Are Republicans Losing The Health Care Debate?

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Poll(s) of the week

This week President Trump tweeted that Republicans would “totally protect” health insurance coverage for the millions of Americans who have pre-existing medical conditions (while Democrats would not, he said) and encouraged people to “Vote Republican.” If this sounds like a bizarre 180-degree turn for Trump and his administration, that’s because it is.

Earlier this year, the administration supported a lawsuit that asks the courts to throw out key provisions of the Affordable Care Act, arguing that the individual mandate and protections for pre-existing medical conditions were unconstitutional. What’s more, Republicans have long campaigned on the promise to repeal the ACA and tried to “repeal and replace” it for much of the summer of 2017.

“The ground has shifted under Republicans and now they’re trying to catch up with this,” said Simon Haeder, a professor at West Virginia University. Haeder said the GOP may be trying to change its tune on ensuring coverage for those with pre-existing medical conditions because the position is now so widely accepted. “A decade ago or so, we had no protections for people with pre-existing conditions,” said Haeder. “And we got those with the ACA, and now they’re so accepted by everyone that Republicans feel compelled to acknowledge they want to support people with pre-existing conditions, despite what they’ve told us for the last eight years.”

But unfortunately for Trump and the Republican party, Democrats seem to be winning the health care public opinion battle: 53 percent of Americans said they trust Democrats to do a better job with health care than Republicans in a recent ABC News/Washington Post poll. Just 35 percent of respondents said they trusted Republicans over Democrats. Similarly, a recent Kaiser Family Foundation poll found that Americans were more likely to trust Democrats over Republicans on specific health care issues like continuing protections for pre-existing medical conditions and reducing health care costs. Even independents have gotten behind Democrats: 60 percent placed their faith in Democrats to protect pre-existing conditions (compared to 19 percent who trusted Republicans) in the Kaiser poll.

FiveThirtyEight Senate forecast update for Oct. 26, 2018

Americans have also come to feel more positively toward the the ACA in the last year. Forty-nine percent of U.S adults view the ACA favorably in the most recent Kaiser Family Foundation poll, compared to 42 percent who view it unfavorably. The popularity of the ACA even reached an all-time high in February of this year, with 54 percent of Americans approving of it according to the Kaiser Family Foundation.

With just two weeks to go until the midterms, both Democrats and Republicans are doubling down on health care as a critical campaign issue. We reached out to experts to see if they thought it was a smart move for Republicans to try to shift the narrative on pre-existing medical conditions, but the experts we spoke to said Republicans were too far behind on the issue to gain much ground. They were also unsure if this might actually hurt Republicans at the polls. After all, health care isn’t the top issue for every voter.

Robert Blendon, a professor of health policy and political analysis at Harvard, told FiveThirtyEight that the best political strategy for Republicans is to “try to not talk about health care.” But Democrats have made health care a core campaign issue, running deeply personal and emotional ads, and Blendon said that has ultimately forced Republicans to respond. “If you’re there and the ads are running and you’re in a forum with a Democratic candidate accusing you, you have to say something. The old argument — ‘We’ll just get rid of it and start over’ — is a total nonstarter.”

In the short term, Republicans’ strategy of supporting protections for people with pre-existing conditions may help reassure some independent voters who were already planning to cast their vote for the GOP, but the experts we spoke with said it’s not likely to sway other voters. And in the long term, experts said today’s positions will make it tougher for Republicans to repeal the ACA, putting them in a difficult legislative position going forward.

Whether Republicans will suffer electoral losses as a result is unclear. But, Eric Patashnik, a public policy professor at Brown University, said in an email that “it is already clear that Republicans have made it even harder for their party to govern if they manage to retain control of both chambers and take another stab at dismantling Obamacare.”

Other polling nuggets

• The most recent poll of Georgia’s gubernatorial race, conducted by Opinion Savvy, shows Democrat Stacy Abrams and Republican Brian Kemp virtually tied. All of the polls conducted this month have put the two candidates within two percentage points of each other. The race remains one of the most competitive in the FiveThirtyEight governors forecast.
• A poll of Alaskans conducted by Alaska Survey Research asked voters who they would vote for in a hypothetical situation where Gov. Bill Walker, an independent, dropped his re-election bid and endorsed his Democratic opponent, Mark Begich. Responses to that question showed Begich trailing Republican Mike Dunleavy by 5 points. On the first day the poll was in the field, that exact scenario came to pass. All three versions of the FiveThirtyEight governors forecast characterize the race as “lean Republican.”
• A poll of the Senate special election in Mississippi conducted by Marist College and NBC News found that no candidate was poised to win 50 percent or more of likely voters. Republican Cindy Hyde-Smith led in the poll with support from 38 percent of likely voters, followed by Democrat Mike Espy, who received support from 29 percent. If no candidate wins at least 50 percent on Nov. 6, the race would go to a runoff three weeks later. FiveThirtyEight’s Classic forecast gives Republicans a 7 in 8 chance¹ of winning that seat.
• In Florida’s gubernatorial race, a Quinnipiac poll found Democrat Andrew Gillum leading Republican Ron Desantis, 52 percent to 46 percent among likely voters. The FiveThirtyEight forecast characterizes the gubernatorial race as “likely Democratic.”
• A poll of Montanans conducted by Montana State University, Bozeman sent a questionnaire by snail mail to 10,215 registered voters; over 2,000 responded, and they gave Democratic incumbent Jon Tester a 3-point lead over Republican challenger Matt Rosendale in the state’s Senate race. But a more recent phone poll of likely voters conducted by Montana State University, Billings gave Tester a 9-point lead.
• A Siena College/New York Times poll conducted in Illinois’s 12th Congressional District found Republican incumbent Mike Bost leading Democrat Brendan Kelly by 9 percentage points. A poll conducted by the same pollster in early September showed a much closer race, with Bost only 1 point ahead.
• In the Minnesota 1st, a SurveyUSA poll shows Democrat Dan Feehan ahead of Republican Jim Hagedorn by 2 percentage points. The FiveThirtyEight classic forecast identifies the race as a toss-up but gives the Democrat a slight edge.
• Polls show incumbent Republican Tom MacArthur’s lead is tightening in the New Jersey 3rd. A Siena College/New York Times live poll (that’s still underway as of this writing² shows MacArthur essentially tied with Democratic challenger Andy Kim. The last time Siena College and The New York Times polled the district, in late September, they found a 10 percentage point lead for Kim. Other recent polls have also shown a close race.
• 56 percent of Americans think that Trump’s response to Saudi Arabia over the murder of journalist Jamal Khashoggi has not been tough enough, according to a SurveyMonkey poll. But there was a partisan divide: 78 percent of Democrats thought Trump should have been tougher, compared to 37 percent of Republicans.
• According to YouGov, 64 percent of Americans say dairy milk is their preferred milk product, followed by 12 percent who prefer almond milk. Identical percentages — 3 percent each — prefer soy milk and coconut milk.
• 76 percent of Americans said they liked Thanksgiving more than Halloween according to a recent YouGov poll. Only 19 percent liked Halloween more, and 5 percent were not sure.
• On Sunday, Brazilians will go to the polls to elect a president in a runoff election, as no candidate secured a majority of the vote in October. Several polls show Jair Bolsonaro, a right-wing populist candidate, with a roughly 15-point lead over his opponent, Fernando Haddad.

Trump approval

President Trump’s approval rating has improved again this week. According to our tracker, 42.8 percent approve of his job as president while 52.2 percent disapprove. That makes for a net approval rating of -9.4 points — a slight improvement from one week ago, when his net approval stood at -9.6 points. But one month ago, Trump was significantly less popular than he is today: 53.2 percent of Americans disapproved of his job performance compared to 41.4 percent who approved, for a net approval rating of -11.8 points.

Generic ballot

According to our generic congressional ballot tracker, Democrats are leading Republicans 50.0 percent to 42.0 percent. Support hasn’t shifted much from one week ago, when Democrats were at 49.7 percent and Republicans were at 41.3 percent. One month ago, Democrats held about the same advantage, 49.4 percent to 41 percent.

Check out our 2018 House, Senate and governor forecasts and all the polls we’ve been collecting ahead of the midterms.