential candidate in 2016.
In one of two letters sent by Portman to the Department of Health and Human Services, the senator requested ACA funds to help a federal health center in Cleveland, where the money could help “an additional 8,966 uninsured individuals” to receive ”essential services,” in his words. In Noem’s case, the congresswoman requested ACA funds to construct a community health center in Rapid City to provide primary services to the uninsured. Both Noem and Portman won office in 2010 campaigning vigorously against the law and have since worked to repeal it.
Though notably less transparent, the behavior of these GOP lawmakers parallels that of GOP governors like Arizona’s Jan Brewer, who blast the president’s health reform package while embracing the millions in Medicaid funds that it provides.
The letter writers include GOP rank-and-file Congress members, leaders and committee chairs, all of whom have supported the repeal effort. David Valadao, for example, a freshman representative who campaigned last year on his opposition to Obamacare, requested funds in a letter to HHS Secretary Kathleen Sebelius two years ago for a program to improve “the general health” of the Fresno County area, which he then served as a California assemblyman. Congressman Jeff Denham, a two-term GOP lawmaker who won his seat with support from Tea Party activists, penned a letter recommending the same application for Fresno County. The county Department of Public Health won the grant. Valadao’s and Denham’s offices declined to comment.
The Affordable Care Act authorizes an array of grants to local hospitals, community health clinics and doctor training programs, as well as public health initiatives to improve health and access to care. The billions of dollars in grants are awarded on a competitive basis, and lawmakers on the state and federal levels have sent letters endorsing applicants.
Texas Senator John Cornyn, the Republican whip, wrote to the Centers for Disease Control to recommend a grant for Houston and Harris County. Congressman Michael McCaul, a Republican and the chair of the Homeland Security Committee, wrote a letter praising the same grant request, calling the effort a “crucial initiative to achieve a healthier Houston/Harris County.” Senators Johnny Isakson and Saxby Chambliss of Georgia, Mark Kirk of Illinois and Thad Cochran of Mississippi also recommended grant request approval for public health or health clinic funding.
House Republicans and the Senate Republican Policy Committee have trashed the ACA’s Community Transformation grants as an Obamacare “slush fund.” In the letters seeking these grants, however, GOP lawmakers have heaped praise on their potential. Cornyn writes in his letter that the grant would help “improve the health and quality of life of area residents.” Congressman Aaron Schock, a Republican from Illinois, congratulated a local nonprofit for winning a Community Transformation grant, noting that the program will give “people the tools to live healthier and longer lives.”
The National Republican Senatorial Committee warns of Obamacare that “as this awful legislation gets ever closer to going into effect, the negative consequences are only becoming increasingly clear.” But the NRSC’s chair, Jerry Moran, has hailed programs that exist because of it. In August, he attended a ceremony announcing a $4.7 million expansion of the Community Health Center of Southeast Kansas. A picture posted on Moran’s official Facebook page shows the senator in a suit with his foot on a shovel to break ground for the health clinic. “That funding—that came from the Affordable Care Act, and he voted no,” says Krista Postai, CEO of the CHC-SEK clinics. She adds that Moran had been supportive of health clinics in the past, and she was disappointed to see him vote against the law that made her clinic expansion possible. Postai noted that her clinics are already improving lives with ACA funding, and that there are thousands of uninsured and disabled people in her community who now receive coverage and preventive care thanks to the law.
Some of the letters obtained by The Nation are from lawmakers who are no longer in office, including Jerry Lewis, Bobby Schilling, Kay Bailey Hutchison and Robert Dold.
The letters of support for ACA grants are a reminder (if one is needed) that some Republican claims against the bill reflect politics rather than policy preferences. GOP Congressman Hal Rogers, who rails against healthcare reform as “socialistic,” wrote a letter asking for an Obamacare health clinic grant almost as soon as the money became available. Federal health centers provide a range of healthcare services regardless of a patient’s ability to pay. The ACA dramatically boosts spending on these centers, by about $11 billion, with the goal of reaching 1.25 million additional patients.
Congressman Bill Cassidy, a Louisiana Republican who has led efforts to repeal healthcare reform, stood next to a 6-foot stack of papers he dubbed the “Obamacare Red Tape Tower of Regulations” at a press conference in May. In October, Cassidy posed for a different type of press event, standing with school administrators in Baton Rouge, scissors in hand, at a ribbon-cutting ceremony for three school-based health centers. The ceremony was a celebration of a $500,000 grant authorized by the Affordable Care Act to expand health clinics in area schools.
Before healthcare reform made nearly every federal health program a political football, the Bush administration routinely requested greater funds for federal community health centers with little controversy. But health clinics once supported by the GOP are now on the chopping block. Republicans, led by Congressman Michael Burgess of Texas, have attempted to roll back the ACA’s expanded clinic funding. Also, several of the repeal bills in Congress have targeted the entire law, including funds for health centers and public health initiatives. The fact that they have sought grants for those centers has not stopped Republicans from voting against them. Louisiana’s Cassidy, for instance, voted for Burgess’s bill to shut down funding for clinics.
Whether cutting a ribbon or signing a letter, no Republicans have acknowledged that the health programs they are endorsing are provided by Obamacare.
Some GOP lawmakers have balked at the charges of hypocrisy. “Sen. Chambliss voted against the Affordable Care Act, just as he did the stimulus package. But the bill passed, and if the money is available, we want Georgians to be able to compete fairly with folks from other states for it,” wrote Lauren Claffey, the senator’s press secretary, in an e-mail. Similarly, Senator Isakson’s office e-mailed a statement from the senator claiming: ”I voted against Obamacare and will continue to work to repeal it. However, one of the most important parts of my job as senator is to assist Georgia individuals, businesses and local governments in their dealings with the federal government. Any time one of my constituents has business with the federal government, I try to be as helpful as possible by supporting worthy projects.”
If these grant letters—sent since the ACA’s implementation in 2010—are any guide, GOP opposition to the law will be seriously tested when the open enrollment period for ACA exchanges begins this fall. What will these Republican lawmakers say to their uninsured constituents who want to sign up?
To the extent that the law is successful, it places its Republican critics in a bind, which is why they’re working so hard to undermine it. “The thing about reading these letters is that they’re well-drafted. If you were to read them as stand-alone, you would say, ‘Gosh, the Affordable Care Act is great,’ not ‘Let’s repeal the bill,’” says Ethan Rome, executive director of Health Care for America Now, a pro-reform advocacy group. Rome points out that Republican lawmakers are not “holding press conferences in front of a community health center saying, ‘I’m here to get this defunded.’” He adds, “Now that would be political courage.”
Read through all of the documents obtained via The Nation's Freedom of Information Act request:
Read Lee Fang's exposé of Paul Ryan’s ACA grant request here.