Medical Debt Relief Won Big in Arizona- and Should Have Been Part of National Dem Messaging
Beyond Abortion, Dems Needed More Local Issues to Define the National Election- and Medical Debt Relief Could Have Been One
Abortion was no doubt a key issue that helped drive Dem turnout and helped ensure any red wave was no more than a “red ripple” as pundits are calling it.
But the GOP demonstrated once again that they can still take a largely local issue like crime (completely hyped and distorted of course) and turn it into a part of their national messaging, which helped drive many of the wins they did have.
Where were the defining local Democratic issues last night?
Amidst close races, including relatively close votes on abortion in Michigan and Kentucky, you had a vote in Arizona, Prop 209, on protecting people against medical debt collectors, which is currently winning by a massive margin of 72% to 28% when vote counting stopped last night.
Medical debt is not a marginal issue. 35% of the public report having medical debt and one out of five Americans have active medical debt collection targeting them. There is $88 billion in outstanding medical debt, with Black, Hispanic, young, and low-income individuals facing a disproportionate share of that burden. 58% of all debt collection actions are about medical debt.
What Arizona’s initiative does is largely make that debt uncollectible against most Arizona residents. Under Prop 209, up to $400,000 in home equity can’t be touched for medical debts, up to $15,000 in automobile equity can’t be touched, and almost none of the wages of workers making up to $50,000 per year could be garnished for debt collection. It also limits the interest rate on medical debt to 3% per year so the debt can’t spiral out of control over time.
As the vote total shows, popular support for the measure was wildly high, much to the chagrin of the Arizona business community, which publicly opposed the initiative but didn’t even bother spending against the measure since its passage looked nearly inevitable.
The question is why similar initiatives weren’t being run all over the country, why Democratic-controlled legislatures weren’t holding votes on similar bills and why wasn’t the US Congress voting on national legislation mirroring the vote?
Whether it’s crime, “critical race theory”, attacks on transgender youth, or immigration, the Republicans are masters of developing themes and using every venue they control to push votes to nationalize their message. Even when Democrats have a popular issue like erasing medical debt, they rarely seem to replicate it on a scale to turn a popular local issue into a defining part of the national debate.
It’s not just that medical debt relief is popular on its own. It also reinforces broader Democratic messaging on the need for more healthcare reforms to lower the costs for families that drive medical debt in the first place. Restricting interest rates on medical debt would have reinforced Democratic messaging on the problems with the Federal Reserve pushing up interest rates to “solve” the inflation problem.
And while student loan debt relief is very popular with many in the Democratic base, particularly young voters (where it no doubt contributed to their turnout last night), it’s not that popular with the broader public (less than 50% support the policy according to YouGov polling). But medical debt relief is wildly popular in national polls, so linking it to student debt relief would build a much more demographically diverse coalition in a more general debate about easing debt burdens on families.
The point is not that medical debt relief is a silver bullet for winning every election. It’s more symbolic of the failure of Democrats to as effectively leverage local issues for national messaging as the Republicans routinely do.
If a progressive issue can get over 70% of the vote in Arizona, the fact that it wasn’t on the ballot everywhere it could be -and being debated in every legislative chamber this year - is a big progressive failure.
In 2024, Dems need to figure out how to better coordinate not just political ads, but legislative fights on the ground to drive national messaging on the issues that can help win elections across the country.