Health care is emerging as a top campaign focus for Democrats ahead of the November midterm elections, with party strategists and candidates arguing that rising insurance premiums and coverage instability have become a defining concern for voters. In Georgia, U.S. Sen. Jon Ossoff told supporters that the issue reflects what he described as President Donald Trump’s abandonment of working people, and he pointed to specific figures he said affect residents in his state.
Ossoff made the case at a rally Saturday in an Atlanta suburb attended by more than 1,000 people, saying that Republicans allowed health insurance premiums to double for more than 20 million Americans, including more than a million Georgians. He also said 200,000 people in Georgia had lost their coverage, framing the change as part of Trump’s second-term agenda and as evidence of Republicans’ approach to health policy.
Democrats have moved their messaging in part away from chasing day-to-day controversies, instead building campaign spots around people who say they are struggling with spiking costs and around candidates’ personal health-care experiences. A Democratic strategist and advocate for Protect Our Care, Brad Woodhouse, said health care is “a banger of an issue for Democrats” and described it as something that would appear throughout the ballot, not just in top races.
In their defense, Republicans have argued that their votes and policies address affordability by reining in federal health spending and cracking down on what they call waste, fraud and abuse. Joe Gruters, chairman of the Republican National Committee, said Republicans are working to bring affordability to the people, and he also cited Trump’s effort to launch a website intended to help patients buy discounted prescription drugs.
The dispute is also tied to a set of legislative decisions Democrats say increased costs at the same time that expanded Affordable Care Act subsidies were set to expire. Democrats point to their previous push for extensions and to leverage they created politically when enhanced ACA tax credits headed toward expiration and Democrats forced a government shutdown over the issue. Republicans, meanwhile, say their actions are designed to limit ballooning health spending while also shifting burdens or costs through policy changes.
Woodhouse and other Democrats describe a strategic opportunity that has grown over time, reflecting that health care was not always a consistent advantage for the party. He said Democrats suffered political losses in 2010 and 2014 after the Affordable Care Act passed without a single Republican vote and after the Obama administration’s Healthcare.gov rollout faltered, and Democrats later sought ways to turn the issue back toward their side. Democrats have also highlighted what they describe as consequences of Republicans’ efforts to repeal and replace the law during Trump’s first term.
Candidates say they are leaning on emotional storytelling and targeted outreach to connect policy changes to daily life. Democratic consultant Stef Feldman, who previously served as an aide to former President Joe Biden, said she is hearing from candidates that voters care about health affordability “more than just about anything else,” and she pointed to a KFF finding that about one-third of U.S. adults are “very worried” about health care costs compared with about one-quarter for groceries, housing or utilities. Feldman’s comments aligned with examples from candidates including Iowa state Sen. Zach Wahls, who has visited vulnerable hospitals and toured pharmacies, and Wisconsin U.S. House candidate Rebecca Cooke, who has met with hospital leaders and shared personal stories about health-care costs.
Ossoff and other Democrats also tie their messages to specific coverage arrangements and premium increases they say followed the expiration of expanded subsidies. Teresa Acosta said her ACA policy now costs $520 a month—seven times more than before expanded subsidies went away—and she said at the Ossoff rally that Trump and congressional Republicans “refused to act.” Acosta said the refusal undermined care that she and more than 1 million Georgians rely on, and she linked the issue to the party’s broader effort to highlight coverage risk in the state.
Republicans say they do not want Democrats to “throw money” at what they characterize as a broken health system without fixing underlying causes. U.S. Reps. Mike Collins and Buddy Carter voted in January against a temporary ACA tax-credit extension that passed the House but stalled in the Senate, and Carter said the extension would be “throwing more money at a broken system, riddled with waste, fraud and abuse, without addressing the root cause of skyrocketing costs.” Other Republicans who supported the temporary extension, including U.S. Rep. Derrick Van Orden, said they did not back the subsidies but voted for the measure to protect constituents.
Van Orden also criticized his own party for allowing the tax credits to expire without an alternative solution, and he argued for a renewed policy push. The account of Democrats’ and Republicans’ competing approaches continues to revolve around whether Congress can pass comprehensive legislation to offset health costs, as the parties disagree on both the scale and the method of any changes.
Swenson reported from New York. Associated Press writer Marc Levy in Harrisburg, Pa., contributed to this report.