Health care dominates 2019 ad spending

More than half of all issue advertising this year has been on health care, and that spending will only increase as the 2020 campaign gets closer.

Between the lines: Most of the top health care spenders are focused on issues like surprise medical bills and drug prices — many of which would cut into the health care industry's profits.

Where it stands: The biggest spender by far is a dark-money group called Doctor Patient Unity.

• It has shelled out more than $26 million on ads opposing Congress' plan to address surprise medical bills. Doctors and hospitals staunchly oppose the leading proposal because it would cost them money.
• AARP and the Partnership for Safe Medicines, an industry group, are on opposite sides of the intense battle over drug prices, which will heat up further this fall.

Health care was a winning issue for Democrats in 2018, but they're not spending much on health care messaging right now.

• One of the top 5 health spenders is One Nation, which is running anti-Medicare for All ads.
• There aren't any pro-Medicare for All groups in the top 5, nor are there any groups running ads explicitly on the benefits of the ACA.

Yes, but: Democrats will almost certainly spend more time and money on health care deeper into the 2020 cycle.

• Health care was still a huge issue in yesterday's special election for North Carolina's 9th district — likely a sign of things to come.
• "Fast forward to fall of 2020, and you will once again see…campaigns litigated on pre-existing conditions, health care costs and drug costs, because Republicans have only made the problem worse for themselves since 2018," Democratic strategist Jesse Ferguson said.

Go deeper: The Democratic hunt for a 2020 down-ballot message