Sen. Deb Fischer’s votes on health insurance are making it tough for many Nebraskans to afford — or even get — coverage.

Votes by Sen. Deb Fischer to gut The Affordable Care Act have come home to roost in the form of more expensive health insurance or lost coverage for thousands of Nebraskans.

Fischer was in lock-step with the GOP when lawmakers voted to cripple the ACA  threatening the health care coverage of tens of thousands of Nebraskans  and has hauled in some $45,000 in donations from health insurance and health care Political Action Committees.

“Fischer went along with this scheme, and now it’s having a devastating impact on Nebraskans who either cannot afford — or even get — coverage,” said Nebraska Democratic Party Chair Jane Kleeb. “Nebraskans need to send people to Washington D.C. who will fight for them, not sell them down the river.”

On Tuesday, President Trump’s former top health  official said the Republican tax law would raise the cost of health insurance for some Americans because it repealed a core provision of the ACA,  according to the Washington Post.

Tom Price, Trump’s first secretary of the Department of Health and Human Services, said people buying insurance on government-run marketplaces will face higher prices because the tax law repealed the ACA’s individual mandate. The mandate had forced most Americans to have health coverage or face a financial penalty, the newspaper reported

Price’s comments are in line with predictions from the nonpartisan Congressional Budget Office, which in November projected that 13 million fewer Americans would have health insurance by 2027 as a result of the elimination of the individual mandate. The CBO also said average premiums in the exchanges would increase by about 10 percent in most years over the next decade, compared with a scenario in which the mandate had been left in place.

Meanwhile,  a new study from the Commonwealth Fund finds that four million Americans — including thousands of Nebraskans — have lost coverage. The study says the rise of the uninsured rate is a direct result of Republican efforts to sabotage the ACA insurance system – from repealing the individual mandate to allowing shoddy, short-term plans that jeopardize coverage for pre-existing conditions.

The Urban Institute says the GOP sabotage of the ACA will lead to 6.4 million fewer Americans with health insurance, while the federal bill for coverage rises by some $33 billion per year. And premiums in the individual market will rise by an average of more than 18 percent.

That’s why health care remains top of mind for voters: the latest HuffPost/YouGov poll found “American voters are more likely to say they’re focused about health care than any other issue” and Kaiser Health reported that the majority of Americans are “worried about their out-of-pocket costs increasing so high that” they won’t be able to afford care.

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