Some analysts say the coming midterm election is a referendum on President Donald Trump. But judging from the political television ads this season the election is also about healthcare. The Wesleyan Media Project said it this way: “It’s official: the 2018 midterms are about healthcare. In the period between September 18 and October 15, nearly half (45.9%) of airings in federal races mentioned the topic while nearly a third (30.2%) of gubernatorial airings did the same. Although both parties are mentioning healthcare, the topic is most prominent in ads supporting Democrats, appearing in 54.5% of pro-Democratic airings."

In the race for a U.S. Senate seat in New York, Democratic incumbent Kirsten Gillibrand has taken the most progressive stance on healthcare. She is supporting the Medicare for All (M4A) legislation proposed by Sen. Bernie Sanders. A statement on her website says, “It’s simple: Healthcare should be a basic human right, not a privilege for the few.”

Republican business woman Chele Farley is running against Gillibrand. Farley’s website does not list healthcare as one of the top six issues she is concerned with, but she has attacked Gillibrand’s support of M4A, citing an analysis by the Mercatus Center at George Mason University, which says that it will cost U.S. taxpayers $32 trillion over the first 10 years of full implementation. Sanders has said that same analysis shows that it would save taxpayers $2 trillion. There is considerable debate on the issue, still Gillibrand is running about 15 points ahead of Farley.

In the Senate race in Pennsylvania, Democratic Senator Bob Casey ran a television ad about a constituent and her twin daughters, both of whom had cancer. The ad warned that Casey’s opponent, Republican Congressman Lou Barletta, would do away with protections for pre-existing conditions, putting the twins at risk.

Barletta cried foul because he has a grandson who is a twin who has cancer, and that he would never deny him healthcare. Casey said the parallels were unintentional and he pulled the ad in Northeast PA.

Barletta said he is in favor of protections for pre-existing conditions, but he did vote in favor of killing the Affordable Care Act (ACA) and replacing it with the American Healthcare Act, (AHCA) which the Congressional Budget Office estimated would have force 23 million Americans off healthcare over 10 years. AHCA would not have ended protections for pre-existing conditions, but it would have allowed states to end other protections established by ACA.

In recent polls, Casey is running about 15 points ahead of Barletta.

In the race for the New York District 19, Congressional seat incumbent Republican John Faso has tried to paint his opponent, Democrat Antonio Delgado, as pushing for a “total government takeover” of the healthcare system with a M4A goal. But Delgado says his position is substantially different. A post on his website says, “My goal is to get us to universal coverage as fast as possible, and the best way to do that is by creating a public option, giving everyone the choice to opt into Medicare.”

Faso says on his website he is “opposed to schemes such as ‘Medicare for All,’ single-payer healthcare which would cost over $32 trillion and result in the highest tax increase in history.” He also says, he “has voted to protect individuals with pre-existing conditions from ever being denied healthcare coverage.” But he also voted twice in favor of AHCA, which would have kicked thousands of people in his district off their health insurance.

A poll by AARP put Delgado ahead in the race by a margin of 43% to 36%, but a more recent one by Sienna Research had Faso at 44% and Delgado at 43%.

In the race for the newly-drawn PA Eighth Congressional District, Republican candidate John Chrin is still opposed to the ACA. A post on his website says, “Obamacare is not working. It has failed in providing affordable, quality coverage and is driving up rates for everyone.” John Chrin supports a healthcare system that puts patients first, allows small businesses to pool together to purchase plans, allows for the purchase of health insurance across state lines, and encourages competition. He adds, however, that he supports coverage for people with pre-existing conditions.

A post by Democrat Matt Cartwright says, “Matt would have supported President Obama’s Patient Protection and Affordable Care Act of 2010. He remains dissatisfied, however, that it did not go far enough to expand healthcare coverage for more Americans and hold insurance companies more accountable for what they charge families.” A New York Times poll has Cartwright ahead by a margin of 53% to 39%.

Many Republicans voted in favor of repealing ACA and replacing it with a plan that would have been worse for millions of Americans; in the same year, they voted in favor of a tax break that gave huge gains to the wealthiest residents. We’ll soon see if voters will hold them accountable.