Opinion | Why Is the Republican Party So Confused About Health Care

Judging by exit polls, the single most effective midterm issue for Democrats was health care — in particular, the argument, made by Democratic candidates across the country, that Republicans were out to eliminate the Affordable Care Act’s regulations governing pre-existing conditions.

So when a Texas judge ruled in December that the entirety of the health law was unconstitutional, he ensured that this issue, and this argument, would remain front and center heading into the 2020 election.

Legally speaking, the ruling is weak, and the case may be tossed in the appeals process. But if it travels all the way to the Supreme Court, it would effectively guarantee that health care remains politically potent throughout the presidential campaign. You can expect the Democrats’ cast-of-thousands presidential field to all swear to protect Obamacare’s pre-existing conditions rules — and President Trump to demonstrate his usual command of the finer points of health care policy in response.

The ruling thus represents a challenge for Republicans — but also an opportunity. At least in theory, it could force the party to finally figure out, or at least start figuring out, exactly what it stands for when it comes to health care policy.