Illinois Democrat who helped implement Obamacare aims to unseat Republican who voted to repeal it

Lauren Underwood would become the first black woman to represent Illinois' 14th Congressional District.

Credit: Lauren Underwood/ Edited: Adam Peck
Credit: Lauren Underwood/ Edited: Adam Peck

Illinois Rep. Randy Hultgren (R) voted to repeal the Affordable Care Act (ACA) nine times since he was first elected in 2010. Now, in the midst of a competitive race, he’s saying he’ll preserve a central feature of the health law.

“I’ve voted 100 percent of the time protecting people with pre-existing conditions that they get coverage,” Hultgren told local media.

When his Democratic challenger Lauren Underwood called him out for lying last week during their only public debate, he told her she didn’t understand or didn’t read the GOP health bill.

“I have a very thorough understanding of what the Affordable Care Act did, the reforms within that law… He perhaps is threatened by that familiarity — the morality surrounding denying health care coverage for people who need it,” Underwood told ThinkProgress, of the exchange.


“So he has taken to insulting my intelligence and challenging my expertise in this area and it’s certainly an area with which he is definitely less familiar.”

Underwood, who is running to become the first black woman to represent Illinois’ 14th Congressional District, has written about how she’s “doubted in eight out of 10 conversations” because of her race and age. While the 32-year-old is often questioned about her statements and stances, Hultgren and dozens of Republicans are given the space to brazenly lie about their positions on health care, and might be believed because they are more widely accepted as authority figures.

Underwood, for her part, has a personal and professional grasp of the health law. She has a heart condition known as supraventricular tachycardia, which is just the kind of medical condition that made access to coverage difficult before the ACA. She’s also a registered nurse, who served as a senior policy adviser for the Department of Health and Human Services under the Obama administration; she was charged with implementing the ACA.

Her read of the GOP health bill is also backed by nonpartisan analysis. The American Health Care Act, which narrowly passed the House with Hultgren’s help, would have weakened protections for people with pre-existing conditions.

“[O]ver time, less healthy individuals (including those with preexisting or newly acquired medical conditions) would be unable to purchase comprehensive coverage with premiums close to those under current law and might not be able to purchase coverage at all,” according to the Congressional Budget Office.


Making matters worse, Hultgren has voted to repeal the ACA without any replacement — beginning with his 2011 vote for the Repealing the Job-Killing Health Care Law Act. Now he could argue he supports legislation that says in the title “Guaranteed Health Coverage for Pre-Existing Conditions,” but the policy he endorses actually falls short of current law because it doesn’t prevent insurers from offering skimpy coverage or charging sicker people more.

“For me, it is not about the Affordable Care Act being the end all, be all,” said Underwood.

She ran for office because Hultgren voted for the GOP health bill 10 days after he promised her and other voters during a town hall that he wouldn’t support a bill that made it harder for people like her to get coverage. 

“For me, it is to say the American people have essential protections that are under threat and we need to make sure that the electorate and the 14th district knows that their representative went along with this scheme to take away their health care coverage. And I want them to know I learned of that, was horrified, and decided to step up and run for Congress,” Underwood said.

If Republicans do well in the midterm elections on Tuesday, they will try to repeal the ACA again. The House currently has enough votes to bring back repeal. And should the GOP pick up more seats in the Senate, Majority Leader Mitch McConnell (R-KY) told Reuters they would start the repeal process all over again.

If Underwood’s elected to the House, she’d try to make health plans offered on the marketplace more affordable by adjusting the formula for subsidies.


“A lot of people living with middle class income are not eligible for the advanced premium tax credits. They’re not eligible for the cost sharing reductions,” she said. “They’re not eligible because of the way that this program was originally designed… We should have a formula that allows middle class people to afford their health care coverage.” 

Hultgren has a slight edge over Underwood in October poll conducted by the New York Times. Underwood is also a black candidate hoping to capture an overwhelming white district that historically votes Republican.

Even still, her views align more with a majority of U.S. voters. Six in 10 say a candidate’s position on continuing protections for people with pre-existing conditions is either the “most important” issue or “very important,” according to a recent Kaiser Family Foundation poll.