Republican Kelly Ayotte’s opposition to ACA clashes with most voters

Former U.S. Sen. Kelly Ayotte voted repeatedly to curtail and kill the Affordable Care Act (ACA). Her record of opposing the popular health care law could become a liability in her run for New Hampshire governor.

Ayotte, a Republican, served in the U.S. Senate from 2011 to 2017. She launched her campaign for governor last year. Primary elections will take place on Sept. 10.

The ACA, also known as Obamacare, was signed into law in 2010. More than 45 million people are currently enrolled in the ACA. Last year, Ayotte cited her opposition to the law as what motivated her to enter politics. 

“My message in 2010 was very much against Washington,” Ayotte said at an Institute of Politics Harvard Kennedy School event, “I was not an incumbent, I was an insurgent, and I was running on what had happened with the health care law, on out-of-control spending in Washington, and some national security issues as well.”

In office, Ayotte voted at least nine times to partially or fully repeal the ACA. That includes backing a 2016 budget resolution that sought to dismantle the program and repurpose its funds. How the funds would be repurposed was never made clear. An analysis by the progressive Center on Budget and Policy Priorities determined that the resolution would cause tens of millions of people to lose their health insurance or become underinsured. 

A 2016 budget that included ACA repeal ultimately passed the Republican-controlled House and Senate with Ayotte’s support. President Barack Obama vetoed the budget.

In addition to voting to repeal the ACA, Ayotte also voted for measures that sought to hamper and impede implementation of the law. In 2013, she backed an amendment to a budget that would have blocked new federal funding for ACA programs. Texas Sen. Ted Cruz authored the amendment and was not shy about its purpose.

“The purpose of this amendment is to advance economic growth and to delay funding for ObamaCare until there is economic growth,” Cruz said. “At a minimum, ObamaCare should not be funded when our economy is gasping for breath.”

Americans for Prosperity, a far-right advocacy group run by billionaire Charles Koch, urged Republican lawmakers to back the Cruz amendment.

Ayotte supported a similar budget in 2011 that aimed to strip funds from the Department of Health and Human Services intended for building the infrastructure needed to implement the ACA. This proposal was also backed by Americans for Prosperity and ultimately did not pass.

Ayotte ran for a second term in the U.S. Senate in 2016 but lost to Democratic Sen. Maggie Hassan. In the course of that campaign, Ayotte falsely claimed that the ACA led to Americans paying higher health care premiums.

“Well I would like to say that saying that the Affordable Care Act is a success – someone needs to say that to the people that I keep meeting with in New Hampshire; families who are paying higher deductibles, are paying higher premiums, and have higher copays, and therefore are having less access to health care,” Ayotte said in a Sept. 2016 debate.

According to a Washington Post analysis from May, health care premiums have net decreased since the ACA was enacted. From 2000 to 2010, health care premiums increased annually at a rate higher than inflation. Today, premiums lag behind inflation. In other words, when costs for food and housing went up in recent years, ACA enrollees did not experience comparable price spikes in health care coverage.

The Kaiser Family Foundation says that 59% of adults have a favorable view of the ACA. A Navigator Research poll from 2023 found that two in three Americans don’t want the ACA to be repealed.

An Ayotte spokesperson did not respond to questions for this story.