John McCain is running for reelection like it’s 2010.

The Arizona Republican has made his opposition to Obamacare — which dominated Senate races across the country six years ago — a central point of his campaign, by all accounts, the toughest reelection fight of his career.


He’s betting that shrinking coverage options and premium increases that could go as high as 65 percent if insurers get their way will resonate with Arizona voters, even as most of his Republican colleagues running this year have moved on to other issues.

The issue helps him run to the right of his GOP primary opponent, while also taking a direct shot at his Democratic opponent, Rep. Ann Kirkpatrick, who called her 2010 vote for the law the one she’s “most proud about.”

“I think it’s a very strong issue,” McCain told POLITICO about his focus on Obamacare. “Eight of the counties in my state will now only have one [health insurer]. They’re staring at 65 percent increases in their premiums. They’re very upset.”

That’s a different strategy than the one McCain’s colleagues are employing. GOP Sens. Kelly Ayotte, Rob Portman, Pat Toomey and Ron Johnson all won their seats in 2010 by promising to oppose President Barack Obama’s recently passed health care law, but they’ve hardly mentioned it in their reelection campaigns this year. Instead, their TV spots have focused on national security, the economy and the opioid epidemic.

None of them, however, face a serious primary opponent and only Johnson is running against a Democrat who was in Congress in 2010.

Brad Todd, a veteran Republican media consultant, sees the lack of Obamacare-focused ads as a missed opportunity. “I think it has been completely overlooked this cycle by too many campaigns,” he said. “It is less popular today than it ever was.”

He’s betting campaigns will start messaging on it eventually. “I really think you’ll end up seeing it in every race,” Todd added.

Putting the president’s law front and center is a double-edged sword, though. This year marks the first presidential cycle in which most of the law’s benefits — insurance coverage that started in 2014 — have been in effect. There are millions of consumers who have gotten life-saving insurance coverage and worry about losing it under a GOP repeal plan.

But there’s been no shortage of news stories about rising premiums and consumers who didn’t realize how much they’d have to pay for ACA plans. And polls show that the law has not gotten more popular, as Democrats predicted it would once coverage rolled out.

Six years ago, many of the most vulnerable Republicans in this cycle rode into office by bashing the recently approved health care law. And it worked — Republicans increased their numbers in the Senate and flipped control of the House. Kirkpatrick was one of the House Democrats who lost her seat in the Republican wave.

This cycle, McCain’s Republican colleagues are focusing instead on the economy, or the worsening heroin and opioid addiction crises gripping their states. New Hampshire, Ohio and Pennsylvania have been hit particularly hard by the epidemic.

Portman of Ohio, for instance, has run four separate spots touting his efforts to fight heroin and opioid addiction in the state, including an emotional 60-second promotion. “He gives as much time and energy and love to this as any of us parents who have lost,” one Ohio parent, Tonda DaRe, says in the ad.

McCain, however, may have more reason to focus on Obamacare than his Republican colleagues.

In Arizona, two insurance companies — UnitedHealth and Humana — plan to leave the state’s Obamacare exchange next year. Blue Cross Blue Shield, which will be the only option for customers in eight counties, has asked state regulators to approve an average rate hike of 65 percent. Most other insurers on the exchange have asked for double-digit rate increases, too. Late last year, the state’s co-op insurance plan went belly up, sending 60,000 customers looking for new coverage.

“Obamacare is failing Arizonans,” the narrator says in McCain’s first TV ad, which started airing last month. “First, a massive rate hike — more than twice the national average. Then America’s largest health insurer abandoned Arizona’s failing Obamacare exchange.”

“Congresswoman Kirkpatrick bragged about her Obamacare vote,” the narrator continues, as the clip plays of Kirkpatrick calling the vote the one she’s “most proud about.”

The bad Obamacare headlines aren’t unique to Arizona, but McCain has been most aggressive about using them.

“The McCain folks have tapped into a serious concern in the marketplace. They’ve got real numbers — it’s not theoretical," said Tom Miller, a health policy expert at the American Enterprise Institute. "He’s got a very tough race, a changing electorate, he has to deal with the Trump stuff — this allows him to say something a little more aggressive and be on the attack.”

McCain has also taken other steps to shore up his anti-Obamacare bona fides. In recent months, he’s given several Senate floor speeches against it and issued statements responding to every piece of bad news on the law. He’s also tried to blunt likely attacks from Kirkpatrick supporters that Arizonians would lose their coverage if the law were repealed by introducing a bill to replace the Affordable Care Act.

Kirkpatrick’s campaign says it isn’t worried about McCain’s Obamacare offensive. While Kirkpatrick lost her seat in 2010 after voting for the ACA, she regained it in 2012 and held onto it in 2014 — a year when many other Democrats in swing districts were swept away.

“Outside groups and national Republicans have spent millions and millions against Ann" over the years attacking her over her vote for Obamacare, D.B. Mitchell, a Kirkpatrick spokesman, wrote in an email. “But Ann's continued to win a Republican district despite these attacks.”

While the ads call out Kirkpatrick, they’re also an effective attack against former state Sen. Kelli Ward, an osteopath who’s challenging McCain from the right in the primary.

In an interview, Ward said she commends McCain for attacking Kirkpatrick on the law — but she doesn’t think he’s the most reliable messenger.

“It is a little disingenuous on Sen. McCain’s part,” Ward said. “He called the very senators who want to stop it —Sen. Paul, Sen. Cruz and Sen. Lee — ‘wacko birds.’”

McCain used the phrase for Paul, Cruz and Rep. Justin Amash of Michigan in 2013 after Paul filibustered in an attempt to block confirmation of John Brennan as CIA director. Paul, Cruz and Lee later led a failed effort to defund Obamacare that caused a partial government shutdown.



