Cedar Rapids, Iowa—Shelley Sullens, a bed and breakfast operator in Cedar Rapids who lost her health insurance two years ago when her husband was laid off from his job, can't stand the Affordable Care Act. Jack Fligor of nearby Hiawatha, Iowa, who lost his coverage when he recently lost his job as a maintenance worker, strongly supports Obamacare.
Those sharply conflicting views are helping shape the climate for the Iowa presidential caucuses, the first-in-the-nation primary contest. And that clash will be expressed Thursday morning in Cedar Rapids, when Republican presidential candidate Dr. Ben Carson and Bill Clinton, the husband of Democratic presidential candidate Hillary Clinton, appear at separate events in town in the lead-up to the caucuses, which take place Feb. 1.
Carson is likely to talk about his plan to repeal the ACA and replace it with what he calls health empowerment accounts—health savings accounts “but with no bureaucrats,” he said elsewhere in Iowa on Wednesday. In contrast, former President Clinton may talk up his wife's proposals to fix the ACA by providing financial assistance to Americans to help them with their high out-of-pocket costs for healthcare deductibles, coinsurance, and prescription drugs, as well as to increase support for Alzheimer's research.
Political observers say healthcare won't be the top issue on the minds of most Iowa caucus-goers when they gather to pick their respective party nominees. But it's top of mind for Sullens and Fligor and may well play a role in the caucus outcomes.
Sullens, who describes herself as a Christian conservative, had a subsidized health plan with her husband through the federal insurance exchange for a short period. But she didn't like what she thought was the exorbitant premium. The couple dropped the exchange plan and switched to a faith-based, insurance-like program in which subscribers help each other cover their healthcare costs.
Then she says she had a nightmarish experience in which she and her husband were still being charged for their exchange plan even after they disenrolled and were threatened with collection action until Sen. Charles Grassley's office intervened.
She's glad she's out of Obamacare because, she said, her premium dollars are no longer going to pay for anyone's abortion or for a prison inmate's sex-change operation. “They can pay for those things with their own money,” Sullens said.
On Wednesday, Fligor was visiting the Community Health Free Clinic in Cedar Rapids to pick up insulin for his diabetes while he waits to see if he's eligible for Medicaid under the state's expansion of the program to low-income adults made possible by the ACA. He's currently working two part-time jobs with no health benefits, and he can't afford to pay out of pocket to see his regular doctor. In the interim he's getting his primary care and insulin at the free clinic, without which he says he'd be lost.
The Republican candidates are “coming through and attacking Obamacare, but losing Obamacare would hurt a lot of people,” Fligor said. “I think healthcare is an issue that will affect people's vote.”