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U.S. President Donald Trump holds a campaign rally in Colorado Springs
Senator Cory Gardner, R-Colo., speaks as President Donald Trump holds a campaign rally in Colorado Springs, Colo., on Feb. 20, 2020.Kevin Lamarque / Reuters file

Key Senate Republicans struggle with their health care records

Republicans used to think taking stands against the ACA would pay dividends, and now they're stuck with voting records they're not sure how to defend.

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As the current Congress got underway early last year, House Minority Leader Kevin McCarthy (R-Calif.) made an important concession: health care was the principal reason Republicans lost their majority in the chamber in the 2018 elections. GOP incumbents tried to pretend they were actually moderate on the issues, but voters saw through the claims.

Two years later, Senate Republicans are clearly worried that they'll soon meet the same fate.

Republican senators facing tough re-election fights this fall are expressing support for insurance protections for people with pre-existing medical conditions, running ads at odds with their own recent votes and policy positions.

Among the most egregious examples is Sen. Martha McSally (R) of Arizona, who backed her party's far-right "repeal and replace" scheme in 2017, and who's still haunted by her record.

But she's hardly alone. Sen. Steve Daines (R) of Montana is pushing the line that he supports protections for those with pre-existing conditions, despite his record. The same goes for Sen. David Perdue (R) in Georgia.

Sen. Cory Gardner (R) of Colorado has a new ad of his own along these lines, claiming he "wrote the bill to guarantee coverage to people with pre-existing conditions -- forever."

In reality, the legislation he introduced has gone ignored on Capitol Hill, which is a good thing since it's badly flawed. NBC News spoke to Larry Levitt, the executive vice president for health policy at the nonpartisan Kaiser Family Foundation, who said Gardner's bill "contains a giant loophole" because insurance companies can simply "deny coverage altogether to people with pre-existing conditions."

The current rules, created through the Affordable Care Act, include “guaranteed issue,” meaning insurance companies have to sell policies to people regardless of health status, Levitt said in an email. "The Gardner bill leaves out that requirement, meaning that insurers could deny coverage to people with pre-existing conditions, as they commonly did in the individual insurance market before the ACA," he said.

Meanwhile, the Colorado Republican has also voted several times to repeal the Affordable Care Act -- which, naturally, would've hurt millions of Americans with pre-existing conditions -- and as a senator, Gardner also backed his party's "repeal and replace" bills, which failed in the face of bipartisan opposition.

To be sure, I can appreciate why so many GOP senators are struggling with this: Republicans used to think taking bold stands against "Obamacare" would pay political dividends, and now they're stuck with voting records they're not sure how to defend. Without access to a time machine, these incumbents can't undo what they've already done -- and what they've done is wildly unpopular with the American mainstream.

But that doesn't excuse efforts to deceive the public.