The California Democrats who fought to flip Republican congressional seats in 2018 used health care as their crowbar. The Republicans had just voted to repeal the Affordable Care Act in the U.S. House -- and Democrats didn't let voters forget it.
Two years later, Democrats are defending the seven seats they flipped from red to blue in California. And once again, they plan to go after their Republican opponents on health care in this year's elections.
But this time around, it's not just about the Affordable Care Act, whose fate now rests with the federal courts. Democrats are highlighting the high costs of prescription drugs, surprise medical bills and cuts to safety-net programs.
Health care "remains the single-biggest priority for most voters in 2020," said U.S. Rep. Josh Harder, a Democrat who represents California's 10th Congressional District, in the northern San Joaquin Valley, which includes the cities of Modesto, Turlock, Tracy and Manteca.
Harder, who defeated Republican Jeff Denham in 2018, made the case then that eliminating the federal health law and its protections for people with preexisting conditions would harm thousands of people in his district, including his younger brother, whose premature birth yielded $2 million in hospital bills.
Health care affordability -- from drug costs to premiums -- is still the No. 1 issue his constituents raise in conversations with him, he said.
"The problems haven't been solved," said Harder, who blamed the Republican-controlled U.S. Senate for stalling on health care legislation addressing prescription and other health care costs. "A lot of folks out here feel like there's still an unbelievably long period before they can see a doctor, and they think that the costs are way too high."
Multiple calls and emails to Republican congressional candidates and the California Republican Party requesting comment were not returned. California voters will select their party's congressional candidates in the Super Tuesday primary March 3.
Health care is indeed a top issue for voters, confirmed Mollyann Brodie, executive director of public opinion and survey research for the Kaiser Family Foundation. (Kaiser Health News, which produces California Healthline, is an editorially independent program of the foundation.)
"What concerns people the most is health care costs and their own affordability of health care," Brodie said. "And when we asked people what they thought Congress should be working on, prescription drug costs came right on top."