Democrats think President Donald Trump will drag down Republicans, but the health care vote shows GOP members in Congress still fear challenges from the right more than they fear Democrats.

While Democrats continue to challenge President Donald Trump at every turn in the hope that his dwindling popularity will hurt Republicans in the midterm elections, Thursday’s House of Representatives passage of a deeply flawed health care bill demonstrates that moderates in Congress are more worried about potential primary challenges from the right than they are Democratic challenges in the General Election.

The bill passed by the House strips away many of the provisions of President Barack Obama’s Affordable Health Care Act by letting states opt out of them. Among those, the requirement that insurance companies offer certain minimum protections and that they don’t charge more for preexisting conditions. Republican leadership added $8 million – spread over five years – to help fund so-called high-risk pools, but the reality is that many people with expensive medical conditions will get priced out of coverage when insurance companies jack up fees. Likewise, companies won’t have to offer minimum protections, so basically we are turning back the clock to where, rather than working to keep people healthy, which is cheaper, we will go the more expensive route of treating people after they are sick. That’s one of the reasons, along with the potential for millions of people to lose health care coverage, that most major health organizations opposed the bill.

Without those protections, you can pretty much rest assured that everyone is going to be paying more for health insurance.

So why, if recent polls said only 17 percent of Americans approved of the Republican plan, would so many Republicans vote for it? Blame years and years of gerrymandering.

Most of the congressional districts are drawn so that the incumbent party is relatively safe. Republicans are elected in districts where the majority of voters are Republican; Democrats where the majority of voters is Democrat. It takes a really bad candidate – or a really angry public – to upset the apple cart and elect someone from another party.

Democrats were gleeful when their candidate, John Ossoff, advanced to a runoff as one of the top two vote-getters in a Georgia special election last month. The district has long been in Republican hands, yet Ossoff almost got the 50 percent needed in the primary to win outright, and Democrats remain hopeful they can take the seat. That June election, now more than ever, will be an early indicator of whether Republicans will be in trouble in 2018.

For now, however, the moderates in the House appear to be more worried about challenges from their own party from candidates who will try to say the incumbent isn’t conservative enough. Primaries are decided, most often, by a smaller percentage of voters, and whether Democrat or Republican, that percentage tends to be most actively involved and politically vocal.

Given that all accounts so far indicate the House health care bill has no chance in the Senate in its current form (remember, senators are elected statewide, thus drawing from a larger pool of moderates), it seems odd that so many Republicans in Congress would stick their neck out for something – and support highly contentious legislation – that won’t pass anyway in its current form.

All of these representatives may feel they can breathe a sigh of relief over potential primary challengers, but come the General Election they are going to have to defend why they voted to end the preexisting condition provision, the minimum care provision, kick millions of people off health care coverage, give a massive tax break to the wealthy and slash Medicare funding. And they will have to do so whether the Senate passes any health care bill or not because, now, they have a record of voting for these cuts.

The far right Republican base is celebrating this victory now. It remains to be seen, however, if they will be able to spin it to their favor during the midterm elections. Judging by Thursday’s House vote, many moderate Republicans are more confident they can weather a Democratic storm than held the same view about surviving a challenge from their own party’s political right.

Time will tell.

 Jim Lee is Editor for Gatehouse Media Delaware. Email him at