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The 2020 elections are being driven by health care. That’s good news for Democrats.

Between coronavirus and Obamacare sabotage, the 2020 presidential race is shaping up to be yet another election driven by health care. Which might deliver another coveted victory to Democrats.

Not because Democrats have done a lot right but, rather, because Republicans keep doing everything wrong.

Ahead of the 2018 midterms, Democrats had an undeniable advantage on health care. Polls consistently showed it as a top campaign issue, and nearly half of political ads in federal races mentioned it. Republicans had just spent the previous year trying to repeal the Affordable Care Act, and voters had finally figured out what they stood to lose: protections for preexisting conditions, the Medicaid expansion and other popular provisions.

After eight years of playing defense on health care, Democrats were at last on offense. The public saw Democrats as protectors of Obamacare and awarded the party control of the House.

But Democrats being Democrats, they soon squandered their advantage.

Almost immediately, Democrats launched a divisive debate over how to improve the current system. Some on the far left demanded that Democrats commit to abolishing private health insurance, which would involve taking employer-based plans away from some 180 million Americans who might be averse to giving them up. The amount of blowback after Obamacare canceled objectively bad insurance plans for just a few million Americans suggests how toxic a single-payer-or-bust purity test could be.

Democrats had put themselves back on defense and had somehow turned an issue that should have been an unalloyed advantage into a political liability.

Luckily for them, Republican incompetence and heartlessness have again come to Democrats’ rescue.

In the years since the GOP tried and failed (and tried, and failed) to repeal Obamacare legislatively, Republicans continued a sort of backdoor sabotage of the law.

They’ve made numerous subtle changes, such as expanding the availability of junk insurance plans that look like a good deal until you get sick and realize the plans don’t cover necessary care. They cut funds for marketing campaigns that alert people about open enrollment periods. They added (probably illegal) Medicaid work requirements and announced a plan to convert part of Medicaid into block grants.

Just last month, the administration implemented an immigration rule that has frightened and confused families into disenrolling U.S.-citizen children from Medicaid and the Children’s Health Insurance Program.

Many of these changes have largely flown under the political radar. But the prospect of a public health crisis has drawn more attention to the holes in our health-care system — including those that may have predated President Trump but have widened under his leadership.

For instance, the rise in uninsured rates since 2016 — a direct result of the GOP’s Obamacare sabotage — takes on new salience. Stories of Americans stuck with big bills for coronavirus testing and hospital stays are likely to discourage people who are uninsured or underinsured from getting screened and treated.

The Trump administration has made plenty of other unforced errors on health policy, many of which are directly related to its handling of the coronavirus epidemic or otherwise laid bare by it.

The president has made clear that he cares more about threats to the stock market than those to public health and has spread misinformation about the risks for both. Trump and his underlings have attacked government experts, including scientists and doctors. And the government’s coronavirus response team is being overseen by a vice president notorious for bungling a previous public health crisis.

Even before concerns about a global pandemic, voters were saying that, once again, health care would be their top issue in the coming election. If these developments weren’t enough to convince voters they can’t trust Republicans on health care, perhaps some news that broke Monday will: The Supreme Court said it would hear another case challenging the constitutionality of the Affordable Care Act.

The case will be heard in the court’s next term — possibly before the November election — and the Trump administration still says it wants the law struck down. It also still doesn’t have a replacement plan if the court were to acquiesce. This, too, represents not only terrible policy but also terrible politics.

Republicans suggest it is somehow improper or unpatriotic for critics to point out the administration’s failures in its handling of coronavirus. They say Democrats should stop trying to capitalize on Republican health-policy screw-ups. To that Democrats should simply reply, as Republicans have in the past: Well, then stop screwing up.




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