In the wake of President Donald Trump’s victory last November, Democrats like Kyle Horton thought there was no hope for saving the Affordable Care Act. “I would have said it was lunacy right after the election,” the North Carolina physician told me on Friday, “and now look where we are.” The defeat of the Senate’s repeal bill early that morning, she enthused, “shows that our resistance and our engaging people on a grassroots level to tell their personal stories is really working.”



But now, with outright repeal off the table indefinitely, Democrats face a new set of challenges in talking about health care. Should they focus their messaging on Trump’s plan to sabotage the ACA administratively, or on working with Republicans to solve the real problems facing Obamacare? And is now the right or wrong time to sell Americans on moving to a single-payer system (a.k.a. “Medicare for all”)?



These are particularly pressing questions for someone like Horton, who’s running for Congress next year in her state’s Seventh Congressional District. She acknowledged the risk that, after last week’s victory, Democrats could let their guard down against enduring threats to Obamacare.

“There may be more complacency,” Horton said. “In particular, I am thinking about the big pharma and insurance lobbyists and how much power they have right now in Washington. They could easily gut certain aspects [of the Affordable Care Act] as they’re pushing to ensure they’re not paying their fair share or to protect their corporate tax inversion schemes.” That’s why Horton says her party needs to “redouble our efforts to ensure that we’re educating people.... Probably not change our message, but ensure that the message never goes away between now and 2018, even if [Republicans] move on to tax reform and other issues.”

Democrats of various stripes are already working toward that end. The group Save My Care launched a national “Drive For Our Lives” bus tour on Saturday to rally support for the ACA. Indivisible Iowa flew a banner around Cedar Rapids warning Republican Representative Rod Blum, “WE ARE #HEALTHCAREVOTERS!” And Sabrina Singh, deputy communications director at the Democratic National Committee, assured me “the issue of health care isn’t going away despite the fail of the repeal vote.” “We’re still going to talk about health care,” she said, noting that Republicans “could certainly try again this year or early next year, so it’s going to be hard for voters to get complacent about the issue.”