Across all congressional races in the 2018 midterms, health care was overwhelmingly the top issue that Democrats referenced in their digital and TV advertising, according to data from Advertising Analytics, a firm that specializes in media ad spending and real time political ad detection.

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Reproduced from Advertising Analytics; Chart: Axios Visuals

Why it matters: In addition to knocking off an incumbent in the White House, Democrats are facing an uphill battle to win the Senate and a very real possibility of losing their House majority. While several themes are emerging for what could be key themes of the party's 2020 platform, candidates have yet to rally around a single down-ballot issue that could turn voters out in droves like health care did in 2020.

By the numbers: In 2018, health care was by far the biggest issue of the 2018 election ads, comprising 16% of all political ads.

  • For Democrats, nearly half (48%) of all ads for House races and half of all ads for Senate races (47%) were about health care. Candidates largely used ads to attack the GOP's efforts to dismantle the Affordable Care Act.
  • Republicans, on the other hand, had no unifying message, campaign on an array of issues — from healthcare to taxes to President Trump himself — down the ballot.

The big picture: Democrats at the top of the 2020 ballot are tackling several key issues like climate change, wealth inequality and universal health care. Messaging at the top of the ballot usually helps inform the party's overall message, which impacts down-ballot races in the House and Senate.

  • It's too early for most local races to begin aggressively campaigning, so down-ballot messaging trends are hard to track at this point.
  • But, focus groups with Democrats in several key states, like Wisconsin and Ohio, suggest that messaging around "The Green New Deal" and "Medicare for All" hasn't broken through for all Democratic voters.

Republicans, led by Donald Trump at the top of the ballot, are also experiencing an issue of mixed messaging.

  • For candidates down the ballot, their messaging will likely be dictated by President Trump, whose approval rating among Republicans hovers around 90%. Trump attaches himself to an array of issues daily through his tweets and tangent-heavy campaign rallies.

Be smart: With nearly two dozen Democratic contenders vying for the 2020 presidential nomination, the lack of coherent messaging is to be expected, says Tara McGowan, a veteran Democratic strategist who now runs ACRONYM, an organization focused on building digital groundwork for progressives.

  • "This early on, the 2020 Democrats are focused on list-building and fundraising, which entails testing a lot of different issues and seeing what resonates," says Niko Duffy, Managing Director at CommonWealth Media, a Democratic strategy firm. "This messaging will undoubtedly focus once the field narrows down."
  • "Democrats are engaged in an exciting and competitive primary right now and that should be their focus," McGowan adds. "As the field narrows, there’s no question that candidates will unify around a shared vision for the country and message to voters, though I doubt that that message will look very different than it did in 2018."

The bottom line: While anti-Trump sentiment likely helped drive Democrats to the polls last cycle, there's no question that a single, pro-policy message helped unify the electorate to overtake Republicans in the House. It seems less likely at this point that Democrats will rally behind a single core issue ahead of 2020.

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