AHIP19: Healthcare likely to be center stage in 2020 election

NASHVILLE, TENNESSEE—Healthcare was a defining issue of the 2018 midterm election, and it’s shaping up to be central to the 2020 presidential campaign, too, political analysts said Friday while speaking at the annual AHIP Institute & Expo. 

Democrats reclaimed the majority in the House of Representatives on a surge of concern about healthcare, particularly the protections for people with pre-existing conditions that are included in the Affordable Care Act (ACA), said Dana Perino, a Fox News commentator and former George W. Bush administration official. 

That makes it a tough issue for Republicans to take on, particularly as they have built their healthcare political message on opposing the ACA. “You can’t just be against everything,” Perino said. “You need to be for something.” 

RELATED: What the 2018 midterm elections mean for healthcare—predictability  

Republicans have so little energy for healthcare issues after the 2018 election that President Donald Trump’s proclamation that the White House will shortly release its healthcare policy platform was met with little fanfare—or outright ignored—by the party brass, Perino noted. 

Across the aisle, the debate on healthcare is almost the exact opposite: “How much reform or change is too much?”

There is a slew of candidates lined up for the Democratic primary in 2020, and they’re all staking their claim on a spot in the “Medicare-for-All” discussion, said David Axelrod, a CNN political commentator and a former Obama administration official. 

He gave the example of Sen. Corey Booker of New Jersey, who’s signed on to the Medicare-for-All legislation that’s led by Sen. Bernie Sanders, I-Vermont. However, Booker has said in interviews that even with complete Democratic control of the government, he thinks such a policy is unlikely to make it to the president’s desk unchanged—meaning, more incremental reform is more possible. 

Democrats also differ on how they define Medicare for All. Some genuinely back Sanders’ plan, while others use the moniker to support other changes such as a public option or Medicare buy-in, Axelrod said. 

RELATED: Berwick—Cost concerns over ‘Medicare for All’ overblown 

“Americans generally don’t want to destroy the private healthcare system,” Axelrod said. 

Both commentators noted that Trump is already using the Medicare-for-All conversation as a political flashpoint—labeling the Democrats as far to the left or socialists—and that’s a trend that will likely continue over the primary season and into the general election next year. 

Perino said it behooves the president to sow chaos in the primary, and Medicare for All is an effective tool for that. Axelrod added that it also distracts from the Republicans’ lack of a cohesive healthcare platform. 

“I thought we left this ‘Medicare is socialism’ thing behind in the 60s,” he joked.