RACHEL MARTIN, HOST:
Four years ago, Republicans went into the midterm elections with a clear focus on health care. They ran on dismantling the Affordable Care Act, or Obamacare. Now the script has flipped. This time around, Democrats believe the issue of health care could boost them to victory in November. NPR's Danielle Kurtzleben has more.
DANIELLE KURTZLEBEN, BYLINE: Leaders of both parties are ready to talk to voters about health care. At a recent breakfast in Washington, Maryland Democratic Senator Chris Van Hollen, who also chairs his party's Senate campaign committee, bragged about a CNN poll from late March.
(SOUNDBITE OF ARCHIVED RECORDING)
CHRIS VAN HOLLEN: When people are asked who do you trust more on health care issues, by a margin of 20 points, voters say Democrats.
KURTZLEBEN: Meanwhile, Senate Majority Leader Mitch McConnell sees health care, and more specifically Republicans' attempts to weaken the Affordable Care Act, as a concrete example of legislative success for conservative voters to rally around.
(SOUNDBITE OF ARCHIVED RECORDING)
MITCH MCCONNELL: I've now been on the Senate three decades. This is the best year and a half for right-of-center policies since I've been here, everything from tax relief to repealing the individual mandate.
KURTZLEBEN: Both parties claim their respective victories, but health care is clearly more motivating for one side. Thirty percent of Democratic registered voters say that health care is the most important issue for candidates to talk about, according to a recent poll from the Kaiser Family Foundation. That makes health care a top issue for Democrats. Only half as many Republicans say health care is the most important issue. Mollyann Brodie, the head of polling at the Kaiser Family Foundation, says it could fuel Democratic turnout this year.
MOLLYANN BRODIE: I think that our poll certainly suggests that if you want to get your base out and motivate them to turn up to the polls, you would want to be talking about health care, for the Democratic side.
KURTZLEBEN: It's definitely motivating Corrine Nagel (ph), a Democrat from Davenport, Iowa.
CORRINE NAGEL: I don't even have health insurance right now. It's not feasible in the state of Iowa at this time. They have decimated Obamacare in this state, and there is only one company. And, of course, they want a lot of money to insure me.
KURTZLEBEN: Iowa has had a rocky experience with Obamacare, to put it mildly. A Politico headline called the state an Obamacare horror story. Iowa had been at risk of having zero Obamacare insurers in the state. There's one now, but high premiums and decisions by state officials have kept some people out of the exchanges. Iowans worried about health care have much more on their minds than Obamacare, however, according to Democratic State Representative Marti Anderson.
MARTI ANDERSON: They're really worried about mental health because everybody has, you know, a sister Jane or an Aunt Bessie or an Uncle Tommy who needs some help, and finding that help is a big deal.
KURTZLEBEN: A mental health care system often described as being in crisis is one of several health care topics driving voters to the polls here. In addition, led by Republicans, the state has in recent years privatized Medicaid, cut funding to Planned Parenthood and passed a strict abortion law, all health care-related decisions that have angered Iowa Democrats. Democratic congressional candidate Pete D'Alessandro says that the issue of health care is inescapable as he talks to voters throughout Iowa's 3rd District.
PETE D'ALESSANDRO: Everywhere you go, regardless of whether it's urban, rural, people are talking about how their premiums have gone up, how they don't have the same coverage they had, how they don't know how they're going to continue to provide for their families or for themselves, get the health care that they need.
KURTZLEBEN: All of that said, Kaiser's Mollyann Brodie cautions against thinking that health care will be the driving force in the elections this year.
BRODIE: Even though they want to hear candidates talk about it, it doesn't mean, I think, this is necessarily a health care election.
KURTZLEBEN: And that's because a force bigger than any policy debate is shaping this year's campaign.
BRODIE: We found that a candidate's support or opposition for President Trump is actually more likely to be named as something important to these voters than necessarily national issues.
KURTZLEBEN: In other words, if you spend your days attacking the president or praising him, many voters won't care about your plans to lower insurance premiums. Danielle Kurtzleben, NPR News, Washington. Transcript provided by NPR, Copyright NPR.