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Data: Kaiser Family Foundation; Map: Harry Stevens/Axios

The number of people with pre-existing medical conditions varies substantially between metropolitan areas, according to Kaiser Family Foundation data. That means even within a single state, different locations would see different results under legislation that erodes the Affordable Care Act's protections

Why it matters: The more people who have a pre-existing condition, the more likely health care is to resonate as an issue in the midterm elections in that state or district.

  • Democrats have been making the case that Republicans threaten pre-existing conditions protections — through legislation, executive action and the courts — and have made this a dominant theme of the midterms. 
  • Some of the areas with the highest number of people with pre-existing conditions are in states with competitive Senate races, such as West Virginia, Tennessee and Indiana. 

The issue makes for absolutely brutal ads, and Democrats know it. They believe one of their most potent lines of attack against Brett Kavanaugh, President Trump's Supreme Court nominee, is arguing he could be the deciding vote against these protections. 

  • Protect Our Care has a new TV ad out today, provided to Axios, that depicts an imaginary broadcast in 2019 or 2020 announcing SCOTUS has struck down the ACA's pre-existing conditions regulations. 
  • The ad targets Sen. Susan Collins of Maine, who voted against the GOP health care bill last year. The pro-ACA group is airing radio ads tying Kavanaugh to pre-existing conditions in both Maine and Alaska. 
  • Kavanaugh's Senate hearing begins Sept. 4, the day before oral arguments in the court case that would strike down the ACA regulations.

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