The 2018 midterms saw 41 Democrats flip Republican House seats, including Illinois-14, picked up by Rep. Lauren Underwood. Roughly half of those districts mirrored Underwood’s: They were more than two-thirds white; a mixture of urban, suburban, and rural middle-income residents who historically supported Republicans. In her district, health care was the number one issue. “As we would travel from place to place to place, everybody was talking about health care,” Underwood recalls.
An incumbent seeking her second term in the middle of a global pandemic, Underwood faces stark challenges. In the final days of the 2020 campaign, she sees the same level of anxiety among her constituents that she saw during the Trump administration’s failed attempts to repeal the Affordable Care Act two years ago. The current health care crisis may serve to strengthen Underwood’s standing among Democrats—and Republicans frustrated with the status quo may cross over to vote for her, just as some did two years ago.
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Kim Hacker, a lifelong Republican, broke ranks to vote for Underwood. Her father and his family voted Republican. Her former husband volunteered for local GOP campaigns. Growing up in the northwest suburbs of Chicago, most of her neighbors supported Republicans. She firmly believed in the party’s tenets of fiscal conservatism, limited government, and family values. Though she knew politicians “spun the truth,” she never considered them to be liars and thought that they dedicated themselves to making the country better for people like her—until her father’s health began to fail in 2008.
He suffered from heart disease, and near the end of his life he was hospitalized and needed around-the-clock care that cost the family thousands of dollars. The Hackers were lucky. Her father saved diligently and had high-quality insurance during his years as a corporate vice president, so her mother would still be comfortable in retirement. For the first time, however, Hacker understood how health care costs could wipe away family savings. She also gained a new appreciation for the difficult work providers do. She rejected Donald Trump in 2016 and supports Joe Biden this year, and she plans to vote for Underwood again.
In 2018, Underwood, a registered nurse, defeated four-term incumbent Republican Randy Hultgren by 52.5 percent to 47.5 percent to become the youngest Black woman in Congress. She is the first woman and African American to represent IL-14, a district that sent Dennis Hastert, a former House Speaker, to Washington for 20 years, and she is only the second Democrat to win in IL-14 in the past 80 years. During her first congressional campaign in the seven Northern Illinois counties comprising her district, Underwood, who worked on the implementation of the Affordable Care Act during her time as a Department of Health and Human Services senior adviser on emergency preparedness and response, got an earful…