Unlike the last few election cycles, paid political advertising that features healthcare issues hasn't played a starring role in the early primaries.
But once the Democratic and Republican nominees are selected, watch out.
The Affordable Care Act and other healthcare issues are going to get plenty of screen time, according to experts who track campaign advertising. Indeed, one analyst estimates healthcare messages, combining both pro- and anti-Obamacare ads, will account for nearly one-fifth of the more than $6 billion that will be spent in this year's massive onslaught of television and digital advertising to voters in the presidential, congressional and gubernatorial campaigns.
That's not surprising since healthcare remains one of the top five issues for voters of both political parties. It's particularly salient for rank-and-file Democrats, according to a Kaiser Health Tracking Poll in January.
“People are confused and uncomfortable with what they have and would like to have something better, but they aren't sure how that would work or what that would be,” said Kip Cassino, executive vice president at Borrell Associates, a media research and consulting firm. “They would love to have someone say in clear, definitive words what the answer is.”
Up to this point, the public isn't getting a clear, simple healthcare message with one exception: Democratic candidate Bernie Sanders is championing a government-run, single-payer financing system, the long-sought objective of the progressive wing of the Democratic Party.
Still, healthcare isn't entirely missing from the campaign. Candidates and the outside groups backing them have mentioned the Affordable Care Act, Medicaid expansion and drug costs in their ads, but it's mostly in passing.
Republican TV spots have stressed opposition to abortion and Planned Parenthood, with some ads attacking GOP candidate Donald Trump for his past support for abortion rights. Republican ads also have attacked GOP candidates, including Ohio Gov. John Kasich, for expanding Medicaid under the ACA. While all the candidates vow to repeal Obamacare, only Sens. Ted Cruz of Texas and Marco Rubio of Florida have made it a major talking point in their advertising.
It's not clear that any Republican advertising—whether on healthcare or any other issue—has been productive. The GOP candidates who have received the most advertising support from super PACs or their own ads—such as retired pediatric neurosurgeon Dr. Ben Carson and erstwhile candidates former Florida Gov. Jeb Bush and New Jersey Gov. Chris Christie—have not done well in the primaries or public opinion polls.
On the Democratic side, Vermont's Sen. Sanders uses the phrase “healthcare for all” in his ads. But he always includes it as just one part of his broader progressive agenda. And while Hillary Clinton has attacked Sanders' single-payer proposal on the campaign trail, she has so far failed to feature the issue in her campaign ads.
Rather, she is plugging her role in passing the State Children's Health Insurance Program in the 1990s and her promise to defend Medicare from GOP privatization efforts. Clinton also has called out high prescription drug prices in her ads, citing her plan to cap consumers' out-of-pocket costs.