Health care falls just below political corruption as the top campaign issue for Americans, according to a recent poll by the Kaiser Family Foundation.
This is certainly the case among some in California's 45th district congressional race, where Republican incumbent Mimi Walters -- who has not made health care a central issue -- is being challenged by Democrat Katie Porter -- who is campaigning hard on the issues of protecting the Affordable Care Act and supporting Medicare for All.
"For Democrats, health care has consistently been at the top of their issue rankings," said Alexandra Cole Macias, a political scientist who volunteers with the nonpartisan group California's 45th. "But for registered Republicans, it's been issues of immigration, it's been issues with respect to taxes."
The district lies in the heart of Orange County; 37 percent of registered voters there are Republican, 30 percent are Democrats. The number of registered voters not affiliated with a party has been growing; it's now at 28 percent.
On a hot late summer day in Tustin recently, about 300 Democrats cheered in a sweaty warehouse to rally for Porter and Democratic candidate for governor Gavin Newsom. Volunteers pressed together chanting "Katie, Katie" while hoping to catch a glimpse of their candidate, who they hope will help flip the House of Representatives to Democratic control.
"Orange County is turning blue!" yelled a young volunteer into a mic. The crowd hollered back.
Porter is campaigning hard on health care. When she took the stage, she didn't take long to hit Walters on the issue, especially her vote to repeal the Affordable Care Act.
"Mimi Walters is selling out our democracy to the highest bidder, passing Trump's tax plan and trying to rip away health care from millions of Americans with preexisting conditions," said Porter.
The crowd booed.
Porter isn't alone. Democratic hopefuls across the country are highlighting the May 2017 House GOP vote to repeal the Affordable Care Act. (You remember the bill that was narrowly defeated in the U.S. Senate when the late John McCain gave it a dramatic thumbs down.)
Porter said she wants to build on the reforms of the Affordable Care Act by expanding access to mental health care and increasing investments in health research, among other steps.
In an interview, Porter said she wants to repeal the law that prohibits Medicare from negotiating drug prices. And she expressed support for the idea of Medicare for All.
"The reality is that the Medicare system delivers -- in the American system -- the highest quality care at the best price point. And so, it's a really good example we should be looking to as we think about how to solve the health care challenges that we're facing," she said.
While working on this story, I contacted the Walters campaign several times seeking an interview with the candidate. When I didn't get a response, I reached out to the Orange County Republican Party, the California Republican Party and the National Republican Congressional Committee. The state party said it would pass my request on to the Walters campaign, but I never heard back.
Walters' campaign website is largely silent on health care. Her congressional website does point to her support for legislation to prevent and treat opioid addiction. It also talks about her support of a bill that backers say would protect people with preexisting conditions if Obamacare is repealed.
Walters does post about health care on social media.
"Individuals with preexisting conditions should not be denied health insurance coverage or charged more regardless of their health status," she said in a video posted on Twitter and Facebook. "Individuals with preexisting conditions must also have access to continuous coverage."
The nonpartisan Kaiser Family Foundation said the bill Walters backs would require insurers to take people with preexisting conditions, but it includes a loophole that would allow insurers to exclude coverage for the treatment of those conditions.
At a forum for candidates running for Irvine City Council, I met one Republican who plans to support Walters, in part because she voted to repeal Obamacare.
"I don't think the Affordable Care Act solved the problems," said Michelle Bolden of Irvine.
Bolden is not a fan of Porter's. She doesn't like ideas such as Medicare for All -- which critics say would be prohibitively expensive.
"I think a lot of the issues are getting too progressive and I'm not comfortable with that," said Bolden.
As for Walters, her Twitter feed focuses mostly on the strong economy and her support for the GOP tax bill. She also attacks Porter in campaign ads as a dangerous "extreme" leftist and a friend of "radical" Massachusetts Senator Elizabeth Warren.
In the end, the race may not hinge on Republicans or Democrats. With independents now comprising nearly 30 percent of the 45th District's registered voters, they may be the ones to decide whether Mimi Walters or Katie Porter will represent the area in Congress.
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