Democrats See Political Gain In Ohio’s Health Care Pain

STEUBENVILLE, Ohio — Democrats long shut out of power in Ohio see mounting voter anger over rising health costs and GOP-backed insurance cuts as their best opportunity in years, if not decades, to flip control of the state.

In the leadup to November’s midterms, emboldened by recent polling showing their candidates tied or leading in statewide races, they’re fanning out to small towns and rural enclaves that don’t typically vote blue to court the voters hardest hit.

More than 160,000 Ohioans have lost Affordable Care Act insurance since Republicans in Washington allowed Covid-era subsidies to expire — nearly a third of the Obamacare market and the biggest coverage dropoff of any state. Another 360,000 are poised to lose Medicaid next year due to cuts Congress passed last year. As Republicans either avoid discussing health care on the campaign trail or dismiss those losing insurance as fraudsters or undeserving of public assistance, Democrats are offering sympathy and pitching solutions.

“When Republicans pass legislation that spikes health care premiums and kicks a bunch of people off of the health care they need to survive, that's a kitchen table issue and it gives us a strong offensive argument,” said CJ Warnke, the spokesperson for House Majority Forward, a PAC aligned with Democratic leadership that plans to run millions in ads in the Dayton and Columbus suburbs to try to flip districts long held by Republicans.

Amy Acton, the state’s former health secretary who hopes to become the state’s first Democratic governor in 15 years, and Sherrod Brown, who is gunning to win back the Senate seat he lost in 2024, told POLITICO that at nearly every campaign stop, voters tell them stories of insurance denials, premiums that have doubled or tripled, monthly pharmacy bills totalling hundreds of dollars, and long drives for health services due to provider shortages and hospital closures.

That proved true at back-to-back events the two Democratic hopefuls held in August in a union hall in Steubenville, a struggling Rust Belt town on the eastern edge of Ohio that has voted overwhelmingly Republican in recent cycles.

During a round table with Acton, Mel Woods, the silver-haired financial secretary of the local chapter of the United Mineworkers of America, became emotional when describing his brother dying of Parkinson's last year after struggling to access and afford treatment, and praised the Democrat’s proposals for bargaining down drug prices and forgiving medical debt.

The previous day, Brown told a packed crowd of burly union carpenters and electricians and retirees that health care is the top issue he wants to work on if he beats Republican Jon Husted in November, and drew gasps from the audience when he described the strict work requirements and other looming changes to Medicaid that Husted and other Republicans approved last year.

In an interview, Brown argued Ohio’s health insurance losses and the effects he expects — hospital closures, infectious disease outbreaks and mountains of medical debt — are making his and other races more competitive.

“People know the system's rigged against them, and they are angry with what's happened with health care,” he said.

"When 500,000 lose their health insurance, what happens to the rest of the system? There’s all this uncompensated care, and then hospitals and doctors have more and more trouble, and everything goes in the wrong direction.”

It’s unusual for Democrats to lavish this much attention on places like Steubenville. But as the state, and others like it, are impacted by the health policies of the Trump administration and GOP-controlled Congress, Brown, Acton and other Democrats see an opening, and they’re reaching far outside the reliably blue strongholds of Cleveland and Columbus into the counties the party had seen slip away.

This summer, they’ve barnstormed places that voted for President Donald Trump in 2024, encouraged by signs that even Ohio voters who have long backed Republicans are receptive to their health care message.

Acton visited the last rural hospital in Darke County on the Indiana border, which is struggling to stay open amid federal funding cuts, held a rally with nurses in Delaware County north of Columbus to protest closure of the only hospital maternity ward in the area, and pitched voters in Allen County between Toledo and Dayton on her plans to use state insurance programs to bargain down drug prices and to buy up and forgive medical debt for pennies on the dollar. Brown, meanwhile, made recent stops in Stark and Tuscarawas counties south of Cleveland, where he pledged to restore Obamacare subsidies and Medicaid funding if given the chance to return to the Senate.

Democrats’ fresh hopes of victory in the bellwether state after years of losses is something Brown, Acton, their supporters, and neutral policy experts attribute in large part to voters’ health care woes.

“We've been a pretty consistently red state for the last 10 years, but these eye-popping statistics about the marketplace coverage loss, and the [spike in] premiums for people who still have coverage, there's just clearly dissatisfaction about that,” said Brian O'Rourke, an analyst at the nonpartisan Health Policy Institute of Ohio.

Republicans drill down on fraud

Beyond Ohio, Democrats from Alaska to Maine and everywhere in between are running on a health care message heading into the midterms and attacking their GOP opponents for backing policies that have eroded insurance coverage and raised out-of-pocket costs.

Their GOP opponents, including Husted and gubernatorial hopeful Vivek Ramaswamy in Ohio, are primarily campaigning on issues other than health care, such as immigration, crime, jobs, and the rising specter of socialism on the left. When they do touch on health care, they promise to crack down on fraud and waste in Medicaid and other programs, but oppose expanding eligibility for government assistance.

O'Rourke thinks that's a boon for the Democrats. Acton and Brown’s decision to run on reversing or mitigating the GOP health policies is proving “compelling right now for a lot of people who normally might not consider voting for them,” he said.

Republicans, meanwhile, contend their focus on health care fraud is both politically popular and morally just. Amy Natoce, a campaign spokesperson for Husted, told POLITICO the “One Big Beautiful Bill Act” the senator helped pass last year — which is predicted to kick millions off their insurance — will redirect government resources to the most needy.

“These commonsense reforms make sure Medicaid is strong and accessible to those the program is intended for: people living with disabilities, kids living in poverty and the elderly,” she said.

Husted has also touted his work in getting a $50 billion fund for rural health included in the GOP megabill, though each state is set to get just a few hundred million dollars per year for five years with tight restrictions on how it can be spent — far less than the Medicaid funding reductions triggered by other provisions in the legislation.

“It is quite a small percentage compared to the total losses that Ohio is going to see in the next few years,” O’Rourke noted.

The Ramaswamy campaign did not respond to questions from POLITICO about Acton’s attacks on his health care record — such as his remark in a 2024 interview that creating Medicare and Medicaid was a “mistake” — and his focus on health care fraud on the campaign trail today.

Ryan Stubenrauch, a GOP strategist based near Columbus who formerly worked for Republican Gov. Mike DeWine, said Husted and Ramaswamy are smart to focus on issues other than health.

When voters are asked “What’s the top issue for you and your family?” he said, “My hunch is that health care would be well outside of the top five, perhaps outside of the top 10. It's going to be jobs, the economy, inflation and maybe data centers.”

Health care pain in the state is real, he said, but it doesn’t “rise to the level” of making the electorate say, “We're going to sweep the Republicans out of power that they've held for two decades based on this.”

‘Number one was health care’

However, in a June AARP poll of Ohioans 50 and older, respondents ranked health care as one of their top affordability concerns, second only to groceries. When it came to influencing their midterms vote, 84 percent said the overall cost of health care was their single most important issue, while 68 percent said prescription drug costs were most important.

An August survey by the nonprofit think tank the Altarum Institute found that more than a third of Ohioans have “experienced financial burdens due to medical bills,” including using up their savings, going without basic necessities, taking out a second mortgage or going into credit card debt — including those with insurance. Supermajorities of those polled, both Republicans and Democrats, said they wanted government action to lower drug prices and make it easier to enroll in and renew Medicaid.

Acton, a pediatrician by training who led the state’s health department through the Covid-19 pandemic, told POLITICO that while she always expected voters to care about health care, their intense fixation on the issue surprised her, and she’s seeing it drive support for her campaign from Republicans and Independents as well as Democrats.

Acton recalled a roundtable she held with women farmers “on both sides of the aisle” in Shelby County, a conservative rural area north of Dayton.

“I expected to hear a lot about their fear of tariffs, and a lot about the business of agribusiness, as their number one issues. But number one was health care,” she said. “It was [stories of] someone having to work a second job off the farm to have health insurance, mental health issues on the farm and rural hospitals collapsing.”

Former Dayton Mayor Nan Whaley, a Democrat who unsuccessfully ran for governor in 2022, said the combination of the state’s health care struggles and total GOP control of the state and federal government makes November a lot more favorable for Acton, Brown and other Democratic candidates than it was during her own race — when Biden, who was deeply unpopular among Ohioans, was in office.

“There's a deep frustration with whoever's in charge,” she told POLITICO. “And if you're in Ohio, Republicans absolutely control every part of your life, and that just makes it a little hard to blame Democrats for problems with health care or anything else. They can't really say it's anybody else's fault. They own it all.”

The nurse and the ‘Medicaid kid’

With Democrats bullish on statewide races, Ohio voters’ focus on health care has also given the party the confidence to go after House seats in redder parts of Ohio that they had once given up on winning.

House Majority Forward has reserved nearly $5 million in airtime to run ads in the state’s 10th and 15th congressional districts, which cover the suburbs of Dayton and Columbus. It’s the group’s first push in those districts in several cycles.

Both seats have been held by Republicans for more than a decade, but the Cook Political Report recently updated their predictions for both races in Democrats’ favor as the challengers run hard on health. Don Leonard, the Democrat running to represent suburban Columbus, describes himself as a “Medicaid Kid” and lists “fighting for universal health care” as a top priority. Kristina Knickerbocker, who is seeking the Dayton seat, is a nurse practitioner who stresses in her press releases and stump speeches that she “has seen the failings of the health care system firsthand.”

Whaley noted that she couldn’t remember Democrats ever making a serious bid to oust Turner during his decade-plus in office, and said the ad buys are a sign of the ground shifting, regardless of the outcome.

“There has been an awakening,” she said. “People are seeing how these elections are having consequences about the health care they have access to.”

Ohio-based and national progressive advocacy groups have mounted their own health care-focused campaigns to flip these same seats — now held by GOP Reps. Mike Turner and Mike Carey.

A few days after Acton and Brown’s events in Steubenville, during a brief break in the thunderstorms that had hammered the state all week, a few dozen local parents, faith leaders and other community members gathered outside Turner’s office in downtown Dayton.

Flanked by activists holding signs reading, “Rep. Turner, fund care, not cruelty,” speakers shared stories of rising premiums, lost Medicaid coverage and costly hospital bills — and said they held Turner directly responsible due to his vote for the 2025 GOP megabill.

“You can be voted out. We are tired of you stopping the very things that keep us going,” Rev. Dr. Aileen Maddox, the pastor of Dayton’s St. Paul AME Zion Church and a member of the social justice nonprofit Ohio Organizing Campaign.

Turner, who did not interact with the protesters, told POLITICO he will “continue to fight to lower health care costs and improve the quality of care for all Americans,” and accused Knickerbocker and her supporters of “pushing a socialist government takeover of health care.”

Just down the road from the Steubenville union hall where Acton and Brown held their events, the staff of the Ohio Valley Health Center is bracing for things to get worse.

The free clinic, which subsists on grants and donations and is staffed by volunteer doctors and nurses, already struggles to serve its roughly 800 patients — with wait times for follow-up appointments often stretching for months.

Alisa DelGuzzo, the clinic’s executive director, sees firsthand how a lack of insurance coverage leads to patients skipping preventive care to manage chronic problems, like diabetes and hypertension, until they become more expensive emergencies.

She expects demand for services to increase significantly after Medicaid cuts and work requirements backed by the Trump administration and GOP congressional majority take effect in January, causing hundreds of thousands more Ohioans to become uninsured. With no state or federal funding on the horizon, she is scrambling to recruit enough doctors, nurses, medical residents and pre-med students to serve them.

“We know the need is going to continue to increase, and how do we meet that demand?” DelGuzzo said. “We need more practitioners, more staff, more grants. But how many grants are out there? There's only so many, so much that can go around.”