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      Obamacare Is Everywhere in the Unlikeliest of Places: Miami

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      A decade after the Affordable Care Act’s federal health insurance marketplace was created, its outsize — and improbable — popularity in South Florida persists.MIAMI — Lídice Hernández opened an insurance agency last year on a busy street, affixing to the storefront a logo that has become deeply familiar in South Florida: a white sun rising over the red stripes of the American flag, all encased in a big, blue O.“Obamacare,” it read underneath.Similar displays are common along some of Miami’s main thoroughfares, almost 13 years after President Barack Obama’s signature health policy, the Affordable Care Act, became law and critics branded it with his name. Everywhere you look, especially during the open enrollment period that runs from November to January: Obamacare, Obamacare, Obamacare.“If we don’t use it,” Ms. Hernández explained of the moniker, “people don’t know that we sell it.”And in Miami, people really want it.On its face, the program’s outsize popularity in South Florida remains one of its most intriguing data points. The evidence is visible in every Obamacare logo deployed — not just on storefronts but on trucks, flags and billboards — to sell health insurance, as agents in the crowded local market jockey to enroll people. This year’s open enrollment period ends on Sunday.Florida has far more people enrolled in the federal health insurance marketplace created by the Affordable Care Act than any other state does, a distinction that has been true since 2015. Driving those numbers has been the Miami area, where older, Republican-leaning Hispanics appeared loath to embrace government-subsidized health insurance when the law was enacted. At the time, it ignited some of the most pitched partisan battles in the nation’s recent history.In particular, some Miamians who had fled left-wing leaders in Cuba and other Latin American countries chafed at the law’s requirement — later eliminated — that people have health coverage or face a penalty, which critics decried as “socialism.”The region has only tilted more Republican since then, flipping red in the governor’s race last year for the first time in two decades. Yet in 2022, the two ZIP codes with the most enrollees in Affordable Care Act coverage nationwide were in Doral and Hialeah, cities west and north of Miami known for their right-leaning Venezuelan American and Cuban American communities. And the county with most enrollees in the country remained Miami-Dade.Lídice Hernández opened an insurance agency in Miami last year. Scott McIntyre for The New York TimesEverywhere you look, especially during the open enrollment period: Obamacare, Obamacare, Obamacare.Scott McIntyre for The New York Times“It’s ingrained in our community,” said Nicholas X. Duran, a former Democratic state representative who used to work for a nonprofit group that encouraged Americans to enroll in Obamacare plans and now works for the health insurer Aetna. “It’s stuck.”So is the ubiquitous logo, which got its start as the symbol for Mr. Obama’s 2008 presidential campaign, said Sol Sender, who designed it. It was never intended to represent the health care law, Mr. Sender said, calling its co-opting by enterprising insurance agents “just pretty organic.”Which is not to say that policyholders, while glad to have coverage, are always happy with their plans. Gisselle Llerena, one of Ms. Hernández’s clients said she had been unable to get her insurer to sign off on a test her doctor recommended.“I have an M.R.I. pending from a century ago,” Ms. Llerena, 50, said in Spanish as she recently dropped in on Ms. Hernández’s office in a modest strip mall. “But the insurance doesn’t want to cover it.”Still, Ivan A. Herrera, the chief executive of the Miami-based UniVista Insurance agency, which caters to Hispanic people and prominently advertises Obamacare plans, said he has seen plenty of evidence that the coverage has helped people.“I know customers who have had open-heart surgery,” he said. “They never went to the doctor. They never had a blood test. They never visited a specialist. And now they can take care of themselves.”Each year, Mr. Herrera’s business has “doubled the amount of people that we have in Obamacare,” he said. “Obamacare is massive.”About 2.7 million Floridians out of the state’s population of about 22 million enrolled in a plan through the federal insurance marketplace, which the health law created, in 2022. Compared with Texas, which has about 30 million people but only about 1.8 million enrollees, “Florida is like an A.C.A. monster,” said Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation, a charity focused on health.The average monthly premium last year for Floridians with marketplace plans was $611, and for those who qualified for federal premium subsidies, the average amount was $552 per month, slightly higher than the national average, according to the Kaiser Family Foundation, a nonprofit health policy group.Early federal data suggests enrollment has jumped again for 2023, with 15.9 million plan selections nationally in the federal marketplace and those run by states, including almost 3.2 million — roughly one-fifth of the total — in Florida.That Obamacare has become part of the fabric of Florida life is also striking given the state’s early opposition to the law, led by Rick Scott, then the Republican governor. Mr. Scott, who is now a U.S. senator, barred “navigators” — those who helped people sign up for coverage — from state health department offices in an effort to undermine enrollment.The Republican-controlled State Legislature has not expanded Medicaid, the federal health insurance program for low-income people, as allowed under the Affordable Care Act, making Florida one of only 11 holdout states. About 790,000 currently uninsured Floridians would be eligible for expanded Medicaid, according to Kaiser; without it, other low-income residents have turned to the federal marketplace for subsidized coverage, which is one reason Florida has such high enrollment.Ivan Herrera, the chief executive and founder of UniVista Insurance, said his company had doubled the amount of clients signed up for federal marketplace plans each year.Scott McIntyre for The New York TimesAbout 2.7 million Floridians out of the state’s population of about 22 million enrolled in a plan through the federal insurance marketplace in 2022.Scott McIntyre for The New York TimesObamacare is also popular in the state because it is home to many retirees who are younger than 65 and not yet eligible for Medicare, the federal health insurance program for older people. Others opt for the health insurance because they have recently moved from other states and may be in between jobs. And many employers in the state do not offer working Floridians robust benefits that include health care coverage.“In South Florida especially, you’ve got a lot of people who are working in entertainment or restaurants, where they don’t have an offer of health insurance,” said Karoline Mortensen, an associate dean and professor of health management and policy at the University of Miami. That is especially true for Hispanics, she added.When the federal health insurance mandate lapsed, Dr. Mortensen found that some Latinos dropped their coverage, suggesting that they had gotten insurance only because they were required to. But Hispanic people still continued to get medical care at far higher rates than they had before the federal marketplace was created in 2013, she said.The Kaiser Family Foundation estimates that Florida is the state with the second-highest percentage of eligible people who have enrolled in an Affordable Care Act plan, said Cynthia Cox, a Kaiser vice president.She credited local leaders and insurance agents with promoting the law’s benefits, even when the state did not. Similarly, Dr. Mortensen referenced a moderate Republican state senator who, when the federal marketplace opened, urged his constituents to enroll.Ilse Torres, an insurance agent in Miami, said she had educated her clients “bit by bit” that Obamacare is not health coverage, as many of them assume, but rather a law that created a federal marketplace and required insurers to cover pre-existing health conditions.After Republicans in Congress tried but failed to repeal the law during the Trump administration, Ms. Torres said, the marketplace stabilized, drawing more major insurers and attracting new policyholders.Ms. Hernández, who voted for Mr. Obama in 2008 but later registered as a Republican, lamented that Congress had not updated the Affordable Care Act to make more people permanently eligible for subsidies to help cover their insurance premiums. (Subsidies were temporarily expanded through the American Rescue Plan and the Inflation Reduction Act, and are in effect through 2025 — a major reason for the recent enrollment bumps.) But she was pleased, she said, that Republican lawmakers had stopped trying to repeal the law.“Obamacare needs to be fixed,” she said. “But when I saw how easy it was to get it, I was like, ‘Oh my God, people don’t know about this. Why don’t more people get it?’”She and her family are now insured through the program.Susan C. Beachy More

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      Covid-19 Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two Years

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      #masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutGuidelines After VaccinationAdvertisementContinue reading the main storySupported byContinue reading the main storyPandemic Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two YearsWith its expanded subsidies for health plans under the Affordable Care Act, the coronavirus relief bill makes insurance more affordable, and puts health care on the ballot in 2022.President Biden after delivering remarks on the Affordable Care Act in November. The changes to the health law would cover 1.3 million more Americans.Credit…Amr Alfiky/The New York TimesMarch 8, 2021WASHINGTON — President Biden’s $1.9 trillion coronavirus relief bill will fulfill one of his central campaign promises, to fill the holes in the Affordable Care Act and make health insurance affordable for more than a million middle-class Americans who could not afford insurance under the original law.The bill, which will most likely go to the House for a final vote on Wednesday, includes a significant, albeit temporary, expansion of subsidies for health insurance purchased under the act. Under the changes, the signature domestic achievement of the Obama administration will reach middle-income families who have been discouraged from buying health plans on the federal marketplace because they come with high premiums and little or no help from the government.The changes will last only for two years. But for some, they will be considerable: The Congressional Budget Office estimated that a 64-year-old earning $58,000 would see monthly payments decline from $1,075 under current law to $412 because the federal government would take up much of the cost. The rescue plan also includes rich new incentives to entice the few holdout states — including Texas, Georgia and Florida — to finally expand Medicaid to those with too much money to qualify for the federal health program for the poor, but too little to afford private coverage.“For people that are eligible but not buying insurance it’s a financial issue, and so upping the subsidies is going to make the price point come down,” said Ezekiel Emanuel, a health policy expert and professor at the University of Pennsylvania who advised Mr. Biden during his transition. The bill, he said, would “make a big dent in the number of the uninsured.”But because those provisions last only two years, the relief bill almost guarantees that health care will be front and center in the 2022 midterm elections, when Republicans will attack the measure as a wasteful expansion of a health law they have long hated. Meantime, some liberal Democrats may complain that the changes only prove that a patchwork approach to health care coverage will never work.“Obviously it’s an improvement, but I think that it is inadequate given the health care crisis that we’re in,” said Representative Ro Khanna, a progressive Democrat from California who favors the single-payer, government-run system called Medicare for All that has been embraced by Senator Bernie Sanders, independent of Vermont, and the Democratic left.“We’re in a national health care crisis,” Mr. Khanna said. “Fifteen million people just lost private health insurance. This would be the time for the government to say, at the very least, for those 15 million that we ought to put them on Medicare.”Mr. Biden made clear when he was running for the White House that he did not favor Medicare for All, but instead wanted to strengthen and expand the Affordable Care Act. The bill that is expected to reach his desk in time for a prime-time Oval Office address on Thursday night would do that. The changes to the health law would cover 1.3 million more Americans and cost about $34 billion, according to the Congressional Budget Office.Representative Frank Pallone Jr. of New Jersey, who helped draft the health law more than a decade ago and leads the House Energy and Commerce Committee, has called it “the biggest expansion that we’ve had since the A.C.A. was passed.”But as a candidate, Mr. Biden promised more, a “public option” — a government-run plan that Americans could choose on the health law’s online marketplaces, which now include only private insurance.“Biden promised voters a public option, and it is a promise he has to keep,” said Waleed Shahid, a spokesman for Justice Democrats, the liberal group that helped elect Representative Alexandria Ocasio-Cortez and other progressive Democrats. Of the stimulus bill, he said, “I don’t think anyone thinks this is Biden’s health care plan.”Just when Mr. Biden or Democrats would put forth such a plan remains unclear, and passage in an evenly divided Senate would be an uphill struggle. White House officials have said Mr. Biden wants to get past the coronavirus relief bill before laying out a more comprehensive domestic policy agenda.Senators Bill Hagerty and Chris Coons at the Capitol on Saturday during a series of votes on amendments to the relief bill.Credit…Anna Moneymaker for The New York TimesThe Affordable Care Act is near and dear to Mr. Biden, who memorably used an expletive to describe it as a big deal when he was vice president and President Barack Obama signed it into law in 2010. It has expanded coverage to more than 20 million Americans, cutting the uninsured rate to 10.9 percent in 2019 from 17.8 percent in 2010.The Coronavirus Outbreak More

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      Pandemic Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two Years

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      #masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutNew Variants TrackerAdvertisementContinue reading the main storySupported byContinue reading the main storyPandemic Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two YearsWith its expanded subsidies for health plans under the Affordable Care Act, the coronavirus relief bill makes insurance more affordable, and puts health care on the ballot in 2022.President Biden after delivering remarks on the Affordable Care Actin November. The changes to the health law would cover 1.3 million more Americans.Credit…Amr Alfiky/The New York TimesMarch 8, 2021Updated 8:30 p.m. ETWASHINGTON — President Biden’s $1.9 trillion coronavirus relief bill will fulfill one of his central campaign promises, to fill the holes in the Affordable Care Act and make health insurance affordable for more than a million middle-class Americans who could not afford insurance under the original law.The bill, which will most likely go to the House for a final vote on Wednesday, includes a significant, albeit temporary, expansion of subsidies for health insurance purchased under the act. Under the changes, the signature domestic achievement of the Obama administration will reach middle-income families who have been discouraged from buying health plans on the federal marketplace because they come with high premiums and little or no help from the government.The changes will last only for two years. But for some, they will be considerable: The Congressional Budget Office estimated that a 64-year-old earning $58,000 would see monthly payments decline from $1,075 under current law to $412 because the federal government would take up much of the cost. The rescue plan also includes rich new incentives to entice the few holdout states — including Texas, Georgia and Florida — to finally expand Medicaid to those with too much money to qualify for the federal health program for the poor, but too little to afford private coverage.“For people that are eligible but not buying insurance it’s a financial issue, and so upping the subsidies is going to make the price point come down,” said Ezekiel Emanuel, a health policy expert and professor at the University of Pennsylvania who advised Mr. Biden during his transition. The bill, he said, would “make a big dent in the number of the uninsured.”But because those provisions last only two years, the relief bill almost guarantees that health care will be front and center in the 2022 midterm elections, when Republicans will attack the measure as a wasteful expansion of a health law they have long hated. Meantime, some liberal Democrats may complain that the changes only prove that a patchwork approach to health care coverage will never work.“Obviously it’s an improvement, but I think that it is inadequate given the health care crisis that we’re in,” said Representative Ro Khanna, a progressive Democrat from California who favors the single-payer, government-run system called Medicare for All that has been embraced by Senator Bernie Sanders, independent of Vermont, and the Democratic left.“We’re in a national health care crisis,” Mr. Khanna said. “Fifteen million people just lost private health insurance. This would be the time for the government to say, at the very least, for those 15 million that we ought to put them on Medicare.”Mr. Biden made clear when he was running for the White House that he did not favor Medicare for All, but instead wanted to strengthen and expand the Affordable Care Act. The bill that is expected to reach his desk in time for a prime-time Oval Office address on Thursday night would do that. The changes to the health law would cover 1.3 million more Americans and cost about $34 billion, according to the Congressional Budget Office.Representative Frank Pallone Jr. of New Jersey, who helped draft the health law more than a decade ago and leads the House Energy and Commerce Committee, has called it “the biggest expansion that we’ve had since the A.C.A. was passed.”But as a candidate, Mr. Biden promised more, a “public option” — a government-run plan that Americans could choose on the health law’s online marketplaces, which now include only private insurance.“Biden promised voters a public option, and it is a promise he has to keep,” said Waleed Shahid, a spokesman for Justice Democrats, the liberal group that helped elect Representative Alexandria Ocasio-Cortez and other progressive Democrats. Of the stimulus bill, he said, “I don’t think anyone thinks this is Biden’s health care plan.”Just when Mr. Biden or Democrats would put forth such a plan remains unclear, and passage in an evenly divided Senate would be an uphill struggle. White House officials have said Mr. Biden wants to get past the coronavirus relief bill before laying out a more comprehensive domestic policy agenda.Senators Bill Hagerty and Chris Coons at the Capitol on Saturday during a series of votes on amendments to the relief bill.Credit…Anna Moneymaker for The New York TimesThe Affordable Care Act is near and dear to Mr. Biden, who memorably used an expletive to describe it as a big deal when he was vice president and President Barack Obama signed it into law in 2010. It has expanded coverage to more than 20 million Americans, cutting the uninsured rate to 10.9 percent in 2019 from 17.8 percent in 2010.The Coronavirus Outbreak More

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      Just When You Thought Politics Couldn’t Unravel Any Further

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      AdvertisementContinue reading the main storyOpinionSupported byContinue reading the main storyThe conversationJust When You Thought Politics Couldn’t Unravel Any FurtherWhat happens when “All the King’s Men” meets “National Lampoon’s Vacation”? Nothing good.Gail Collins and Ms. Collins and Mr. Stephens are opinion columnists. They converse every week.Feb. 22, 2021, 5:00 a.m. ETCredit…Sarah Silbiger/Getty ImagesGail Collins: Bret, my favorite recent political story was Ted Cruz’s Terrible Vacation. Partly because it made Ted look like such a jerk.Bret Stephens: Gail, first off all, my heartfelt sympathies and condolences to all of our friends suffering in Texas, and not just because Ted Cruz is one of their senators.Also, isn’t the whole Cancún Caper such a perfect encapsulation of Cruz’s character? He’s what happens when “All the King’s Men” meets “National Lampoon’s Vacation.” He’s Shakespeare’s Richard III as interpreted by Mr. Bean. He is to American statesmanship what “Fifty Shades of Grey” was to English prose writing, minus the, um, stimulus.Gail: Wow, that is one hell of a series of analogies.Bret: I get carried away when it comes to the junior senator from Texas.Gail: But there was also a pet angle that allowed me to revisit the saga of Mitt Romney driving with a dog on the car roof.Bret: “Pet angle” is our double entendre for the day.Gail: Mitt’s canine transport certainly fades in comparison. Meanwhile, one of Biden’s dogs just got attacked on a right-wing Newsmax show for looking … unpresidential. I think “from the junkyard” was the term used.I’m going to go out on a limb and say the president’s German shepherds will get the public’s support.Bret: If everyone just got a goldendoodle like mine, ours would be a happier, saner world.Gail: In the non-canine world, I’m already getting worried the Democrats will lose control of Congress. That’s sorta the pattern when people vote in nonpresidential years. Wondering if it would help if Nancy Pelosi and Chuck Schumer sponsored a pet show.Bret: Don’t be so fatalistic, Gail. In the Senate, you have incumbent Republicans retiring in Pennsylvania, North Carolina, Ohio and possibly Wisconsin, all of which are swing states and potential Democratic pickups. And Georgia and Arizona, both of which have Senate races in ’22, seem to have swung solidly blue.Gail: Thanks, I needed that.Bret: As for the House, Republicans did well last year by recovering a lot of the close seats they lost in swing districts in 2018. But Democrats will have a three-word magic weapon to wield there, too: Marjorie. Taylor. Greene.Gail: And how about Lauren. Opal. Boebert. The Republican from Colorado who appeared at a virtual House committee meeting sitting in front of a stash of guns she said were “ready for use?”Bret: Our colleague Jen Senior had a terrific column the other day on this whole phenomenon of right-wing women whose political strategy seems to involve out-feminizing women and out-masculinizing men. It’s a case of Tammy Wynette meets Rambo, I guess.But back to the 2022 races. If and when the stimulus package passes and the pandemic finally ends, Democrats look to be in a good position. What are your worries?Gail: Nothing along the line of the Democrats deserving punishment. So far they’ve done pretty darned well, multiple crises considered.But I keep remembering how stunned Barack Obama was when the voters tossed Democrats out of their House and Senate seats two years into his administration. People just get … tired. Or disappointed because stuff they hoped would happen probably hasn’t.Bret: As I recall, Obama devoted his first two years in office to using a 59-seat Senate majority to jam Obamacare through Congress in 2010, and voters responded later that year with a “shellacking,” as Obama called it. I think the lesson for Democrats is to stick to popular legislative items and resist sweeping progressive proposals.Gail: Then the lesson would be not to try anything that would answer a major national problem.Bret: A.k.a. a giant, wasteful government program. Sorry, my knee is starting to jerk.Gail: If it wasn’t for Obamacare, millions of Americans would be without health insurance. They wouldn’t be protected from losing coverage because of pre-existing conditions. It certainly wasn’t perfect, in part because of resistance from certain lawmakers who were in the thrall of the insurance industry. But one way to judge its overall success is to look at the Republicans who are now terrified to oppose it.Bret: As I remember it, Obamacare succeeded in pricing people out of the private insurance plans they had and were happy with and which Obama promised they could keep.Gail: Well, that promise thing was … imperfect. But I certainly don’t want Biden to avoid serious reforms because he’s worried about 2022. Already disappointed that we’re not seeing much action on gun control.Bret: All I want for Purim this year is immigration reform. It’s the most important long-term issue facing the country if we are going to continue to have demographic growth and an equal-opportunity society and we have a rare legislative opportunity to solve it with a bipartisan grand bargain. If Biden also wants to build lots of bridges, tunnels and high-speed rails, I’m down with that, too.Gail: Go infrastructure! But whatever happens, I’ll be nervous about an off-presidential-year election.And how about you? If I offered you Republican control in the House and Senate would you take it? With glee or a feeling of foreboding?Bret: The Senate, sure. I’m a big believer in the virtues of divided government. The House, definitely not.Republican representatives have a spectacular talent for political self-harm. It’s a major reason Bill Clinton was able to win re-election in 1996, by running against Newt Gingrich’s government shutdown. And it’s also a reason Obama got a second term in 2012, after Republicans forced another fiscal crisis in order to achieve unpopular budget cuts — cuts they abandoned during Trump’s presidency.Gail: Yeah, and there’s nobody less concerned about budget deficits than a Republican member of Congress with a tax-cut bill.Bret: The Republican hypocrisy here is notable, but it’s also a function of the party’s Trumpian captivity. My advice to Republicans is, first, break with Trump and, second, break with Trump. But that’s not likely to happen, is it?Gail: Trump loses the election, his unpopularity costs Republican Senate seats, and then he eggs on rioters who storm the capitol. But that good old Republican base still loves him.Bret: Trump worship is the political equivalent of a substance addiction. It makes you delusional, it makes you sick, it makes you mean, it causes agonizing withdrawal symptoms and, to borrow a line from Neil Young, all Republicans can say is, “I love you, baby, can I have some more?”Gail: And he’ll stay active. His private financial disasters are going to be a distraction, but also an incentive. If he dropped out of the political game, he wouldn’t be able to fill the tables at Mar-a-Lago with paying guests who also happen to be prominent politicians and lobbyists.And of course, if the Republicans are going to get rid of him, they’ll need an alternative. Who’s your pick of the week for the next nominee not named Trump?Bret: Nobody I like has a snowball’s chance in hell. Ideally it would be someone like Rob Portman, who’s retiring, or Charlie Baker, who’s from Massachusetts, or Mitch Daniels, who left politics a long time ago to go do something truly valuable with his life. There’s also Ben Sasse, whom I like a lot. But I just don’t see him getting the nomination.That leaves me with a choice between Nikki Haley, Josh Hawley, maybe Ron DeSantis. In that lineup, Haley is the easy favorite. What do you think of her?Gail: Well, depends on the moment since she seems to change her political positions every 15 minutes. Gail said snidely.DeSantis is awful on matters like vaccine distribution, and you have to admit it isn’t every governor who plans to have state flags fly at half-staff for Rush Limbaugh. Hawley was a disaster during the whole capitol riot crisis, and I notice he’s the only Republican who’s voted against every single Biden cabinet nominee so far.I loved it when Sasse called Hawley’s behavior “really dumbass,” so he’d have to be my favorite. Although I understand he’s not exactly a front-runner.Speaking of national political names, what do you think about Andrew Cuomo’s latest troubles?Bret: You mean that his administration deliberately underreported the number of Covid deaths in nursing homes and then tried to cover it up for fear of a federal investigation? Or that he later threatened to “destroy” a state lawmaker who had dared to criticize him?All I can say is: This is a scandal that could not have happened to a nicer guy.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.AdvertisementContinue reading the main story More

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      ‘We’ve Harmed the Senate Enough’: Why Joe Manchin Won’t Budge on the Filibuster

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      WASHINGTON — Senator Joe Manchin III of West Virginia, the most conservative member of his party in the Senate, has a message for fellow Democrats hoping to capture the majority and quickly begin muscling through legislation to bring about sweeping, liberal change: not on his watch.With Democrats mounting an intense, long-shot campaign to win two Georgia Senate seats whose fates will be decided in runoffs in January — a feat that would give them control of both chambers of Congress along with the presidency — Mr. Manchin’s unequivocal stance against ending the filibuster means that President-elect Joseph R. Biden Jr. would still need substantial Republican support, and probably Mr. Manchin’s seal of approval, for any major move.In a wide-ranging interview in his office, Mr. Manchin, 73, a former governor, argued that moderates in both parties needed to assert themselves in a new Senate, no matter which party is in charge. He said that his party had lost rural voters because of an ultraprogressive message that scared them, and he criticized Republicans for selling their “souls” in subservience to President Trump.This interview has been edited for length and clarity.Q: It strikes me that you’re going to be playing potentially an extremely important role if we end up with a 50-50 Senate. Would you agree with that?A: I would think the only reason that people are assuming that — you can tell me if it’s true or not — is because of my independent voting. I’m pretty independent. If it makes sense, I go home and explain it. If it doesn’t make sense, I don’t. Sometimes that’s a real strong Democratic issue they’re really happy with, and sometimes it’s a Republican issue they’re happy with. I think I’m the most moderate or centrist — as far as centrist voting — than anybody else in Congress, 535 people.Q: What do you make of the election results over all?A: I just can’t believe that 72 million people were either that mad or that scared of the Democrat Party to vote for what I consider a very flawed individual. Here’s a person who lost 230,000 lives under his watch, basically denounced the science completely because it might hurt him politically, has a lack of compassion or empathy for humans, and denigrates anybody and everybody that does not agree with him. How 72 million people could still walk in and say, ‘Yeah, it’s better than that,’ I just can’t figure it out.That was a sobering thing for me. My state got wiped out this election. So I would say, I’m just looking at myself, I have not been good at my message. I know why I’m a Democrat. And I know that I’ve never seen the Democrat Party forsake anybody.Q: Why do you think West Virginia and the rural areas have gone so red?A: I can tell you what they said: ‘Listen, I just couldn’t bring myself to vote for another Democrat that might give support to the very liberal wing in Washington that I don’t agree with and have nothing in common with. I don’t have anything in common with people who talk about defunding the police. It looks like they’re condoning riots.’ There’s not a member in the Democratic caucus that condones any of this violence or riots or looting. None.I just would hope that people would start looking at the person that they’re voting for and not the party they belong to. A Democrat who’s a moderate-conservative like myself is much needed to bring other people to that moderate position.Q: The Democratic Party thought it could take back the Senate this year, and there’s still a chance that maybe that can happen if you get both of the seats in Georgia. But in order to pass major legislation, you would have to either get some Republican support or kill the filibuster. You’ve long opposed killing the filibuster. Why is that?A: I can assure you I will not vote to end the filibuster, because that would break the Senate. We’ve harmed the Senate enough with the nuclear option on the judges. We’re making lifetime appointments based on a simple majority. The minority should have input — that’s the whole purpose for the Senate. If you basically do away with the filibuster altogether for legislation, you won’t have the Senate. You’re a glorified House. And I will not do that.Q: So there’s no issue where you would agree to end the filibuster? Let’s say there’s a badly needed new coronavirus stimulus package, and the Republicans won’t make a deal.A: No. If we can’t come together to help America, God help us. If you’ve got to blow up the Senate to do the right thing, then we’ve got the wrong people in the Senate, or we have people that won’t talk to each other. You know, I’ve always said this: Chuck Schumer, with his personality, he’ll talk to anybody and everybody. You can work with Chuck. Chuck is going to try everything he can do to try to engage with Mitch again.Q: Are there any other issues where you would draw a line in the sand and stand up to other members of your party?A: I’ve done that. I was that one vote for Brett Kavanaugh. I thought there had to be evidence, and I never saw evidence. The country was in a feeding frenzy. And there was no Democrat that was going to buck that. I said, ‘I’m not going to ruin a person’s life because there’s no evidence.’And wouldn’t it be so befitting if he votes to uphold the Affordable Care Act? God, oh my. Redemption! Is there redemption here? He and I had a long conversation, and I basically said, ‘I’m pleading with you and your inner conscience, whenever this comes before you, I want you to think about 800,000 West Virginians who couldn’t get insurance before because of a pre-existing condition. I want you to think about 160,000 West Virginians that were so poor, they had nothing.’Q: It does seem like Democrats have won the argument on the Affordable Care Act. Six years ago, Republicans were campaigning on blowing up Obamacare; now they’re running ads saying they’re protecting pre-existing conditions.A: Here’s the thing. It’s 16,000 jobs in West Virginia. Three million jobs in America. You want to be a vote that basically eliminates three million jobs? You want to be a vote that wipes out your state? It’s crazy.Q: Is there any chance of a bipartisan group of moderates — you, Senator Susan Collins, Republican of Maine, and some others — emerging that can advance compromise policy in a new Senate?A: We used to have meetings all the time, either in here or her office. We had 10 or 12 or 13, sometimes as many as 20, working through the fiscal crisis or different things, trying to find a pathway forward. We need to be more vocal with our leadership.Q: What does it mean to be a Democrat in 2020?A: To me, it still means the compassion that we have for people, but also the dignity of work. That has to be our driver. It’s the economy, it’s all about the economy. You can’t help anybody if you have no economy and no resources to help them.When it comes to workplace safety, it’s the Democrats everyone turns to because they know they’ll do something. When it comes time to protect people’s jobs and opportunities, it’s the Democrats who will fight to protect that. We’re trying to give quality health care, so people can basically contribute to society. With that, look at the economy that we created: a billion dollars coming in our state. We don’t say that, and we don’t seem to get credit for that.So I’m back on track. I know why I’m here, and I know why I’m a Democrat, and I’m going to fight like the dickens.Q: You did a video with a mix of Democrats and Republicans asking people to respect the results of the election. Why do you think that so many Republicans are unwilling to acknowledge reality and stand up and say, ‘You lost, Mr. President’?A: I don’t know. I don’t know the value of being a U.S. senator, or a governor, or a congressman or anything that’s worth selling your soul or your convictions. These are all good people who for some reason aren’t speaking up. They’re hoping it just kind of goes away.Why rouse up 70 million people that were willing to vote for all his flaws, knowing he’s a very flawed human being? He instilled something, the anger in people, feeling like, ‘Hey, I’m getting the shaft here, I’m getting shorted.’ So, they just want that to kind of go away and see if it calms down rather than putting themselves in the iron. And I understand that. But it would be so refreshing to have a majority of all of my colleagues and my friends on the Republican side say, ‘Listen. It’s time now to move on.’ More