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Democrats have had limited political success running on the Affordable Care Act, even with its relative popularity. Now President Trump’s health care cuts may have given the issue new resonance.
March 23, 2026, 5:00 a.m. ET
Tom Perriello, a Virginia Democrat who was swept from the House in 2010, in large part because of his vote for the Affordable Care Act, is trying for a comeback this year — but far from running away from that vote more than a dozen years ago, he’s embracing it.
“What’s aged politically even better than my support for the A.C.A.,” Mr. Perriello said, “was the fact that I was pushing right to the end for it to be stronger.”
“When I got kicked out of office,” he added, “I kept fighting for things like Medicaid expansion in Virginia.”
A Democrat embracing this issue might not seem like a novel concept; the party has been more trusted on health care for a while now, though the public hasn’t often seen it as a top issue. But in 2026, Democrats like Mr. Perriello have a new script on health care that could prove more potent. It’s affordability, not access.
And polls show that when voters say that affordability is their biggest concern, for many, they’re talking about health care.
“Health care costs are out of control,” said Shawn Spencer, 48, of Greene County, Va. “I don’t have insurance, so I’m paying a boatload when I need care.”
