The image above was tweeted out by the Democratic Party of Arkansas, with this message: “Over 155,000 of Arkansans now have private health insurance. Tom Cotton wants to take it away from them.” Notice also the focus on women, a group that Democrats will try very hard to motivate to turn out against Cotton.  

As we’ve been pointing out for some time (and as Republicans may be starting to realize), while Obamacare remains unpopular, the politics of health care are more complicated than “Obamacare bad” and there are risks to an all-Obamacare-all-the-time strategy. Americans are tired of hearing about it and repeal is even more unpopular than the law itself. Meanwhile, Medicaid expansion in particular is broadly popular even though “Obamacare” is not. Across the country, Democrats in statewide races are taking a look at whether Medicaid expansion could be a political winner for them (both in expansion states and states that refused) and many Republican candidates are dodging the expansion issue even as they slam Obamacare (Greg Sargent at the Washington Post has been cataloging this for weeks; some examples here and here and here and here and here and here). 

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In Arkansas, things are especially complicated given the private option, the state’s unique plan to use Medicaid funds to purchase private health insurance for low-income Arkansans. The policy was enacted by a bipartisan supermajority and has support among moderates and independents — and more than 155,000 Arkansans (and counting) have gained coverage under the private option. But Cotton’s Tea Party base hates it. So Cotton does everything he can to dodge the issue and avoid taking a position. But even if he keeps saying that the private option is a “state-based issue,” the fact remains that the core of Cotton’s campaign is repealing the Affordable Care Act. And the private option is funded by…the Affordable Care Act. No Obamacare, no private option. Cotton says he would replace Obamacare with something something something, but he has offered nothing in the way of concrete details on a plan to cover the folks that would lose their health insurance without the private option. If Cotton gets his way and repeals Obamacare, more than 150,000 Arkansans would lose their coverage (not to mention 45,000 more on the Marketplace). 

This is what Democrats are going to hit Cotton on, as seen in the flyer above. Obamacare remains a net negative for Democrats, but Cotton’s position means ending the coverage that around 200,000 Arkansans have gained under the law. It means ending the private option, which is significantly more popular than “Obamacare” (you see the same thing in Kentucky, where lots of folks still hate Obamacare but love Kynect). Sen. Mark Pryor himself will mostly avoid talking about Obamacare, but he’s on much stronger ground defending the private option. 

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And note the focus on the recently released private option demographics showing that 61 percent of beneficiaries are women. Democrats have struggled in recent years to get their core constituents to the polls in non-presidential election cycles. They need issues to get Democratic women in the party’s base motivated, and this could be one. It will tie in with attacks on Cotton on his votes against the Violence Against Women Act and the Lily Ledbetter Fair Pay Act, as well as his opposition to a state minimum wage hike (the issue polls well with more or less everyone, but particularly single women). And while Pryor himself probably doesn’t want to touch this, Cotton’s sponsorship of a “Personhood” bill which would ban some forms of contraception is another issue that Pryor’s surrogates may highlight. 

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