President Donald Trump’s State of the Union address on Tuesday offered a preview of the economic debate that could tip the presidential election this fall.
The speech crystallized a key question: Will voters measure their personal economic well-being primarily through trends in unemployment and the stock market, or by whether their income is keeping up with their costs, particularly for health care? It’s a crucial distinction, because polls show that while a clear majority of Americans give Trump positive marks for his handling of the economy, a large majority also consistently disapprove of his record on health care.
“While economic indicators are generally moving in the right direction, health-care indicators are not,” says Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, a nonpartisan group.
On Tuesday night, Trump triumphantly rattled off figures about buoyant job growth, record-low unemployment among African Americans and Latinos, and soaring highs for the stock market. Though some of the figures were exaggerated, and others represented more of a continuation than a break from the economy’s performance under President Barack Obama, fact-checkers generally found relatively little to debunk.
But Trump’s treatment of health care was very different. Though he was just as assertive in his tone, the president made a series of false claims—in particular, he repeatedly lied about his administration’s unrelenting efforts to gut the Affordable Care Act. To Democrats, Trump’s determination to surround his health-care record with what Winston Churchill once called a “bodyguard of lies” clearly signaled that the president recognizes how vulnerable his record could prove this fall.
Polls leave little doubt that voters express much more positive assessments of the economy than the health-care system. “Because people see health care as so central to both their personal well-being and their financial well-being, health care stands out as Trump’s No. 1 vulnerability,” says the longtime Democratic pollster Geoff Garin. “The simplest way for people to understand the Trump economy is that whatever wage increases they are getting are smaller than the increases in their health-care premiums and out-of-pocket health-care costs.”