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Expand chart
Data: Kaiser Family Foundation Health Tracking poll conducted April 20-30 and June 11-20 2018. Margin of error ±5%; Chart: Chris Canipe/Axios

In recent elections, Republicans have effectively used health care and anti-Affordable Care Act sentiment to rally their base. Now, the repeal effort has made the ACA more popular and given Democrats a weapon to use to motivate their base and reach out to independents.

Between the lines: The importance of health care as a national priority is sometimes overstated — but our recent polling shows it really could be a decisive issue in the midterms. That's because it has been surging as an issue for Democrats, and in an election many see as a referendum on President Trump, it may now be as important a factor as Trump is.

By the numbers: The surprising number from our tracking polls: 33% of Democrats pick health care as the top factor in their vote in the upcoming elections, while 30% pick Trump. For the general public, 25% pick health care, about the same percentage as pick Trump (26%).   

The health care surge is reflected in the public’s ranking of issues that will be important to their vote. Usually, health care ranks as one of a group of top issues behind the economy and jobs. Now, health care is the top issue for Democratic and independent voters for the midterms, and tied for second with immigration for Republican voters.

  • In fact, health care actually ranks higher now for Democrats than it did for Republicans in the anti-ACA elections of 2010 and 2014, when it ranked third on their list of issue priorities.

Health care is not one issue on the campaign trail — it’s a collection of issues. Protections for pre-existing conditions is the most important issue to voters right now, topping others like ACA repeal, drug prices, stabilizing the marketplaces, and even the possibility of the Supreme Court overturning Roe v. Wade.

But the polling shows that all the health issues currently on the agenda are breaking through, particularly with Democrats and independents. Two issues — protections for people with pre-existing conditions and drug prices — have unique bipartisan traction, which can matter in swing states and races.

It is hard to completely separate Trump from health care, since many people believe the Trump administration is working to make the ACA fail (56 percent) and nearly half feel that’s a bad thing (47%, and 77% of Democrats).

The other side: The ultimate role health care plays will depend on how effectively the issue is prosecuted in the campaign by Democrats, and how Republicans respond. And a lot can still happen between now and November to change voter priorities. A big combat operation overseas, a report from the Mueller investigation or any big unexpected development could bump health care down the hierarchy of voter concerns.

The bottom line: I have always been cautious about hyping health care as a factor in elections. But if circumstances do not change, this is an election where health care may not only be a top issue, but also a critical factor in the vote.

Go deeper

Dems' immigration plan hits major roadblock

Senate Majority Leader Sen. Chuck Schumer. Photo: Alex Wong/Getty Images

The Senate parliamentarian ruled Sunday that Democrats cannot include pathways to citizenship in the $3.5 trillion budget reconciliation package, per a copy of the ruling obtained by Axios.

Why it matters: It's a blow to Democrats who hoped to provide pathways for millions of undocumented immigrants in the U.S. Using reconciliations would have allowed them to pass politically contentious immigration changes with only 50 votes, as opposed to the usual 60 required.

FBI says human remains found in Wyoming likely Gabby Petito

Gabby Petito. Photo: FBI

Human remains found in Teton County, Wyoming, are "consistent with the description of" missing 22-year-old Gabby Petito, said FBI Denver official Charles Jones at a news conference Sunday.

Details: The cause of death had yet to be determined, but Jones said: "Full forensic identification has not been completed to confirm 100% that we found Gabby, but her family has been notified of this discovery." Authorities said they're continuing the search for her fiancé, Brian Laundrie.

6 hours ago - Politics & Policy

Beto not even best Dem against Abbott

Beto O'Rourke speaks at a rally at the Texas State Capitol in June. Photo: Sergio Flores/Getty Images

Actor Matthew McConaughey’s nine-point lead in a theoretical matchup against Greg Abbott shows just how vulnerable the hard-right Texas governor could be in a general election.

Why it matters: Abbott has won conservative accolades for his abortion, mask and vaccine bans. Axios reported Sunday that former Rep. Beto O’Rourke is preparing to announce a gubernatorial challenge — but a recent poll shows he’s not even the most popular Democrat in the state.

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