Healthcare has long proved to be a key campaign issue for Democrats, particularly when they flipped a whopping number of seats in the House of Representatives during the 2018 midterm elections. But despite the focus on health issues this year again — during the deadly COVID-19 pandemic — the tactic has yet to deliver some key congressional seats to Democrats.
The nation continues to wait on results in a number of races that are too close to call and which Democrats may be at risk of losing.
Still, House Speaker Nancy Pelosi praised her party for succeeding in maintaining control of the House even though Republicans have so far flipped eight seats. Democrats have converted just two.
"Our race this time was all about healthcare," Pelosi said this week, adding: "Our purpose in this race was to win so that we could protect the Affordable Care Act and that we could crush the virus," she said.
The issue of health has consumed the American public this year as the uncontrolled coronavirus pandemic has sickened millions, killed more than 235,000 and spurred record job losses. Some typical healthcare issues Congress was poised to tackle faded into the background. Still, deep red states did usher in Medicaid expansion at the ballot box in earlier elections this year.
At the top of the ticket, healthcare was the main focus in the sprint up to the election, according to data gathered by Wesleyan Media Project. Almost half of Democratic candidate and former Vice President Joe Biden's TV ads focused on healthcare while President Donald Trump focused on taxes and the economy.
"Both Democratic and Republican Senate campaigns have focused their advertising on health care, a sign of just how important the issue is this cycle," the Wesleyan Media Project noted.
But as the pandemic has only intensified, some analysts say, it took attention away from the traditional consumer healthcare concerns Democrats had wanted to focus on.
On the other hand, others say without many results, it's too early to tell whether focusing on healthcare was the pivotal issue in 2020 as it was in 2018's midterms.
"I think it is far too soon to tell. Clearly the ACA message wasn't the salient issue of the election as it seemed to be in 2018, but we did see healthcare playing a big role," Chris Sloan, a principal at consultancy Avalere, said.
However, earlier in the year, healthcare issues did move the needle at the ballot box as voters in two deep red states approved Medicaid expansion, a central piece of the ACA.
In 2018's midterm elections, the Democrats' strategy was to focus on healthcare and the key protections that were at risk if the ACA was repealed. That messaging proved pivotal for Democrats as they wrangled 42 seats from Republicans to gain control of the House in what was then characterized as a blue wave.
"We won because from the beginning we focused on healthcare," Pelosi said at the time. The decisive victory led her to take back the title of speaker of the House.
But of the 42 seats Democrats won in 2018, six have been picked off by Republicans and 14 are still at risk of being flipped back. Some of these contests were considered key races to watch in battleground states.
In Florida, Democrats Debbie Mucarsel-Powell and Donna Shalala, a former HHS secretary, both lost re-election after previously winning in 2018. Powell's race in particular was considered a key race to watch as she ran against Republican Carlos Gimenez, mayor of Miami-Dade County, who is viewed by many as a moderate and has considerable name recognition, according to the Miami Herald. Biden lost in Florida after failing to pickup enough votes in Miami-Dade.
In other key battleground states, Democrats ceded ground to Republicans, losing seats in Iowa's 1st Congressional District and Minnesota's 7th Congressional District where longtime Democratic Rep. Collin Peterson and House Agriculture Chair lost to Michelle Fishbach, a former lieutenant governor.
Other 2018 newcomers were also toppled in Tuesday's race, including Kendra Horn of Oklahoma's 5th Congressional District and Joe Cunningham in South Carolina's 1st.
In another intensely watched race, Democratic newcomer Xochitl Torres Small lost her seat in New Mexico's 2nd Congressional District to Republican Yvette Herrell, a former state legislator.
A number of House Democrats are at risk of losing their seats as the races are still too close to call, including Lauren Underwood, a nurse, of Illinois' 14th Congressional District, who delivered a stunning upset in 2018 when she unseated Republican Randy Hultgren.
Policy experts contend that the pandemic may have diverted attention away from the traditional healthcare talking points as job losses mounted amid continued economic turmoil.
"Most Democratic candidates defined their healthcare policies around the pandemic and were not — understandably — very focused on consumer cost issues. Even the ACA issues didn't resonate as well as other issues given the intensity of the economic issues, the dominance of COVID-19 and the political polarization that drove voting decisions," Dan Mendelson, founder of Avalere, said.
On the other side of the chamber, it appears that Republicans will retain control of the Senate, though the Democrats have picked up two seats — one in Arizona and the other in Colorado.
Democrats had hoped to take both the House and Senate, which would have enabled them to save the ACA if the landmark law is overturned by the U.S Supreme Court.
In less than a week the high court is set to hear oral arguments in the case seeking to end the landmark law that guarantees basic consumer protections.
A split House and Senate almost guarantees gridlock that would keep Democrats from achieving any major healthcare reform.