Welcome to POLITICO’s West Wing Playbook, your guide to the people and power centers in the Biden administration. With help from Allie Bice. Send tips | Subscribe here | Email Alex | Email Eli The last half-decade of American politics has been defined by its seismic shifts. But one constant has emerged: Democrats do better when they run on health care. Tuesday’s midterms were no different. Despite a dour economic mood, displeasure with the president, and historic trends against them, Democrats delivered strong showings across the board, putting President JOE BIDEN in position to keep critical hold of the Senate (and according to some starry-eyed aides, potentially even the House). As the party sifts through the results in search of what went right, an early conclusion is that for all the focus on inflation and debates over democracy, tens of millions of voters were motivated by everyday health concerns — and that sizable group trusted Democrats far more than Republicans to address them. “If you look at these individual members and who succeeded, health care was a huge part of what they stood for and talked about,” said LESLIE DACH, chair of the Democrat-aligned health group Protect Our Care. “The American people completely reject the Republican plans on health care.” In key races, vulnerable Democrats like Sen. MAGGIE HASSAN of New Hampshire, Rep. ABIGAIL SPANBERGER of Virginia and Rep. SUSAN WILD of Pennsylvania ran on cutting drug costs and making health care more affordable. Biden spent the midterm stretch run hammering Republicans for suggesting cuts to Medicare. And looming over it all was abortion, where the threat to reproductive rights juiced Democratic enthusiasm and hardened opposition to GOP challengers. Among those who said the Supreme Court’s overturning of Roe v. Wade had a major impact on which candidate they supported, 65 percent voted for the Democrat, polling from the Kaiser Family Foundation shows . Democrats have enjoyed a clear political advantage on health issues since 2017, when GOP attempts to repeal the Affordable Care Act backfired spectacularly and pushed support for the law to new heights. Since then, party leaders have sought to make health care a centerpiece of their agenda because, well, it’s popular. “It has been in some ways an organizing principle that really defined and divided the parties,” said former Obama-era health secretary KATHLEEN SEBELIUS. “And I think the Dobbs decision was just another piece of this puzzle.” It’s a remarkable shift from 2014, when then-Sen. MARK UDALL (D-Colo.) was widely ridiculed for focusing so much of his unsuccessful re-election campaign on reproductive rights (Mark Uterus became the moniker of mockery). But inside the White House, there was little hesitation at leaning hard into health care, even as some aides acknowledged Biden's own discomfort with making abortion a central pillar of his campaign message. A Biden adviser said officials crafting the president’s economic message centered it on cutting household costs in large part to make for an easy pivot to Democrats’ well-received moves to boost access to prescription medicines and health insurance. Though some Democrats worried that meant the White House wasn’t talking about inflation enough, the strategy appeared to pay off, as literally any Biden official will now happily inform you. As the White House prepares the next phase of its agenda, health care is likely to play an even larger role. The just-passed cap on insulin prices for Medicare beneficiaries officially kicks in next year, and Biden is eager to sell it as concrete evidence he’s lowering costs. Democrats have also discussed voting to expand that cap to all Americans as a way to further pressure Republicans, after the GOP blocked an initial attempt earlier this year. “We’re just getting started,” Biden declared at a Democratic National Committee event Thursday. On abortion, Democrats have floated a range of options, from holding a variety of show votes to pushing policies that pre-emptively protect other reproductive rights. There’s little that Biden can single handedly do, advisers acknowledged. But at minimum, Tuesday’s results justified their belief that abortion has become just the latest in a long line of health issues that are surefire winners for Democrats. “It’s a lesson the Republicans never learn when it comes to health care,” Dach said. “People don’t want their freedoms taken away.” MESSAGE US — Are you JESSICA SCHUBEL, the White House director of the Affordable Care Act and health care? We want to hear from you! And we’ll keep you anonymous. Email us at westwingtips@politico.com .
| 
