Seven years after Obamacare crushed Democrats at the ballot box, the party is using health care to launch a revival, saying President Trump and congressional Republicans are paying a price for their fumbled repeal effort and will sink further next year.
Voters in Maine last week opted into Medicaid expansion, a key plank of the 2010 law, and Virginia voters pointed to health care as they swatted aside Mr. Trump’s endorsement of the Republican candidate for governor and chose Democrats up and down the ballot.
“The No. 1 issue for folks who supported our candidate was health care,” said Sen. Mark R. Warner, Virginia Democrat. “Bring it on.”
Meanwhile, Obamacare is polling better than ever, enrollments are outpacing last year’s and progressive groups are plotting to turn the fight over Obamacare into electoral wins, blanketing social media and selling $25 T-shirts and $15 coffee mugs to anyone who pledges to be a “Health Care Voter.”
It’s a major turnabout from 2010, when President Obama’s heavy mandates and D.C.-centric reforms sparked talk of “death panels” and a “government takeover” of health care.
Republicans seized control of the House that year and haven’t forfeited it. Though Mr. Obama was re-elected, Senate Republicans used Obamacare’s shaky start against Democrats in 2014 to retake the chamber, and Mr. Trump rounded out their gains by seizing the White House on a platform of repeal.
But efforts to repeal and replace Obamacare faltered out of the gate and sputtered in the Senate, leaving the Republican base empty-handed and forcing Mr. Trump to find piecemeal ways to dismantle the law before another push in the spring.
Even the spark that drove the 2010 tea party wave — Mr. Obama’s “individual mandate” to either hold health insurance or pay a tax — is becoming a hot potato for Republicans. Scorekeepers said a repeal would result in 13 million fewer insured Americans by 2027.
Repealing the mandate would save money, allowing for deeper cuts in a tax overhaul, yet Democrats — citing the fallout from Virginia elections last week — argue that Republican lawmakers will get burned if they reignite the health care fight.
“What was interesting to observe was that, overwhelmingly, the leading issue that people said they voted on was health care. And I think that the Republicans in Congress should take heed of that as they try, once again, to inject certain repeals into their tax bill,” said House Minority Leader Nancy Pelosi, California Democrat.
Health care was the most important issue for 37 percent of Virginia voters, according to NBC News’ exit poll, far exceeding gun policy (17 percent) and immigration or taxes (14 percent apiece).
Some Republicans say Democrats are boasting much too early.
Virginia has become a reliably blue state over the past decade, and it’s not as susceptible to economic swings because of federal jobs in the northern part of the state, so Mr. Trump’s populist message didn’t resonate as much as in other states, said Republican Party strategist Ford O’Connell.
“Democrats would be wise to not overinterpret what happened last week in the commonwealth,” he said. “Heading into 2018 midterms, overall health care is not the political liability it once was for Democrats. That said, the 2018 Senate map is decidedly pro-Trump and anti-Obamacare.”
Some Republicans say failure to repeal Obamacare is what suppressed their party’s voter enthusiasm in blue and purple states and that there is still time for Capitol Hill lawmakers to slash taxes on businesses and households before regrouping on health care.
Democrats, with new swagger, are betting that Republicans will pay a price even if they enact their agenda.
“A lot of people were really upset that Donald Trump and Republicans tried to take away their access to affordable health care,” Sen. Chris Van Hollen, Maryland Democrat, told “Fox News Sunday.” “And they’re going to be really mad if they try and pass this huge giveaway to huge corporations that’s going to be paid for by millions of middle-class families.”
Despite a positive Senate map, Mr. O’Connell said, health care might be a liability for some House Republicans next year, particularly in the Northeast, so the party will need a near-perfect replacement to get something through the Senate and fully change the narrative.
Until then, Republicans hope voters will hold Democrats accountable for even higher premiums and fewer choices under President Obama’s signature program.
The law fell short of enrollment targets in its early rounds, leading to a sicker-than-expected customer base. Insurers either fled the market or raised rates, causing pain for unsubsidized customers and raising the price tag for taxpayers who foot the bill for low- and middle-income enrollees.
Subsidies are more generous than ever, however, because of Mr. Trump’s decision to cancel “cost-sharing” payments, which triggered rate hikes.
As a result, Democrats say, Mr. Trump’s antipathy toward the law is the only thing holding back the program.
More than 600,000 people signed up on the federal HealthCare.gov website in the first four days alone, and several of the state-run exchanges said they have seen unusually high interest.
“We want to keep up this momentum, so we’ve got a lot of work to do to enroll even more people,” said Lori Lodes, who promoted the law under Mr. Obama and launched the “Get America Covered” campaign. “If the administration were doing everything they could to help people enroll, instead of undermining the law every chance they get, imagine how many more people would be signing up right now.”