President Trump with Missouri Attorney General and Senate candidate Josh Hawley at an event in Springfield, Mo., on Sept. 21. (Charlie Riedel/AP)
Opinion writer

If there is a single campaign ad that is emblematic of the 2018 midterm election, it may be this one from Missouri Republican Senate candidate Josh Hawley, who is running to unseat Democratic Sen. Claire McCaskill:

Well isn’t that heartwarming. After all, an estimated 130 million Americans, or about half of those too young to qualify for Medicare, have preexisting conditions. And, until just a few years ago, with the implementation of the Affordable Care Act, having one meant that insurance companies could deny you coverage or only offer it to you with premiums so astronomical, no ordinary people could afford them. They even did a thing called “rescission,” a situation in which you would either have an accident or get sick, and your insurer would then comb through your history and find an excuse — hey, you never told us you got treated for acne eight years ago! — to retroactively cancel your policy and leave you in the cold at the moment you most need the coverage you’ve been paying for.

That was outlawed by the ACA, as were denials for preexisting conditions. So we have that measure of health security now, and it’ll stay that way thanks to caring Republicans such as Josh Hawley. Right?

If you suspect the answer to that question is “Actually, no,” give yourself a pat on the back. Because Hawley, the attorney general of Missouri, is one of a group of Republican officials who filed suit to have the entire ACA struck down. If the suit succeeds, insurers will once again be able to deny anyone a policy because of a preexisting condition, and charge as much as they like.

Republicans have never lacked for chutzpah, which is what it takes to file a lawsuit intended to take away protections for preexisting conditions, and then run a soft-focus ad about how committed you are to protecting those with preexisting conditions. Hawley’s position is that he actually wants to take away those protections now, but give them back later with some future piece of legislation — one that does all the things about the ACA you like, but none of the things you don’t.

Why do I say this is emblematic of the entire 2018 campaign? First, because this is happening all over. Despite all the attention we pay to the Russia scandal, Brett M. Kavanaugh’s Supreme Court nomination and President Trump’s tweets, health care has been the dominant issue on the campaign trail; half of all the ads aired by Democrats have included it.

This lawsuit couldn’t have come at a worse time: Because pretty much every Republican already wanted to repeal the ACA root and branch, Democrats can quite accurately say their opponents want to take away coverage for preexisting conditions. The Republican position is widely abhorred; a recent Kaiser Family Foundation poll showed that 75 percent of Americans, including a majority of Republicans, say it’s “very important” to them that the protections remain in place. The issue also lends itself well to emotional stories about people struggling with illness who would be bankrupted or worse if they didn’t have the protection, stories that can be fit into 30-second ads such as this one from McCaskill. So Republicans are responding by insisting that they too want to protect preexisting conditions.

Something similar is happening on the Affordable Care Act’s expansion of Medicaid: Republicans who used to oppose it are now softening their opposition, especially when they’re running for governor and their Democratic opponents start talking about all the residents of their state whose insurance Republicans want to take away. In a result that must have broken Republicans’ hearts, a recent Fox News poll found that the ACA is significantly more popular than the tax cut the GOP passed last year.

The next reason Hawley’s ad is representative is that it’s not just ridiculously dishonest; it shows the complete vacuum where Republican policy ideas are supposed to be. The GOP has been saying it wants to “repeal and replace” the ACA since 2010, yet, in all that time, it couldn’t be bothered to come up with the “replace” part, other than a perfunctory bill slapped together here or there so it could say it supported something. When it tried and failed to repeal the law after taking control of Congress and the White House last year, it once again turned to the courts, in the form of the lawsuit filed by Hawley and others. And if they win? Republicans will come up with something, one supposes. It’ll be great, you’ll see.

You see all kinds of dishonesty in campaigns — candidates making mountains out of molehills, saying they “led the fight” for some popular piece of legislation when all they did was vote for it, distorting their opponent’s records on this or that. But you don’t usually see them claiming to be the savior of the very thing they’re trying to destroy.

What could be more 2018 than that?