An insurance agent helps a woman shop for insurance under the Affordable Care Act. (Joe Raedle/Getty Images)

THERE’S A long list of issues on which the Trump administration, and Republicans generally, are out of step with most Americans, yet on few of them is the chasm so broad or so deep as on health care.

On Tuesday, voters made that clear in a pair of purple states, Virginia and Maine, while for the past week Americans across the country have been surging to sign up for health-care coverage under the Affordable Care Act, which the White House and congressional Republicans have tried to repeal and, failing that, sabotage.

The health-care message was hammered home in Virginia and Maine by huge electoral margins. In exit polls across the Old Dominion, 2 out of 5 voters identified health care as their top concern — more than twice as many as named any other issue. Among those health-care voters, 77 percent favored the Democratic candidate, Lt. Gov. Ralph Northam, who supports Obamacare and expanding Virginia's Medicaid program under the law; just 23 percent backed the Republican, Ed Gillespie, who opposes both.

In Maine, a referendum to expand Medicaid under Obamacare, which would extend health insurance to some 80,000 low-income adults, won in a landslide, 59 percent to 41 percent. That was a direct rebuke to the Republican governor, Paul LePage, who vetoed Medicaid expansion five times after it was approved, also five times, by the state legislature.

The outcome in Maine, which would become the 32nd state to expand Medicaid under Obamacare but the first to do so by referendum, may prompt similar ballot measures in other GOP-dominated holdout states. Nationwide, some 2.5 million uninsured adults who could gain access to Medicaid live in the remaining states that have balked at expansion; about 15 million Americans have signed up for Medicaid under the expansion.

It’s not that Americans haven’t heard Republican arguments that expanding health coverage to vulnerable adults will translate into a long-term expense for states — although under Obamacare the federal government will cover at least 90 percent of the cost. In fact, voters have taken into account those warnings — as well as the likelihood that expanded Medicaid will create jobs and bolster the finances of some hospitals — and decided they favor expansion anyway.

The Trump administration and Capitol Hill Republicans are deaf to the fact that too many Americans lack health insurance. Even after Congress's attempts to repeal Obamacare; even after the administration slashed outreach and marketing efforts for the open-enrollment period; and even after Mr. Trump killed subsidy payments to insurers, threatening higher premiums for some policies, sign-ups through had roughly doubled in the enrollment period's first week, through Nov. 7, compared with the previous year.

No matter how often Mr. Trump and the GOP call for a federal retreat from ensuring decent health care and insurance, Americans are plainly unconvinced. In fact, there is every indication, including rising approval ratings for Obamacare itself, that the public has rejected the Republican health-care agenda in favor of an active government role. They delivered that message about as clearly as imaginable on Tuesday. Will Republicans in Virginia and around the nation finally pay heed?