After the Supreme Court upheld the ACA, Karl Rove urges Republicans to “start talking about” proposals that already failed politically

Rove falsely claims the law affects only “7 or 8% of the entire electorate,” ignoring the preexisting condition protections for an estimated 100 million people

Written by Eric Kleefeld

Published

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.

From the June 17, 2021, edition of Fox News’ America’s Newsroom with Bill Hemmer and Dana Perino

DANA PERINO (CO-ANCHOR): Karl, is “repeal and replace” Obamacare dead?

KARL ROVE (FOX NEWS CONTRIBUTOR): I think so. I mean, I think what people want to hear is, “We’ve heard that, we know that’s where you’re coming from, but what is it that you’re for?”

Now remember, the advantage that the Republicans have is that the Affordable Care Act affects only about, you know, 7 or 8% of the entire electorate, that’s what’s that covered by it. But what the downside of that is, is that the rest of the electorate — particularly those that have coverage through their employer — they want to know, “What are you going to do to make it better for me?”

And Republicans have ideas they can talk about. We want to be — we want transparency in pricing and outcomes. So when you go to a doctor, or go to a hospital, you know how much it’s going to cost, you know how good they are at it. We — Republicans talk about allowing small businesses to join together and pool their risk and get the same discounts that big companies get — about allowing more people to save more money for their out-of-pocket health care expenses tax-free. There are lots of things Republicans can talk about. They just need to start talking about them.

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.