Don’t Forget Health Care

Republicans have given Democrats no shortage of contrasts for the upcoming election. They have fought efforts to control inflation, help up promotions to military officers, and tried to defund everything from FBI agents to food security. Amid this, however, Democrats also have a big opportunity to distinguish themselves on health care. According to Gallup, 9-in-10 voters say reducing health care costs is important, which cuts across party, ideology, and race.

In the not-too-distant past, a very prescient Democrat won the presidency with an internal commandment to remember that “it’s the economy, stupid!” But that commandment also added “and don’t forget health care.”

Democrats: don’t forget health care. Make health care a keystone of each campaign. Here are three reasons why:

1. Democrats win when they run on health care.

Health care is a personal issue for voters—and a strategic issue for Democrats. In 2018, when Democrats took back control of the House of Representatives, health care was the top issue for voters. In exit polling, health care ranked as the most important issue facing the country, topping immigration, the economy, and guns. Health care was also the most important issue for independent and battleground state voters. Throughout the election, Democratic candidates ran on lowering prices and Republican attempts to repeal the Affordable Care Act (ACA). The result: massive gains for Democrats.

That salience continued into 2020. With the pandemic raging, then-candidate Joe Biden made defending the ACA a central piece of his campaign. COVID and health care policy together were right behind the economy in terms of top issues for voters. As a result, Democrats captured the White House and the Senate.

Health care is just as salient going into the 2024 election. In the recent Gallup poll, half of all Americans are likely to vote for a candidate outside their party who says health care costs are their top priority. That includes half of independents and 40% of Democrats. The overturning of Roe v. Wade has also kept health care front of mind. Abortion was the second most important issue for voters in 2022, just four points behind inflation. In the 2023 off-cycle elections, abortion was on the ballot in Ohio, Kentucky’s gubernatorial race, and Virginia’s state legislature—leading to Democratic victories in all three states. As Axios noted, “Abortion rights have won every time they've been on the ballot since the Supreme Court overturned Roe v. Wade.” Today, health care is still right behind inflation on issues most important to voters.

2. Republicans are still saying no to health care.

Republicans hate the ACA more than the Red Sox hate the Yankees, and they are still fighting it. Plus, they have come out swinging on other health care issues. They are saying:

• No to Medicaid coverage in states that haven’t expanded it for the working poor.
• No to lowering drug costs by voting against the Inflation Reduction Act.
• No to Medicare coverage by pushing to raise the retirement age.
• No to a woman’s right to choose an abortion or birth control.

Their positions are very unpopular with voters—including their own. Support for Medicaid is over 75%, including 65% of Republicans. Over 80% of the public support the Inflation Reduction Act’s policies to reduce prescription drug costs. Seventy percent of voters oppose raising the eligibility age for Medicare. Calling yourself pro-choice is at a record high.

While Democrats should differentiate themselves from unpopular Republican policies, they also should pursue bipartisanship in areas where possible. One example is recent efforts in Congress to lower patients’ hospital bills. Democrats can work with Republicans where their values align but should not shy away from big fights like defending the ACA.

3. The Affordable Care Act has never been more popular.

The ACA has been a generational success—no matter how many times the GOP tried to repeal it. Those with preexisting conditions can no longer face discrimination through coverage denials and higher costs. Essential health benefits are now covered, and women can’t be charged more for insurance. Young adults can stay on a parent’s insurance until they are 26, and ACA coverage is even more affordable with an average monthly premium of $50.

That success has swayed public opinion. Six-in-ten adults have a favorable view of the ACA, including 89% of Democrats and 62% of independents. Two-thirds of Americans are opposed to repealing the ACA. This is record-breaking support for the law, which has been more popular than not since 2016. That popularity has increased as enrollment in the ACA marketplace has grown. Right now, over 20 million Americans get coverage through the ACA. And action by President Biden and Congressional Democrats to expand the ACA and cap premium costs at 8.5% of enrollees’ incomes will only continue to help.

Every recent election seems existential—and 2024 is no different. Democrats should make sure to build on their success in past elections, the lack of support of Republican positions, and the popularity of the Affordable Care Act. We need to run on health care to win.

To find out how Democrats can win on health care issues in 2024, click here.