May 21, 2019

The 2020 health care election

House Speaker Pelosi, last June. Photo: Toya Sarno Jordan/Getty

Amid the hullabaloo over purported immigrant hordes, alleged Chinese perfidy on trade and a Green New Deal, Americans — crossing lines of age, party and gender — are united in what they really care about, according to a new poll: Health care.

Details: Eighteen months before the presidential election, the finding suggests potential peril for President Trump should he be seen as insensitive on the issue, says John Della Volpe, polling director for RealClear Opinion Research, which conducted the survey.

By the numbers:

  • 45% of Democrats, 30% of Republicans and 31% of independents ranked health care as their No. 1 issue from a list of 6 that were shown. For Republicans, 29% said the economy was No. 1 and 28% said immigration.
  • 62% said health care is their No. 1 or 2 most-important issue.

For all generations, the No. 1 and 2 issues combined are making sure that all Americans have access to health care and lowering its price, according to the poll.

  • For Millennials and Generation Z: 58% ranked them the top 2 issues
  • Gen X: 60%
  • Boomer/Silent: 67%

Democrats are bound to double down on the issue: "It's only the earliest days of his campaign. But when it gets to the general election, there is no question that if [Trump] doesn't address his plan for health care in America, it will be a problem," Della Volpe tells Axios.

At this stage, both parties have staked out sharp-edged positions:

  • In March, the administration asked an appeals court to rule the entire Affordable Care Act unconstitutional. Previously, it was seeking only to invalidate parts of the law. Now, Trump says he will propose a plan to replace Obamacare after the 2020 elections.
  • Striking down the law would leave several million people without health care, and eliminate a requirement that insurance guarantee coverage for pre-existing conditions and keep children on their parents's policy through the age of 26.
  • Against this, Democrats in the House have sought documents from the administration explaining how it decided to seek the act's invalidation. They have set a deadline this Friday for a response. Several Democratic presidential candidates are seeking "Medicare for all," expanding the program to all age groups.

Thought bubble from Managing Editor David Nather: "There are other issues that both parties are working on — like lowering drug prices. But the lawsuit won't help Republicans defend themselves against Democratic warnings that they'd get rid of health coverage for people with pre-existing conditions. That message helped drive the big Democratic gains in 2018."

  • Chris Arnade, author of "Dignity: Seeking Respect in Back Row America," who has been driving around the country for several years reporting on addiction and poverty, said health care is "the one thing that brings out frustration."
  • "Health care is where the rubber hits the road," Arnade tells Axios. "The number of stories I hear of people who have no health care — it's sad. People make awful choices — 'do I go into debt to get my daughter's health addressed? Do I go to the hospital?'"
  • "It's so costly to the working class. They are receptive to someone like [Sen. Elizabeth] Warren or [Sen. Bernie] Sanders who say we need change. People are receptive to change."

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