John Bel Edwards, a Democrat, won reelection as governor of deep-red Louisiana on Saturday by a comfortable 40,000 votes — after President Trump had repeatedly campaigned for his Republican opponent. Worse for Trump, this came after he positively begged voters to support the Republican, casting it as a referendum on himself by saying: “You got to give me a big win, please.”

Yet Edwards won, in large part, by also stressing his implementation of the Affordable Care Act’s Medicaid expansion in the state during his first term. Indeed, Edwards’s lead pollster, Zac McCrary, told me during an interview that no single issue was more important in driving the governor’s victory.

All of which underscores an important truism about the Trump era, one often neglected by pundits: A key reason Democrats have been racking up wins in Trump country may be the president’s embrace of conventional GOP plutocratic economics.

The story typically told about recent Democratic gains is that Trump’s hideous personal qualities, his public racism, his corruption, his destructive handling of international alliances, and his most visible cruelties — such as migrant children being kept in cages — are driving white moderates away from the GOP.

That is no doubt true, but it leaves out a big piece of the story. Trumpism has two sides: It fuses his racism and malignant, destructive nationalism with his total abandonment of the economic side of his populist nationalism, via a massive tax cut for the rich and a vigorous but failed effort to roll back health coverage for millions.

In Louisiana, Edwards’s victory carried echoes of Democrat Andy Beshear’s triumph in deep-red Kentucky’s gubernatorial race two weeks ago. As a New York Times analysis noted, Edwards won in a state that Trump carried in 2016 by 20 points with the same coalition that drove Beshear’s victory in Kentucky, by energizing “a combination of African-Americans and moderate whites in and around the urban centers of his state.”

If that coalition holds for Democrats nationally, the Times continued, it could put Trump’s reelection “in grave jeopardy next year.”

The Medicaid expansion was also a very important issue in driving the Democratic win in Kentucky (though the deep unpopularity of Republican incumbent Matt Bevin helped), and in fueling the Democratic takeover of the Virginia state legislature on the same day. (Health care also helped drive the 2018 Democratic takeover of the House via many suburban, Republican and Trump districts).

In Louisiana, Edwards ran multiple TV ads featuring ordinary people with serious health problems talking directly to the camera about how much they relied on the Medicaid expansion, which covers nearly a half-million people.

Edwards also ran ads savaging the health care plans of his GOP opponent businessman Eddie Rispone, who seriously fudged his intentions but left no doubt that he’d dramatically alter the program and potentially roll it back.

“We were explicit in the role the governor played to expand Medicaid and the risks Rispone posed to it,” McCrary, Edwards’s lead pollster, told me. “No single issue was more important than the Medicaid expansion.”

“There is no better example of tangible accomplishment directly attributable to the governor than fighting for health care coverage for 400,000-plus working people,” McCrary continued.

Importantly, McCrary noted that the Medicaid expansion was not perceived by Louisiana voters as primarily an issue involving the urban poor or minorities. Indeed, he said, it was seen as a positive selling point for Edwards among the moderate and suburban whites whose alienation from the Trump-era GOP is so often discussed these days.

“This was universally popular with all the groups that are part of the Edwards coalition,” McCrary told me, adding that this was the case in part because many beneficiaries are working. “Everybody has a horror story about health care costs, including in these suburban areas.”

The result, McCrary said, is that “even in these deep-red states, Medicaid is approaching the popularity of Medicare and Social Security,” and isn’t perceived as “some type of welfare program.”

All of this represents a stunning turnaround from only a few years ago, when the Affordable Care Act had unleashed white-hot rage in red America and helped drive GOP takeovers of the House in 2010 and the Senate in 2014.

But beyond this, the role of the Medicaid expansion in driving these Democratic victories goes to a deeper truth about this moment.

Trump campaigned on a species of economic nationalism that was supposed to combine nationalist policies on immigration and trade with pro-worker economic policies such as robust infrastructure spending to create jobs and a refusal to embrace orthodox GOP ideological hostility toward safety nets. But Trump sold out on that latter half, fully embracing Republican plutocracy while going all in on the first half of the equation.

Indeed, this combination, and not simply the president’s embrace of a more overt nativist and xenophobic anti-immigration and anti-trade nationalism, is what really defines the Trump-era GOP.

“U.S. right-wing populism is globally unique in combining nativist and social conservative voters with economic elite policymaking,” is how political scientist Matt Grossmann puts it, adding that Republicans are uniquely “trying to do nativism while moving right on areas like health and taxes.”

Of late, Democrats have had great success in capturing white suburban moderates without it costing them the energy of the base — and perhaps the unique toxicity of that combination is a big part of the story.

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