A year ago Friday, Democrats sarcastically serenaded Republicans with chants of "Nah nah nah nah, hey hey, goodbye" as the GOP shoved legislation through the House scuttling the Obamacare health care law.
Now, Democrats battling to capture House and Senate control in November's elections are trying to weaponize that roll call, in which 217 Republicans voted yes. In Michigan, Arkansas and elsewhere, Democrats are hammering Republicans for voting to replace the increasingly popular statute with a bill Congress' own budget experts said would have boosted premiums and the ranks of the uninsured.
"Voters are very upset with the actions Republicans took" trying to repeal Obama's law, said Sen. Chris Van Hollen, D-Md., who heads the Senate Democrats' campaign committee. "This is an issue that we're seeing at the top of voters' minds, and this is across all states."
To sharpen the effect, many ads couple the healthcare vote with last December's passage of a GOP tax cut, which disproportionately helped businesses and wealthy Americans. A spot by a liberal group hits Rep. Mike Bishop, R-Mich., for supporting both, saying, "Representing Michigan should mean representing the middle class."
Republican strategists offer mixed views on the issue's impact. Pennsylvania Rep. Charlie Dent, among only 20 Republicans who voted against the House repeal bill, said GOP candidates will be vulnerable because of the bill's impact and because President Donald Trump privately labeled the GOP measure "mean" a month after it passed.
"That ad more or less writes itself," Dent said of the inevitable Democratic campaign spots.
Georgia Democratic hopeful Bobby Kaple, seeking the nomination for an Atlanta-area district, says, "Thank God for Obamacare" in his spot showing his two young children, born premature but healthy after expensive medical bills.
In Arkansas, cancer survivor Clarke Tucker says he'll "stand up to anyone who tries to take your health insurance" as he competes for the Democratic nomination for a seat surrounding Little Rock.
"Health care is on their mind every day, and I understand that," Tucker said of area voters in an interview.
Democrats are also using the issue in their battle for the Senate, where Republican proposals to scrap Obama's law flopped last summer, dooming the effort.
Rep. Jacky Rosen, D-Nev., seeking to oust GOP Sen. Dean Heller, has run an ad saying, "Repeal and replace Sen. Dean Heller" that contrasts his support for repeal legislation with his initial opposition.
In Arizona, Democratic Senate hopeful Rep. Kyrsten Sinema is highlighting her family's loss of health insurance when she was a child, saying, "I know what it's like for a family to struggle to make ends meet."
The Democratic charge on health care represents a turnaround from recent elections. Just months after passage of the Affordable Care Act in 2010, Democrats lost control of the House as Republicans tapped into fears about the government's growing role in health care. Four years later, Republicans grabbed Senate control following the botched rollout of the health law's online insurance markets and some people's loss of policies that fell short of the statute's coverage requirements.
The failed GOP repeal effort helped turn the tables. A Wall Street Journal-NBC News poll last month showed people trust Democrats over Republicans for handling healthcare by 18 percentage points. A Kaiser Health Tracking Poll in February showed Obama's law with a favorable rating from 54 percent of Americans, its highest score in more than 80 Kaiser surveys since the statute's enactment.
"They walked the plank on a disastrous economic agenda," said Charlie Kelly, executive director of the House Majority PAC, which backs Democratic candidates. He said the votes underscore a narrative of: "Wait a minute, these guys are absolutely not standing with working families. They're trying to screw me on my healthcare."
The most optimistic GOP strategists hope to use healthcare to damage Democrats by accusing them of favoring government-financed healthcare, a top priority for 2016 Democratic presidential hopeful Sen. Bernie Sanders, I-Vt. About a third of Senate Democrats and two-thirds of House Democrats have backed such legislation, a favorite with the party's most liberal voters, which Republicans say would prompt government decision-making about care and tax increases to finance the proposal's huge costs.
"A bigger government is not something they want to run on," GOP pollster Jon McHenry said of Democrats.
Former Rep. Tom Davis, R-Va., who once headed the House GOP's campaign organization, said Republicans "would have owned" healthcare and steadily growing insurance premiums had they successfully enacted legislation. Instead, he says, "They may or may not own the outcomes," adding, "I don't think it's a silver bullet for Democrats."
Democrats say they've gotten further ammunition from subsequent GOP actions. These include Trump's halt of federal subsidies that helped insurers contain some costs and his easing of restrictions on short-term insurance plans with low costs but skimpy coverage.
Last May, the nonpartisan Congressional Budget Office estimated that the House-passed bill would have left 23 million additional people uninsured by 2026 and boosted premiums an average 20 percent this year.
Marking the vote's anniversary, the liberal Save My Care was airing a 30-second television ad in Washington, D.C., showing Trump and Republicans celebrating the House vote last May in the White House Rose Garden.
"We won't forget" appears on a black screen after newscasters intone the bill's impact, including letting insurers charge higher prices for people with pre-existing medical conditions.
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