WASHINGTON _ Missouri Attorney General Josh Hawley won't offer details about his role in the Republican lawsuit that could strike down insurance protections for people with pre-existing conditions.
The threat of a big change in the law governing pre-existing conditions is the biggest, arguably most effective weapon Democrats have in the extremely tight race for U.S. Senate in Missouri.
Hawley is one 20 GOP state officials who joined a federal lawsuit earlier this year that could end Obamacare and those protections. But Hawley and his top aides have refused to explain any details of his involvement.
He proudly touted his role in the case in February, announcing in a news release that his office "will continue to fight to take health care choices out of the hands of bureaucrats and return them to the hands of Missourians and their physicians."
Eight months later, Hawley's decision to join the Texas-led case has become a political headache as Democratic Sen. Claire McCaskill and her allies have launched a series of attacks on Hawley over the lawsuit's impact on pre-existing conditions.
"It's a top testing message against Josh Hawley. It's a huge vulnerability," said Chris Hayden, a spokesman for Majority Forward, a Democratic-aligned super PAC.
With pressure mounting, Hawley's office has refused to clarify his role in the case after oral arguments took place in Texas last week. McClatchy first asked the office for an explanation of Hawley's work on the case Monday.
Mary Compton, the attorney general's spokeswoman, repeatedly promised to provide information about the work attorneys in Hawley's office contributed to the case. Thursday, Compton sent McClatchy an email Thursday afternoon that included no details about what attorneys for the state actually did on the case.
"Missouri is one of 20 states involved in the lawsuit. Texas is lead counsel. Now that the case has been submitted to the court, the parties are largely awaiting the court's decision. To the extent that there is additional work to be done, AGO attorneys are coordinating with their co-counsel in other states," Compton said.
Hawley has previously stated on his campaign Twitter account that he supports protections for pre-existing conditions, but his campaign did not immediately make him available for an interview Thursday to discuss his health care positions more thoroughly and square this position with the lawsuit, which could strike down the Affordable Care Act.
The ACA bars insurance companies from denying people coverage based on pre-existing conditions.
After McClatchy posted a story online, Hawley's campaign issued a statement reasserting his support for protecting pre-existing conditions that did not offer details on how to accomplish that if the ACA goes away.
"This lawsuit is about the individual mandate. It's unconstitutional for the government to force us to buy something we don't want. Senator McCaskill would have you believe that the only way to cover pre-existing conditions is to keep all the failures of Obamacare," Hawley said in a statement. "That's simply not true. I'm committed to covering those with pre-existing conditions, and we don't have to break the Constitution to do it."
McCaskill relished an opportunity to tear into Hawley on the issue during a Monday visit to the University of Missouri-Kansas City.
"Josh Hawley had a decision to make about six months ago, eight months ago, and he had to decide, 'Do I use my job and taxpayer money to file a lawsuit to wipe out every protection in the ACA?'" McCaskill told a crowd of mostly college students.
"He could be arguing that pre-existing conditions can stand on its own because he's saying he supports it. But oh no, you know what he argued in the case? That none of it is severable, that it all has to go," she said.
Hawley's office already faces a Missouri Sunshine Law complaint from Protect Our Care, a liberal-leaning coalition of Missouri health care groups, for not turning over records related to his communications with President Donald Trump's administration on the case.
The lawsuit argues that the Affordable Care Act should be struck down after Congress' decision to end the individual mandate in last year's tax bill. The individual mandate requires people to purchase insurance or face a tax penalty.
The Justice Department decided against defending the mandate and other provisions of the law in court, including the protections for pre-existing conditions. Democratic attorneys general have mounted the defense in court.
Hawley has faced a barrage of attacks on the issue in recent days both from national and state-level Democrats.
McCaskill's campaign this month launched a series of web videos highlighting 30 Missourians with pre-existing conditions to hammer this point. On Thursday, McCaskill released an ad in which she discusses her own battle with breast cancer and asserts that the insurance companies already have too many senators on their side.
Majority Forward, a Democratic super PAC with ties to Senate Minority Leader Chuck Schumer, launched a television ad campaign Tuesday featuring a cancer survivor who says she is angry that Hawley "filed a lawsuit to allow insurance companies to deny care for Missourians with pre-existing conditions." The PAC will spend seven figures on ads attacking Hawley this fall.
The same day the ads launched, Democrats in the Missouri Senate proposed a non-binding resolution Tuesday calling on Hawley to withdraw the state from the case, contending that nearly 2.5 million Missourians risk losing their insurance if the suit is successful due to pre-existing conditions.
The resolution would be unlikely to pass the GOP-controlled legislature.
That figure has previously been used by Missouri Democrats and may overstate the lawsuit's impact in the state. PolitiFact called the 2.5 million estimate "half true" in a July analysis that determined the figure includes people who would face premium increases and coverage exclusions if the ACA was struck down, not just Missourians who would lose coverage.
The Kaiser Family Foundation calculated the number of nonelderly Missouri adults with declinable pre-existing conditions under the pre-ACA law was nearly 1.1 million based on 2015 data.
Beth Partin, 56, a Kansas City copy editor, said she first purchased insurance through the federal health care exchange in 2016, four years after she survived a bout with breast cancer. Her annual mammograms are considered an essential service fully covered under the ACA, but that could change if the law is struck down in court.
"Insurance companies would consider the mammogram to be a form of cancer treatment even though it's preventive care ... so it would cost me a lot more money," said Partin, who will volunteer for McCaskill's campaign on Saturday.
Robynn Kuhlmann, an associate professor of political science at the University of Central Missouri, said that Hawley's decision to join the lawsuit made sense strategically in February, but that it potentially gives McCaskill "a leg up in this election."
She noted that 25 percent of likely Missouri voters in an NBC News/Marist College poll conducted Aug. 25-28 identified health care as the most important issue in determining their vote this election. The poll also found Hawley and McCaskill deadlocked at 47 percent among likely voters.
"If they're making decisions based on their pocketbook, McCaskill's stance on health care ... is going to be much more palatable when you're trying to make a decision to vote," Kuhlmann said.
Ray Bozarth, the executive director of the Missouri Republican Party, rejected the notion that the legal fight over the ACA care could prove a decisive in the election.
"Obamacare raised premiums and deductibles for working Missourians and small businesses. ... I don't blame Claire for trying to get re-elected, but I think whether it's her campaign or whether it's her platform I think they're all ineffective," Bozarth said.
Hawley's campaign has emphasized other issues besides health care, focusing its energy in recent weeks on attacking McCaskill for not specifying how she'll vote on Judge Brett Kavanaugh's nomination to the U.S. Supreme Court.
On Thursday, Hawley published an op-ed on FoxNews.com in support of President Donald's Trump's proposal to build a wall along the southern border.
