Fox News contributor Karl Rove’s comments followed Thursday’s 7-2 ruling by the U.S. Supreme Court to uphold the Affordable Care Act, rejecting a lawsuit brought by Republican-led states that sought to overturn the entire law.
Rove appears to have derived his figure of only “7 or 8% of the entire electorate” being affected by the ACA by combining the numbers of people who directly obtain their health coverage either through the ACA health insurance exchanges or those who have benefitted from the expansion of Medicaid eligibility in participating states.
However, the Affordable Care Act’s key provisions also protect the greater number of people who obtain health insurance coverage through their employers — most notably coverage for preexisting conditions. These protections cover between 54 million to 133 million people, depending on the range of the definition, thus encompassing a much wider section of the population than Rove acknowledged.
In addition, while Rove says Republicans “need to start talking about” their policies, his appeal for them to run on “transparency in pricing” in health care sounds similar to ideas previously advanced by Fox Corp. board member and former House Speaker Paul Ryan (R-WI) in 2017, who objected to the entire principle of health insurance as an economic mechanism for sharing costs and instead spoke positively of switching over to an economy of individual price-shopping for important medical procedures.
At the time, the nonpartisan Congressional Budget Office projected that the Republican health care bill would have led to 23 million more people being uninsured in 2026, while individuals with preexisting conditions would have had to pay higher premiums. The bill’s widespread unpopularity, even after its defeat in the Senate in July 2017, led to health care becoming a major issue in the 2018 midterm elections, helping drive Democratic gains that year.