Democrats tout their health care bonafides in midterm stretch run

With the midterms looming, vulnerable congressional Democrats are wagering that health care provisions in the just-passed $740 billion reconciliation bill will give them an edge and possibly preserve their razor-thin majorities.

Why it matters: Recent projections show Republicans likely to flip control of the House. But Democrats are trying to reprise their 2018 campaign playbook with messaging around bill language allowing Medicare to negotiate the price of some drugs and extending enhanced Affordable Care Act subsidies for three years.

Driving the news: Rep. Abigail Spanberger (D-Va.), who's locked in one of the most competitive House races in the country, told Axios the difference this time is that Democrats delivered on their promises.

• "I think it's a monumental step and a very significant change that we are making to a system that hasn't been working for a very long time," Spanberger said after a campaign event at a health clinic in Woodbridge, Virginia.
• Her "mission accomplished" message is one of several that Democrats are deploying on the campaign trail.

Democratic Senatorial Campaign Committee Chair Gary Peters (D-Mich.) portrays passage of the bill as a victory over the pharmaceutical industry and entrenched Washington interests.

• "Every Republican voted against the bill because it holds Big Oil, Big Pharma and other corporations that have been jacking up prices accountable," Peters said in a statement.
• Sen. Michael Bennet (D-Colorado), took a similar tone, touting the way Democrats finally "overcame the pharmaceutical industry" during a Thursday campaign event.
• Rep. Val Demings (D-Fla.), who won a Democratic primary this week to challenge Sen. Marco Rubio (R-Fla.), has contrasted her support for the bill with Rubio's opposition and how the Inflation Reduction Act helps the working class.
• Rep. Lauren Underwood (D-Ill.) during a town hall this week emphasized how health insurance premiums are going to stay low for Americans, due to the Affordable Care Act subsidies being extended, as well that it will fight inflation.

The big picture: Capping prescription drug prices is the most popular provision in the bill, according to a recent Morning Consult poll, which said 76% of voters supported the measure, including 86% of Democrats, 71% of independents and 69% of Republicans.

Yes, but: None of the bill's provisions will take effect before the elections. And the economy and making ends meet will still be foremost on voters' minds, despite falling gas prices and slowing inflation.

• "One of the reasons why the health care bill isn't going to have as much of an immediate impact is its going to take time for the consequences to take shape in the electorate ... the new Medicare rules will be a huge impact on their finances but it's not clear how visible that will be right away," said Stephen Farnsworth, a political science professor at the University of Mary Washington.

Be smart: The bill nonetheless fulfilled decades of Democratic promises that they'd let Medicare directly negotiate the cost of prescription drugs.

• Crossing that threshold lets Democrats portray themselves as agents of change while they also issue a full-throated defense of abortion rights following the demise of Roe v. Wade.
• The party's hopes were buoyed on Tuesday when Pat Ryan defeated Republican Marc Molinaro in a special election in New York's 19th congressional district after he made abortion rights a key focus of his campaign.
• Farnsworth sees parallels with 2018, when high Democratic turnout was driven by anger over former President Trump and a desire to change directions. Health care then, too, was a rallying point.
• "That's the way normally midterm elections work. They're really painful for the party controlling the White House. This situation is very different because of the Supreme Court ruling more than anything else," he said.

Spanberger said while abortion is definitely an issue voters care about, she believes the health policy wins will also shine through.

• "Everybody knows somebody on Medicare, if it's not you, it's your parents or your grandparents. And so many of the constituents I represent and small business owners rely on the Affordable Care Act for their health care coverage," said Spanberger. "For the people who are most directly impacted, it's life changing."