Health care dominated the 2018 midterms, and Democrats benefited from the message, Time national political correspondent Molly Ball told attendees of the Hot Issues in Health Conference near Denver on Thursday.
Ball was a keynote speaker at the conference, sponsored by the Colorado Health Institute. The conference drew a standing-room-only audience Thursday for issues certain to dominate the upcoming 2019 legislative session: mental health services, substance abuse, how to remake the state Division of Insurance into a more consumer-driven advocate, and of course, universal health care.
Politicians in both parties campaigned on continued health insurance coverage for pre-existing conditions, Ball said.
But voters didn't believe Republicans, who have tried dozens of times to repeal the Affordable Care Act, she added.
What also cost Republicans, Ball said, was that between 2016 and 2018, the Affordable Care Act, aka Obamacare, went from being hated by the general public to being popular for the first time in its history. President Trump did something President Obama couldn't, she said.
"He made Obamacare popular."
In 2016 Republicans promised their base that they would repeal Obamacare, but they lacked a viable replacement for it. That put them in the worst of both worlds, she said.
The base was disappointed by Republicans' failure to repeal Obamacare, and the repeals made Democrats mad -- and that resulted in voter turnout, she said.
As a result, health care, and not opposition to the president, became the top message for Democrats, with 55 percent of Democrats' ads nationally focused on health care. Only 20 percent of Republican ads at the national level focused on health care. Exit polling showed 41 percent of voters, a plurality, viewed health care as the top issue, and 75 percent of those voters voted for Democrats.
Ball said it's also likely that with partisan gridlock in Washington, repeal of the Affordable Care Act won't go anywhere. But Democrats, with only the House under their control, will have little chance of enacting a "Medicare for All" plan.
"You can bet on the status quo," Ball said.
Other big themes in the midterms, according to Ball: generational and women. That's reflected by the Democrats' takeover of the U.S. House. When you look at the House, Ball said, "you'll see the stark divide in our country" with 125 women in the new Congress. About one-third of the Democrats' side is white men, she said, while 90 percent of the Republican House caucus is white men.
The election was also about a backlash against an unpopular president, she added. It helped drive historic turnout, with Democrats winning by a margin nationwide of about 9.7 million votes, the largest margin in history.
The population is starting to look more like Colorado, which she called a blue state. The population is younger, more diverse, more educated. It also makes sense to think of the election in terms of geography, split into urban, rural and suburban voters, whom Ball said drove the engine of the Democratic wave. Of the 41 seats flipped by Democrats, 38 were in suburban areas, including Colorado's 6th Congressional District.
But the country is more divided politically than it's ever been, and Ball said people seem to like it that way.
"What I hear from voters is not that they want to come together with fellow Americans," Ball said. They say "The other side is the problem. Winning is more important than coming together."
So what does 2019 hold for health care? Ball pointed out the federal tax bill removed the individual mandate, which forces Americans to buy health insurance or pay a penalty. That's going away in 2019, and the effects of that are, as of yet, unpredictable. The Trump administration has managed to unwind other parts of the Affordable Care Act, such as adding in more work requirements for Medicaid recipients and allowing people to buy low-cost health plans that don't cover as much of a person's health care costs. But this is tinkering around the edges, Ball said.
In 2020, she expects Democrats to focus even more strongly on universal health care or "Medicare for all," an issue that was also a cornerstone of Gov.-elect Jared Polis' campaign.
Ball also said she believes the backlash against Trump in the midterms will have a more lasting effect than Trump and his administration.
"Trump's win [in 2016] is already dwarfed in political effect by the backlash that came after it," she said, adding that Democrats will have to solve their identity crisis in the next two years.
"Democrats are looking for the next Obama," she said.
In the wake of the 2018 midterms, Republicans, nationally, do not think everything is fine, she said.
"They're worried about the future of the party and whether they can win back suburban and women voters," especially with a president who "is not a great ambassador" to those voters.
The "dog that didn't bark" in the 2018 midterms: taxes and the economy. The tax bill wasn't even an issue the president campaigned on, choosing instead to focus on immigration and the caravan of immigrants seeking asylum in the United States.
But Trump's focus on national identity is not what voters focused on either. The big message from the electorate is that "tribalism is not who we want to be as a country."
Ball is a Denver native and a graduate of Cherry Creek High School. Her parents both taught at the University of Denver.
Editor's note: This article was updated at 1:30 p.m. Dec. 6 to correct the name of the publication Ball works for, in the headline.