MEMO: The More Things Change, The More They Stay The Same

September 21, 2020

TO: Interested Parties

FROM: Priorities USA

DATE: September 21, 2020

RE: The More Things Change, The More They Stay The Same

Our nation is in the midst of a pandemic that has killed more than 200,000 Americans and thrown the country into the worst economic downturn since the Great Depression, with millions out of work. A Supreme Court seat just opened up less than 50 days out from a presidential election. We have been through approximately 18 million news cycles since Donald Trump took office. These are unprecedented times, no doubt.

But no matter how much has changed, at least one thing has remained consistent throughout the last four years — Democrats have a winning message on health care.

Over the weekend, The New York Times ran the headline, “Joe Biden’s Court Vacancy Plan: More Talk of Health Care and the Pandemic.

The pandemic makes health care more important. The Supreme Court fight makes health care more important. Anyone who tells you otherwise is lying.

Priorities USA has spent the least four years consistently beating the drum for Democrats to focus on health care, and health care messaging has been central to our paid communications. It worked with great success in 2018 and works even more effectively now. We will continue to communicate with battleground voters about Trump’s attacks on health care until Election Day. This isn’t just about message discipline, it’s about responding to the issue voters have consistently ranked as most important year after year. There are other issues and there are many important fights, but health care is and always has been the dominant issue of this election. Voters are complicated but politics can be simple. Don’t overthink this one.

Priorities USA on Health Care


  • 9/3/20: “Similarly, when these voters were exposed to a battery of potential attacks on Trump, two stood out head and shoulders above the rest as the most concerning: 1) Trump’s plans to cut Social Security and Medicare so he can pay for more tax cuts for the wealthy; and 2) Trump’s continued efforts to gut health care coverage for millions of Americans, including patients with pre-existing conditions, even in the middle of a pandemic.”

  • 7/16/20: “A message that presents Trump’s health care policies as putting the interests of insurers and drug companies ahead of what is best for average people raises major concerns for 82% of recent movers.”

  • 6/11/20: “Despite all the changes that have transformed American life over the past several months, some aspects of the race have remained remarkably stable. Chief among them is the electorate’s continued focus on health care. For the fifth straight iteration of this poll, respondents cite health care as the most important issue to them, with 50% of voters choosing it as one of their top four issues.”

  • 2/6/20: “If Democrats want to win, we — and most importantly our candidates for President — must increase our focus on the issues that affect voters’ lives on a daily basis. Priorities USA polling has consistently found that messages focused on health care, drug prices, wages and Medicare and Social Security are effective both at moving voters away from Trump and at galvanizing the Democratic base.”


  • 9/19/19: “Health care remains the top issue for voters across the battleground states, with gun violence, wages keeping up with the cost of living, and government corruption rounding out the top four. Health care holds a significant lead, as it did in the lead-up to the 2018 elections.”

  • 7/23/19: “Health care dominated the 2018 midterms and the issue is set to be at the top of voters’ minds once again in 2020. In Florida, 52% of likely voters cite health care in their top four issues, the only issue cited by a majority (‘wages keeping up with the cost of living’ came second with 33%, followed by immigration with 31%).”

  • 7/22/19: “Health care and immigration are the top issues for Latino voters in Florida, Arizona and Nevada, but Democrats must conduct significant outreach to engage voters on the specifics of Trump’s policies to fully take advantage of the salience of the messages available to us, particularly on economic issues.”

  • 5/20/19: “2020 will be an election where pocketbook issues and the difficulties people face in keeping up with the cost of living will be front and center – and no pocketbook issue is as important as the cost of health careHealth care is far and away the most important concern for voters in battleground states and is even the top concern among Trump voters and independents.”

  • 3/26/19: “A newly elected Democratic majority has a constitutional duty to conduct responsible oversight of the Executive Branch and the single most important thing we can do to beat Donald Trump in 2020 is to focus on health care and the ways that Trump has hurt American families economically by enacting policies that are meant to help corporations and the wealthy. These two things were true before the Mueller investigation and they are true today.”

  • 3/13/19: “A majority of voters do, however, feel that their incomes are not keeping up with the rising cost of living. The costs of things like health care, education, and housing stand out in particular as economic trouble spots for voters.”

  • 2/22/19: “To convince these voters that Trump’s economic policies have failed them, Democrats should focus on issues specific to these voters’ lives, like health care and the cost of living.”


  • 11/16/18: “Democrats defined the negative impacts of Republican policy well in 2018 – as a focus on health care propelled Democrats across the country.  As voters consider who they plan to support in 2020, health care remains top of mind as every group told us that health care was going to be the most important issue in their decision.”

  • 8/3/18: “One of the clear and important takeaways from this survey is that Democrats and progressive should be playing offense against Trump and Republicans on economic issues, including on the cost of health care.”

  • 7/31/18: “Cuts to health care are deeply upsetting in the Latino community. Latinos have the highest rates of lacking insurance and had the largest gains in access under Obamacare. 84 percent think the government should do more to increase health care access, including Medicare and Medicaid.”

  • 5/29/18: “Only 15 percent of voters say their own income is going up faster than the cost of living, while 77 percent say health care costs are increasing”

  • 3/22/18: “Note that tax breaks for pharmaceutical companies and health insurance companies appear to especially inflame voters, who are extremely concerned about rising health care costs today.”

  • 2/13/18: “Even while waging other important fights, Democrats must continue to focus on economic issues like taxes and health care and not allow themselves to be sidetracked and distracted by Trump’s latest tweets. This is important for both persuading and mobilizing voters in November.”


  • 11/17/17: “Any further attacks on the health care system injected into Republican tax reform proposals will exacerbate these vulnerabilities and further degrade voters’ confidence in President Trump and congressional Republicans.”

  • 9/18/17: “New research conducted on behalf of Priorities USA among key groups of persuadable voters and mobilization targets shows that there is a broad and growing identification of Donald Trump as someone who looks out first and foremost for the wealthy at a time when the economic situation for the middle class is seen as getting worse rather than better. Voters’ economic concerns are driven by worries about affording the cost of health care.”

  • 8/2/17: “On health care, Trump’s threats to withhold insurer payments should be cast as nothing less than sabotage of the insurance markets that would directly lead to premium hikes.”

  • 7/28/17: “The failed attempt by Senate Republicans to pass a bill repealing the Affordable Care Act does not mark the end of Republicans’ political problems on health care.”

  • 6/30/17: “Our survey tested 11 different criticisms that have been made about the Republican health care bill. All of these criticisms raised ‘big concerns’ among at least half of the voters we surveyed; all but two of the criticisms raised big concerns among at least 60 percent of voters.”

  • 6/26/17:  “Our research indicates that Obama-Trump voters are exactly the kind of voters most likely to be persuaded by Democratic messaging about the Republican health care bill. This suggests that health care remains the most effective wedge that could potentially bring these persuasion targets back into the Democratic fold.”

  • 5/26/17: “a key imperative for Democrats and progressive organizations is to bring even greater attention to the health care issue in the weeks and months to come.”

  • 5/16/17: “The bottom line: if you are a Republican, the key takeaway from this research is that you want voters to know as little as possible about the AHCA and to forget about it as soon as possible.  But for Democrats and other progressives, the survey highlights the importance of educating voters and making sure they always remember that their GOP representatives supported passing this bill.”

  • 4/28/17: “As Democrats continue to press their case against Trump and Republicans, they should emphasize health care most of all. It presents a rare opportunity in that it not only galvanizes core Democratic voters, but is also one of the likeliest issues to help win back voters lost to Trump.”

  • 4/24/17: “In particular, Democrats should highlight the economic ramifications and loss of coverage that would occur as a result of Trump and Republicans’ health care proposals, as Trump’s health care policies are particularly concerning to drop-off voters.”

  • 3/24/17: “Republican incumbents in these swing districts are held in reasonably good standing as of now—but support is soft, and information about the health care proposal has a dramatic impact on moving voters against reelecting Republicans.”

  • 3/10/17: “Progressives should continue to make economic arguments on health care – focusing on how the GOP bill will cost seniors more but include new tax breaks for millionaires and CEOs.”

  • 3/1/17: “On one issue after another—from jobs to tax reform to health care—Trump’s alignment with Speaker Paul Ryan and the House Republicans will enable Democrats to drive a wedge between Trump and voters we need to persuade and excite in order to win again.”

  • 2/13/17: “The Republican Party’s health care agenda – Medicare privatization, cutting Medicaid, and repealing Obamacare with no replacement – is also a key vulnerability among both turnout voters and soft Obama-Trump voters. These policy items are among the top concerns for both groups about the Trump-Republican agenda and a majority of Obama-Trump voters say cutting spending on Medicaid and Medicare would be ‘bad for people like them.'”