A Kaiser Family Foundation tracking poll from last month illustrates a very basic problem for Republicans now that Donald Trump has decided to burn the Affordable Care Act down: It's still far more popular with voters than it is unpopular—50 percent favorable to 39 percent unfavorable.
But more than that, the ACA is now part of the fabric of health care for millions of Americans—the 25 million who have insurance because of it, and everyone else who enjoys the protections it provides. That has certainly increased its popularity, as has the unrelenting threat to it from Republicans.
Republicans are now facing that reality, forced to by Trump's newly invigorated campaign against the law. "Quite obviously, more people have health insurance than would otherwise have it, so you got to look at it as positive," said Sen. Chuck Grassley. The Iowa Republican is chairman of the Senate Finance Committee, one of the key congressional committees with jurisdiction on health care. He's less than enthusiastic about the prospect of having to come up with a replacement bill, as Trump has promised.
There are even two Republican state attorneys general, Dave Yost in Ohio and Tim Fox in Montana, who have submitted briefs to the federal court arguing for the ACA to be upheld. "The court’s decision, if affirmed, will deprive millions of non-elderly Ohioans and Montanans of coverage for preexisting conditions," they wrote. "It will also negatively affect countless others who organized their affairs in reliance on the Act's many unrelated provisions."
There's no way 2020 isn't as much of a vote on health care as 2018 was; Trump has guaranteed that with his sabotage. He and his fellow Republicans aren't going to be able to fearmonger against Democrats on "socialism" while tens of millions of people face losing the security the ACA has given them.