Democrats are making health care the centerpiece of their political comeback strategy after the disastrous 2024 elections.

They zeroed in on rising costs and access to coverage to move past the political headwinds they hit last cycle from transgender issues and the illegal immigration mess they helped create.

Not only have congressional Democrats taken a stand on health care by voting to shut down the government, but they are also increasingly promoting the cause in campaigns across the U.S.

Former Rep. Abigail Spanberger sounded the alarm to voters in Virginia’s gubernatorial race, warning that President Trump’s signature legislation could lead to the closure of rural hospitals across the Old Dominion.

Rep. Mikie Sherrill criticized Republican efforts in the New Jersey governor’s race for driving up health insurance costs and slashing Affordable Care Act subsidies, moves she says will strip coverage from countless Americans.

In New York, Zohran Mamdani, the mayoral front-runner, has condemned GOP proposals that threaten to cut food assistance and impose new eligibility requirements that could push millions of New Yorkers off their health care plans.

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Democrats have struggled mightily to craft a cohesive, unifying message beyond their strident opposition to Mr. Trump, who secured a second term by campaigning on hard-line immigration policies, sweeping deportation promises, “America First” trade measures, a revival of domestic manufacturing, and lower energy costs.

Mr. Trump also seized on cultural flashpoints, frequently mocking Democrats over transgender issues — particularly the participation of biological men in female sports and the inclusion of transgender individuals in the military.

Within the Democratic Party, friction persists about what ideological direction to take.

Some urged a bold shift leftward, embracing the progressive vision of Mr. Mamdani, the democratic socialist in New York City’s mayoral race who energized young voters and won the Democratic nomination.

Others argue for a more centrist approach to win back moderate voters whom the party’s liberal wing has alienated.

As it stands, Democratic leaders in Washington have drawn a firm line in the sand to battle over health care.

SEE ALSO: Republicans double down on not negotiating with Democrats during government shutdown

“The Democrats’ efforts to try to pivot to health care have been undermined by their relentless pursuit of trying to spend billions to pay through Medicaid the health care of millions of illegal aliens and able-bodied adults who refuse to work at the expense of hardworking taxpayers,” said Trump pollster John McLaughlin.. “They have shut the government down to benefit illegal immigrants and people who refuse to work. They don’t represent us. They represent them.”

Democrats reject the claim, insisting illegal immigrants are ineligible for federal subsidies under the law.

But some illegal immigrants are, in fact, eligible, depending on how and when they entered and what country they are from.

Those here under Temporary Protected Status, some asylum-seekers, and those granted “parole,” for example, are eligible to join the Obamacare marketplaces and receive taxpayer-funded subsidies.

Nonetheless, Democrats believe public opinion is on their side, citing recent Kaiser Family Foundation tracking polls showing broad support for extending enhanced COVID-era subsidies under the Affordable Care Act. According to the data, 77% of Americans — including 80% of independents and 63% of Republicans — favor keeping the subsidies, which are set to expire at the end of the year.

If President Trump and Congress fail to renew the tax credits, KFF estimates that average premiums for individuals who purchase their own insurance will spike by 75%. Roughly four million people could lose coverage due to unaffordable costs over the next decade.

Republicans are pushing back against the cost of extending the enhanced COVID-era health care subsidies, which have led to a surge in Obamacare enrollment. According to the nonpartisan Congressional Budget Office, maintaining those subsidies would result in approximately $350 billion in costs over the next decade.

Democrats, meanwhile, aren’t too fazed by the price tag.

Indeed, various wings of the party — from democratic socialist Sen. Bernard Sanders to establishment stalwart Hillary Clinton — come together in support of reversing Republican-led cuts to health care spending.

“You can quote me on this until the cows come home: I am not going to allow tens of thousands of fellow Americans to die because they are thrown off of health care,” Mr. Sanders said on CNN.

Ms. Clinton, who lost to Mr. Trump in the 2016 election after defeating Mr. Sanders in a contentious Democratic primary, accused Mr. Trump of holding the “government hostage until Democrats agree to raise health care costs for millions of Americans and give him more unchecked power.”

Despite the high stakes, most Americans report hearing “little” or “nothing” about the looming expiration of these subsidies — a troubling sign for Democrats as they try to break through the noise in an increasingly polarized political climate.

That communication gap has raised concerns about whether their health care-heavy message will resonate with voters.

Christy Setzer, a Democratic strategist, said she understands why Democratic leaders are focused on reminding voters that Mr. Trump has failed to deliver on his promise of lowering prices and that his support among low-income voters is eroding.

But she said it would be a “huge missed opportunity” for Democrats to hold Mr. Trump and the GOP accountable for “the lawlessness, the military invasions of American cities with a ’goon squad’ to rough up and imprison Americans, firing hundreds of thousands of federal workers, [and] a dead job market.”

“That sounds like a lot of different messages, but it comes down to, ’With Trump, you are the enemy,” she said.

Health care has remained a central issue in recent midterm elections, especially as costs continue to rise and coverage remains a concern for millions of Americans.

In 2010, Republicans swept into power after vowing to repeal and replace Obamacare, and renewed that commitment in 2014 on their way to expanding their House and flipping control of the Senate.

Then, in 2018, Democrats flipped more than 40 House seats, gaining control of the House after voters identified health care as the top challenge facing the country, followed by immigration and the economy.

For their part, Mr. Trump and Republicans express interest in fixing the health care system. They also blame Democrats for the system’s shortcomings, saying Democrats foisted Obamacare on the American people and failed to fix it when they had the opportunity.

• Seth McLaughlin can be reached at smclaughlin@washingtontimes.com.