A big issue US voters might be missing

Mary Ellen McIntire –

Democrats who say they are determined to keep voters focused on healthcare this year were hoping that the Supreme Court would hand them a ready-made campaign ad and a potential courtroom win.
Instead, the court recently punted on a major decision over whether to kill the 2010 healthcare law that expanded coverage to more than 20 million Americans. Now, Democrats hope that by shifting their attention to high prescription drug prices they might still mobilise voters and help the party maintain its edge on healthcare, the public’s top domestic concern, although Republicans also are focused on drug prices.
But without a high-profile appeals hearing at the Supreme Court about the fate of the 2010 law, it could be harder for Democrats to drive interest in the lawsuit, Texas vs Azar, ahead of Election Day.
“There’s a lot of concern and apprehension in what (overturning the law) would mean, and yet it’s been playing out for so long, it hardly feels like a new story and it’s hard to maintain the same level of urgency,” says Melinda Buntin, chair of the health policy department at Vanderbilt University. “Yet the extreme disruption that would be caused by the repeal of the (healthcare law) is just as real as it’s always been.”
The lawsuit brought by Texas and other conservative state attorneys general to overturn the law came after Congress ended its penalty for those without insurance. The Trump administration backed the suit, calling for the entire law to fall. But several blue-state officials and the House defended it and requested a quick resolution. If the high court had expedited the case, Democrats
could have pointed to it as an imminent threat.
So far, the lawsuit hasn’t appeared to register with voters in the same way congressional GOP efforts to roll back the law did in 2017, when the Obamacare repeal proposals dominated town hall meetings and led to protests on Capitol Hill. Democrats leveraged voters’ fears that they would lose coverage, which helped flip the House to Democratic control in 2018.
“People thought, women voters in particular thought, we’ve sent a clear message” on healthcare, says Democratic pollster Celinda Lake. “Then (President Donald) Trump went at it right away, again. That really energised voters because they thought, ‘Wow, he really didn’t hear us.’” Legal experts on both sides of the aisle are skeptical of the case’s legal arguments, but the risk to the law remains. Whether voters are aware of that is an open question. But broad concerns over healthcare do remain top of mind for voters, polls show.
Republicans hope to counter their rivals’ message by taking advantage of divisions among Democrats over whether to undertake another ambitious overhaul of the healthcare system. Liberal presidential candidates, including independent Senator Bernie Sanders of Vermont and Massachusetts Democratic Senator Elizabeth Warren, would move the nation towards a government-run system, while moderates including former
vice-president Joe Biden say that idea is too costly.
Douglas Holtz-Eakin, president of the right-leaning American Action Network, said Republicans will have an easier time focusing on those proposals without a more immediate threat to the 2010 law.
“It takes off the table having to talk about comprehensive reforms that would be in lieu of the ACA, and that I think is probably to their benefit,” Holtz-Eakin says, using the law’s acronym. “They can instead focus on some issues where they feel they will have something to say.” 
— dpa