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On Senate campaign trail, it’s health care, health care, health care

Georgia Democratic candidate for Senate Jon Ossoff spoke to a crowd during an event this month.
Georgia Democratic candidate for Senate Jon Ossoff spoke to a crowd during an event this month.Brynn Anderson/Associated Press

Democrat Jon Ossoff slammed incumbent GOP Senator David Perdue this week for downplaying the threat of the coronavirus and voting four times to overturn the Affordable Care Act. “You’re attacking the health of the people that you represent,” the 33-year-old Ossoff said during a debate.

That race is in Georgia. But a voter in any number of other states could have expected to hear a similar message from Democrats this fall.

From North Carolina to Montana, Democrats trying to win Senate seats have hammered Republican incumbents for their efforts to scrap the ACA and its most popular provisions.

In doing so, Democrats are taking a page out of the playbook they used to flip the House in the 2018 midterm elections.

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This cycle, however, Democrats have paired their laser-focus on health care — particularly promising they will ensure that people cannot be denied coverage for preexisting conditions — with criticism of Republican missteps on handling the still-raging pandemic.

The combination is a powerful one, Democratic strategists say, and if Democrats wrest back control of the Senate it will be in large part thanks to the party’s disciplined spotlight on defending the ACA, and Republican attempts to overturn it.

The pandemic “brought a new urgency to the issue,” said Ian Russell, a Democratic media consultant working on races up and down the ballot. He said he’s “lost count” of the number of ads he’s cut containing the phrases “preexisting conditions” or attacking a Republican for opposing those protections.

“There are now over 8 million Americans who now have a preexisting condition, having contracted the coronavirus. . . . And if you didn’t have the protections of the Affordable Care Act, all those people could be denied coverage," he said.

The data tell the tale.

A whopping 44 percent of all ads aired on broadcast TV over the past two weeks by Democratic Senate candidates focused on health care, making it the top issue, according to a new report by the Wesleyan Media Project, which tracks political ads.

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In North Carolina, which has emerged as the most expensive Senate race in history and one that could decide who controls the chamber, Democrat Cal Cunningham has made incumbent Senator Thom Tillis’s votes against the ACA and his role blocking Medicaid expansion while in the state Legislature a central theme of his campaign.

Cunningham doubled down on the message as he pushed back on negative ads from Tillis, a first-term Republican, that attacked Cunningham’s trustworthiness amid a sexting scandal with a woman who alleges the two had an extramarital affair.

“Thom Tillis is desperately attacking my personal life because he doesn’t want to talk about his own record,” Cunningham says in one recent ad. “Thousands of families without health care. Unaffordable prescriptions. And a relentless effort to take away coverage for people with preexisting conditions.”

The Wesleyan report found that Republicans are also emphasizing health care as the top issue in their closing message, with about 33 percent of their TV ads focused on health care.

While the Wesleyan Media Project doesn’t delve too deeply into the specific framing of the issues in the ads tracked, codirector Travis N. Ridout said his sense is that Republican ads tend to be in response to Democratic criticism.

“They are being exposed to a lot of Democratic attacks on this, so they’re needing to put up a defense,” said Ridout. “My sense is [the Republican response] is kind of a general ‘I’m going to protect people, protect their health care,' so people aren’t worried it’s all going to be taken away.”

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Republican candidates are vulnerable on the health care issue for the same reasons they were two years ago: Congressional Republicans have voted repeatedly to scrap the ACA but failed to successfully do so, most notably in 2017, when the Senate GOP fell just short of the needed votes to replace the law.

Since then, the GOP has failed to coalesce behind a viable alternative to the law that their base still loathes but has otherwise grown far more popular in the 10 years since it passed — particularly its preexisting protections.

And the coronavirus has only intensified concerns about health insurance and insurance coverage for treatments and an eventual vaccine, experts say.

Still, Republican strategists are skeptical that Democrats' health care messaging is responsible for the GOP’s struggles in key states.

“The Georgia Senate races aren’t competitive because Jon Ossoff is talking about health care. It’s a competitive race because President Trump is at the top of the ticket and there are people with ‘Republican’ behind their names” further down the ballot, said Jon McHenry, a GOP pollster and strategist. That same dynamic is at play in many other down-ballot races, he said.

Michael Steel, a Republican strategist who worked on Jeb Bush’s 2016 presidential campaign, said that far more effective than arguments about the ACA are Democrats' attacks on Republicans for inadequately responding to the pandemic and failing to do enough to blunt the economic consequences it unleashed on the country.

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“I mean, when you can’t go to a baseball game, or a movie theater, or a bar, or visit an older, elderly relative, the argument that if you repeal the Affordable Care Act without a replacement that includes preexisting conditions . . . it’s just so tangential to the actual crisis that we’re facing,” he said.

Celinda Lake, a Democratic pollster who is working for Joe Biden’s presidential campaign, disagreed.

“It’s a really, really strong message,” particularly among suburban women, non-college-educated white women, and Latino voters, a group that has gained the most health care coverage under the law, she said.

Messages targeting rising health care costs and protections for preexisting conditions resonate most deeply, she said.

COVID-19 has deepened and broadened the salience of Democrats’ health care messaging, she said. For one, a lot of people have lost work in the pandemic, and that often means losing health insurance, too.

Furthermore, “people are absolutely convinced that COVID will be treated as a preexisting condition if [insurers] are allowed to do it. People are very worried about the affordability of a vaccine or treatment,” and are convinced they won’t be within reach for those without insurance, Lake said.

As for Republicans, including those who support a lawsuit filed by the Trump administration and 18 Republican state attorneys general asking the Supreme Court to strike down the ACA, Lake said average voters are fed up with their lack of workable solutions to the health care worries.

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“Voters are like, ‘Enough already. If you have ideas, improve it.’ ”


Victoria McGrane can be reached at victoria.mcgrane@globe.com. Follow her on Twitter @vgmac.