While many Republican strategists and conservative pundits struggled to make sense of how a Democrat could have been so successful in Pennsylvania’s 18th district on Tuesday, voters sent a clear message: Health care is a priority.

Election night exit polling by Public Policy Polling found that among PA-18 voters who said health care was the most important issue, Democrat Conor Lamb beat Republican Rick Saccone by a margin of 64 to 36. Saccone’s support of the Republican health care agenda — namely, efforts to repeal the Affordable Care Act (ACA) — made 41 percent of voters less likely to vote for him. Fifty-three percent of voters disapproved of GOP efforts to repeal the health care law and 48 percent believed Republicans are trying to sabotage the law since they failed to repeal it.

These numbers are all the more surprising given the fact that PA-18 is a Republican district that gave Donald Trump a 20-point victory over Hillary Clinton in 2016.

But as Forbes’ Bruce Japsen previously reported, health care is especially important in Western Pennsylvania. Although health care premiums have risen (a rise which officials in Pennsylvania attribute to Trump’s “refusal to make cost-sharing reduction payments for 2018”), the University of Pittsburgh Medical Center (UPMC) — the region’s largest non-governmental employer — has grown substantially under the ACA.

Pennsylvanians — namely, those living in rural areas — have also benefited from the state’s Medicaid expansion under the ACA, which went into effect in 2015 and has been touted by health experts as means of addressing the state’s opioid crisis. Pennsylvania Gov. Tom Wolf (D) declared the epidemic a statewide disaster emergency earlier this year.


While Lamb has acknowledged that Obamacare has its flaws, he ran his campaign on fixing and building upon the law, rather than repealing it. If Medicaid expansion were repealed, approximately 585,000 Pennsylvanians would lose health coverage.

Gov. Wolf attributed Lamb’s apparent victory on Tuesday partly to health care, saying in a statement Wednesday morning that “Conor Lamb’s win proves that Pennsylvanians want leaders who put the lives of people ahead of party politics. Conor will fight for quality and affordable health care, family sustaining jobs, to rebuild our infrastructure, and to combat the heroin and opioid epidemic.”

Tuesday’s exit polling data doesn’t bode well for Republicans in the 2018 midterm elections — and it appears to be part of a larger trend.

“If the Republican health care agenda can’t sell in a district that is this Republican, it’s an anchor around the ankles of Republicans in the more competitive battleground districts of the midterms,” Democratic strategist Jesse Ferguson told Forbes.

Voters sent the same message in Virginia’s gubernatorial race in November, when 67 percent of those who cast ballots said health care was the most important or a very important issue to them. Those individuals voted for Democrat Ralph Northam by a margin of 62 to 32.