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Midterm Elections

Exclusive: Democrats flood airwaves with health care ads, while GOP spots tout Trump in 2018 midterms

President Donald Trump looms large in Republican ads ahead of the midterm elections.

Corrections and clarifications: An earlier version incorrectly stated the number of ads aired from January to July by Democratic candidates and outside groups. The figure should be nearly 56,000.

WASHINGTON – Senate Democratic candidates and allied outside groups have devoted more than 40 percent of their TV ads this year to health care – spending a combined $17 million on spots pledging to protect people with pre-existing conditions, fight for lower drug prices and guard against cuts to Medicare.

The sharp focus on health care from Democrats stands in contrast to a more diffuse message on the GOP side. In hotly contested races across the country, Republicans and the GOP-leaning groups have divided their ad dollars on a broader set of issues – spending about $10.5 million on spots embracing President Donald Trump, $14 million on ads touting the GOP tax law and $7.6 million on commercials highlighting a hard line on immigration.

The divergent ad strategies – based on a USA TODAY analysis of data from Kantar Media – offers a snapshot of Senate races as the primary season draws to a close and candidates pivot toward the general election only three months away.

From January through July, Democratic candidates and outside groups aired nearly 56,000 ads focused on health care, far and away the most common issue highlighted. The second-place star in Democratic spots was jobs and unemployment, featured in about 30,000 spots.

Prep for the polls: See who is running for president and compare where they stand on key issues in our Voter Guide

Republicans spent most of their paid TV time talking about Trump, if only by a sliver. GOP candidates and allied outside groups have aired 45,000 pro-Trump ads this year.

The GOP’s signature legislative achievement  – the sweeping tax cut – drew slightly fewer spots, at 43,000. More than half of those tax cut ads were paid for by Republican-leaning groups, as opposed to the candidates themselves.

Immigration and the roaring economy were essentially tied for third place among GOP spots, with 34,000 and 32,000 ads, respectively.

The figures highlight one advantage Senate Democrats have in an otherwise difficult election cycle. Ten incumbent Senate Democrats are up for re-election in states that Trump won in 2016, which gives Republicans a huge playing field for possible pickups.

But those Democratic incumbents have faced only nominal primary opponents, while Republican challengers in Indiana, Montana and elsewhere have spent months in bitter GOP nominating battles.

“Democrats haven’t had competitive primaries, so they’ve been focused on general-election messaging most of the cycle,” said Jennifer Duffy, who analyzes Senate races for the nonpartisan Cook Political Report. “Republicans have only been in general-election mode for about a month." 

Health care has surged as a top voter concern, and it could  be as important a factor in the midterm elections as Trump, said Drew Altman, head of the Henry J. Kaiser Family Foundation.

“I’ve always been cautious about hyping health care as a factor in elections,” Altman wrote for the website Axios. “But if circumstances do not change, this is an election where health care may not only be a top issue, but also a critical factor in the vote.”

Health care ranks as a higher priority for Democrats this year than it did for Republicans when they crusaded against the Affordable Care Act in 2010 and 2014. The issue is closely tied to Trump because of Republican efforts to undo the law either through legislation or executive action.

“I support the Affordable Care Act and voted against all of President Trump’s attempts to repeal it,” Sen. Dianne Feinstein, D-Calif., whose campaign has spent the most money on ads that mentions health care, boasts in an ad.

Sen. Dianne Feinstein, D-Calif., is running ads defending health care legislation.

Rep. Jacky Rosen, D-Nev., who is trying to unseat Republican Sen. Dean Heller, is hitting him hard for voting to repeal Obamacare.

“He decided not to cross Trump,” one ad says.

Even in states that Trump won easily, Democrats focus on health care. An ad by Montana Sen. Jon Tester features a cancer patient accusing Tester’s GOP challenger, Matt Rosendale, of making health insurance less affordable in his role as the state’s insurance commissioner.

Voters listed pre-existing conditions as their top health care campaign issue in a Kaiser Family Foundation poll in June. Most Democratic and independent voters – as well as about half of Republicans voters – say a candidate’s position on preserving protections for people with pre-existing conditions is either the “single most important factor” or a “very important” factor in their vote. It’s the top campaign issue for voters living in battleground areas such as Florida, according to the survey.

The Democrats’ focus on health care “shows how the Republicans really blew it in 2017 by making health care their No. 1 legislative priority,” then failing to pass legislation to repeal and replace Obamacare, said Steven Smith, a political science professor at Washington University.

“The news from the Trump administration, with its cutting around on the edges of Obamacare through administrative action, has kept the issue alive and hasn’t done Republican candidates any favors,” he said.

On the GOP side, the high volume of pro-Trump ads are striking because in midterm elections, candidates often try to run away from their party’s president. The Kantar data, as well as an analysis by the Wesleyan Media Project, found GOP candidates are doing the opposite: praising Trump at record rates.

“The president’s party tends to lose seats in midterm elections, and so typically candidates from the party tend to avoid tying themselves to the incumbent while opponent partisans typically go on the attack,” said Michael Franz, co-director of the Wesleyan Media Project. “It is really striking that Republicans are overwhelmingly embracing Trump and very rarely criticizing him.”

Democratic candidates and left-leaning outside groups have aired about 8,100 anti-Trump spots. 

Tennessee senate candidate Phil Bredesen, a moderate, is walking a fine line regarding opposing President Donald Trump.

Democrats are navigating a difficult electoral map. In the 10 states where Trump won and Senate Democrats are up for-election, the president remains relatively popular, and Democrats cannot afford to alienate any potential crossover voters.

Some of these “red state” Democrats even mention Trump positively, such as Heidi Heitkamp in North Dakota and Joe Manchin in West Virginia.

“Look, I’m not running against Donald Trump,” Tennessee Democrat Phil Bredesen says in a TV spot his campaign launched in March. He promised in that spot to work with Trump on issues where they're in sync, though more recently he highlighted his opposition to Trump's tariffs. 

Bredesen is a moderate and a popular former governor, running in a state Trump carried by 26 percentage points. It's no wonder he's circumspect in his criticism, said Smith, the Washington University professor.

"I think it’s a question of treading carefully, picking your spots, criticizing the president where a policy is really unpopular in your constituency,” Smith said.

Contributing: Fredreka Schouten

More:Exclusive: Secret money funds more than 40 percent of outside congressional ads

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