Affordable Care Act still winning...

Democrats bet big on Obamacare to win Virginia statehouse

By RACHANA PRADHAN

Virginia Democrats are betting health care will help them take control of the state legislature in November, following their rout of Republicans two years ago that nearly eliminated the GOP’s hold on the Virginia statehouse.

Democrats are already pouring tens of thousands of dollars into ads targeting the health care records of GOP incumbents in newly competitive races, hoping to capitalize on recently redrawn legislative districts seen as more favorable to Democrats. And new polling data says health care ranks high for potential voters.

State lawmakers will face voters for the first time since Virginia adopted Obamacare’s Medicaid expansion in an election that will test whether some of the same pro-Obamacare messaging can work again. The off-year election will be watched closely as a harbinger for 2020, after Virginia’s last statewide elections forecast the mid-term blue wave, although Democratic presidential hopefuls are in a bitter and sometimes muddled fight over the future of the landmark health law. Another health care-fueled Democratic victory in Virginia this fall could be a worrying sign for President Donald Trump, who has sought to seize an advantage on health care since failing to replace Obamacare.

Both of Virginia's legislative chambers are up for grabs this fall, with Republicans holding just a razor-thin majority in each chamber. A full Democratic takeover could usher in the most liberal government in Virginia history and empower the party to redraw electoral maps for the state legislature and congressional seats in 2021.

Little polling has been done on the legislative races, more than two months out from the election, but results from a Roanoke College poll last week showed health care ranked as a top issue for potential voters, narrowly behind education and the economy. The poll also showed that Democrats had a slight advantage over Republicans on a generic ballot.

House Democrats in an initial $90,000 digital campaign are running health-focused ads against two high-profile GOP incumbents — Speaker Kirk Cox and Appropriations Committee Chairman Chris Jones — for being against “affordable health care,” even though the two powerful lawmakers voted for Medicaid expansion last year.

The fight for Medicaid expansion, as well as backlash to Trump amid the state’s leftward shift, drove Gov. Ralph Northam’s successful 2017 campaign and helped Democrats nearly retake control of the Virginia House of Delegates. In a replay of that strategy, Democrats are reminding voters that Virginia Republicans, including Cox and Jones, had long opposed Medicaid expansion, which has covered more than 300,000 low-income Virginians since enrollment started last November, and they contend only Democrats can be trusted to preserve the program.

“You know why we were able to move forward and pass Medicaid expansion, it was because we had a successful wave election [in 2017],” said state Del. Eileen Filler-Corn, who leads the House Democratic caucus. “You can see who fought against it — which party, which members, year after year."

Jones, a pharmacist who’s represented a district near Virginia Beach since 1998, has run multiple ads touting his support of the program. One ad calls him Medicaid expansion’s “deciding vote,” though the program passed with a comfortable margin in the House. Another said “he led the fight to expand Medicaid and voted to improve our mental health system.”

Democrats say Jones is distorting his record on Medicaid expansion now that his political career is at risk.

“What I’m hearing from voters most is that, they are offended and upset that Chris Jones is putting out false information about his record," said Clinton Jenkins, the Democrat challenging Jones. “He wasn’t a leader in health care reform, he voted against it four times. That’s what I’m hearing."

Jones and Cox did not respond to multiple inquiries from POLITICO.

Nationally, establishment-aligned Democrats hope the party in 2020 can maintain its advantage on health care by vowing to preserve Obamacare, even as progressives push for a "Medicare for All" system that would virtually abolish private insurance and provide everyone government coverage. Trump and Republicans have tried to tie all Democrats to the Bernie Sanders-backed health plan, deriding it as "socialist" and wildly unaffordable to taxpayers.

In Virginia, though, health care will compete for attention with other high-profile issues Democrats and outside groups will lean on heavily to drive turnout in an off-year election. That includes a push for stricter gun laws after 12 people were killed during an attack in Virginia Beach this May.

Rachel Bitecofer, a political scientist at Christopher Newport University, said guns and health care are the two biggest issues for voters in competitive districts Virginia Democrats are trying to flip in November.

"Health care in their belief is an issue that attracts moderate voters," she said.

Medicaid expansion was long favored by Virginia residents but Republican lawmakers had refused the program since 2014, when states could first broaden coverage to millions of poor adults with hefty federal funding under Obamacare. The program has continued to be popular in Virginia after it became law last year. Three-quarters of Virginians supported expansion months after its passage but before enrollment started, according to a September 2018 statewide poll by the University of Mary Washington in Fredericksburg.

“Defending Medicaid expansion is a message that I think resonates for Democratic voters and is an important message for candidates this year,” said Gaby Goldstein of the Sister District Project, a progressive advocacy group working to flip control of state legislatures to Democrats.

Political experts and strategists said health care, unlike in the previous election cycle, may not be the single defining issue for Virginia voters, partly because Democrats already won on Medicaid expansion.

"Whenever you have a big victory in a legislative matter like that, the voters who were on the winning side tend to forget and move on," said Democratic strategist Ben Tribbett. “It becomes far less potent of a political issue for the people who won."

Republicans now have a 51-48 majority in the House and a 20-19 advantage in the Senate. Should Democrats take control of the statehouse, they seem unlikely to pursue a single-payer plan like Medicare for All or a public option, which state lawmakers in some Democratic strongholds have recently pursued.

Virginia Democrats haven’t yet articulated a unified health care agenda for next year, but individual candidates have highlighted health care priorities like protecting access to abortion, improving rural health care and making health care prices more transparent, in addition to protecting Medicaid expansion.

Democrats may seek to undo a requirement for some Medicaid enrollees to work, which was essential for securing GOP support for expansion last year. State officials are now reviewing a near-final agreement with the Trump administration to implement coverage restrictions, and an announcement is expected in the coming weeks, according to two officials with knowledge of the discussions.

Filler-Corn, the House Democratic leader, didn’t rule out the possibility that her caucus would scrap the work requirements upon taking back the chamber.

"That’s something that will need to be discussed,” she said.

Senate Republicans, facing election for the first time since 2015, are focusing their health care message on lowering health care costs. They have criticized Northam for vetoing legislation expanding short-term health plans and association health plans for businesses, two major pillars of the Trump administration’s effort to promote cheaper, skimpier alternatives to Affordable Care Act coverage.

“You can’t talk about health care without talking about the cost of health care for the people purchasing it,” said state Sen. Siobhan Dunnavant, a Republican who voted against Medicaid expansion and faces an electoral challenge from a sitting House Democrat. Her campaign has been running health-care focused ads, including on the cost of prescription drugs.

Dunnavant, an OB-GYN who represents parts of the Richmond suburbs, said she’s comfortable explaining her vote against Medicaid expansion.

"The only conversation was between expanding Medicaid under the Affordable Care Act or doing nothing, and neither one of those was a good option in my opinion,” she said.