Recently the AASM profiled the Republican leaders in the House of Representatives and described how they may affect the efforts of the Trump administration to repeal the Affordable Care Act. This week, we profile the three most prominent Democrats in the House and explain how they may react to any attempts to repeal Obamacare in the 115th Congress.

Representative Nancy Pelosi, House Minority Leader

As the minority leader of the U.S. House of Representatives for the 115th Congress, Rep. Nancy Pelosi will play a major role for the Democrats in the upcoming health care debate. As the leader of the Democratic Party in the House, Rep. Pelosi is tasked with developing the minority position, negotiating with Republican leadership, directing Democratic caucus activities on the chamber floor, and leading debate for the Democrats.

First elected in 1987, Rep. Pelosi has spent her entire career representing the city of San Francisco on Capitol Hill. She became the House minority leader in 2002, becoming the first woman to lead a major party in the House. On Jan. 4, 2007, Rep. Pelosi went on to become the first woman to be sworn in as the speaker of the House. When the Republican Party regained the majority in the House of Representatives in 2010, she returned to the position of minority leader, a position she retains today.

Prior to joining the leadership, Rep. Pelosi worked on health care issues that revolved around HIV and AIDS. The Congresswoman has worked to accelerate the development of an HIV vaccine, expand access to Medicaid for people living with HIV, and increase funding for the Ryan White CARE Act, the AIDS Drug Assistance Program, the Minority HIV/AIDS Initiative and other initiatives for people living with or at risk for HIV/AIDS.

During her time as speaker, Congress passionately debated the merits of the Patient Protection and Affordable Care Act – now known as the Affordable Care Act (ACA). Although she advocated for a single-payer health care system, Rep. Pelosi was unable to include the provision in the bill. On March 23, 2010, the House passed the Senate’s version of the ACA by a slim 219-212 margin, without garnering a single Republican vote, thereby establishing a new, albeit controversial, health care program for the United States.

Representative Richard Neal, Ranking Member of the Committee on Ways and Means

As the new ranking member of the House Committee on Ways and Means, Rep. Richard Neal will be the senior Democrat involved when any substantial changes to the ACA are referred to this committee. As the newest committee of the United States Congress, it has jurisdiction over all tax, trade and economic growth policies and entitlement spending, including Social Security, Medicare, welfare and unemployment compensation. Rep. Neal has represented Massachusetts’ 1st Congressional District, located in the western and central parts of the state, since 1988.

Rep. Neal has been a longtime advocate of health care reform, as he was involved in the unsuccessful Clinton health care plan of 1993. In 2009, he assisted in the development of the House’s version of the ACA. As the chairman of the Select Revenue Measures Subcommittee within the House Committee on Ways and Means, he helped to develop the bill’s financing plan. Although he supported the ACA, the Congressman communicated his preference for a “piecemeal” approach to health care reform, saying it would allow for a more reasonable debate.

Recently, Rep. Neal defended the law by arguing that it enabled 137 million Americans to gain access to preventive services without cost-sharing, addressed chronic conditions like obesity and diabetes, and expanded Medicaid eligibility. Rep. Neal has reiterated many of his Democratic colleague’s statements by saying that if Congress repeals the health care law’s tax hikes, insurance exchange subsidies and Medicaid expansion, then 22 million people would lose their health care insurance.

Representative Frank Pallone, Ranking Member of the Energy and Commerce Committee

As ranking member of the House Committee on Energy and Commerce, which has jurisdiction over the Department of Health and Human Services, Rep. Pallone could block or amend any legislation sent to his committee that would repeal the ACA.

Rep. Pallone has represented central New Jersey since 1988. During his career, Rep. Pallone has been lead sponsor of several health care bills, including the Cardiomyopathy Health Education, Awareness, Risk Assessment, and Training in the Schools (HEARTS) Act, which would provide information to parents, schools, and health professionals to increase awareness of cardiomyopathy and sudden cardiac arrest. In addition, he introduced the Sudden Unexpected Death Data Enhancement and Awareness Act, which would devote resources to preventing and raising awareness of stillbirths.

As chairman of the Energy and Commerce Committee during the 111th Congress, Rep. Pallone played a key role in authoring and passing the ACA. In recent weeks, he has explicitly stated his strong opposition to any efforts to repeal the legislation. Rep. Pallone explained, “What does this really mean to the average person? If you repeal this, what you’re going to do is you’re going to go back to days when you pay more out of pocket, you can’t get health insurance, your benefit package shrinks and you just have some skeletal plan or catastrophic plan that doesn’t cover anything.”

Conclusion

As the debate on the next phase of federal health care programs commences in the coming weeks, these three prominent representatives will yield tremendous influence as they try to protect the Affordable Care Act from repeal. They played key roles in the passage of the historic legislation seven years ago, and each has a unique perspective that will shape their advocacy: Rep. Pelosi’s strong desire for a single payer system, Neal’s support of the ACA’s achievements in providing access to care and Medicaid expansion, and Pallone’s concern for the impact on the uninsured.