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After this past week, every Democrat I know fears another Donald Trump victory in 2020.

They may be right. Trump’s favorability rating is at its highest point. A record-high stock market and low inflation and unemployment bode well for incumbent presidents. Indeed, a leading economy-based election model predicts Trump beating the Democrats by 4 percent.

Yet there are good reasons not to become glum about the current disarray. Given this economy, any other president would be coasting to victory. Trump is not. In almost every recent high-quality poll, Trump is either losing or in a dead heat with potential Democratic challengers.

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Democrats need to stop worrying about temporary vicissitudes and keep focused on the absolute key to winning this November that has received woefully little attention: turnout. As the author of one economic prediction model puts it: “Trump wins if the economy and his approval rating are about the same a year from now as today, and turnout is typical.” (emphasis added)

Turnout being typical is neither a given nor preordained. It is something people and organizations have the capacity to improve — or suppress. Typical turnout, even in presidential election years, fluctuates substantially: 54.2 percent in 2000; 60.4 percent in 2004; 62.3 percent in 2008; 57.5 percent in 2012; and 55.7 percent in 2016. In the 2018 Democratic rout in the House, was propelled by the highest level midterm turnout since 1914, at 53.4 percent — nearly a 12 percent absolute increase over the previous midterm.

There are three tangible things that can be done to increase turnout and advance a Democratic victory.

First, the Democrats need to launch a concerted voter registration and turnout campaign. Scared silly about turnout, the Republicans are firing up their base and suppressing minority and young voters. Democrats need to respond now.

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A Democratic turnout campaign should be targeted to just six states. The consensus among election prediction models is that 2020 will boil down to just Arizona, Florida, North Carolina, Pennsylvania, and Wisconsin. In almost all the models, Michigan is already Democratic. However, this year is no time to be overly confident.

Within these states, the turnout campaign needs to emphasize minorities, youth, and independent women. In 2016, nonvoters skewed younger and less white. They are hostile to Trump, making the probability they will vote Democratic very high.

What could be done in a swing state with a $25 million turnout campaign? Studies indicate that for reliable get-out-the-vote efforts, the return on investment is one vote for every $31 to $91. As more people turn out, the marginal cost will probably go up. In a presidential year with a relatively high turnout, the ROI might be one vote per $100 to $200. Thus, a very conservative estimate suggests a $25 million investment in a state could translate into more than 125,000 votes. This would swing states like Wisconsin and Pennsylvania, where Trump’s 2016 margins were 27,257 and 44,292 votes, respectively.

Second, the turnout campaign should emphasize social connections. Empirically, robocalls, TV ads, and direct mail turnout campaigns don’t work. If behavioral economics and social media have taught us anything, peer pressure and how we are viewed by our community, family, and peers drives behavior. So too do social norms. If we are told that voting is standard among our neighbors and friends, then we are inclined to do it too. As Alan Gerber of Yale argues: “[P]eer pressure when it comes to voting is effective because people perceive the social desirability of participating rather than sitting out. So turnout effects can be enhanced by a message that conveys the impression that a voter’s participation is being noticed by others.”

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A turnout campaign using social connections has to begin now — not in June. Many of these potential voters need to be registered. Getting the data on social connections, communicating the voting message in a salient form multiple times, takes months not weeks. Delay until the Democrats have a candidate is too risky. Starting today is not too soon.

Third, the campaign needs to be built around fear of Trump and uncertainty about health care. Trump rode fear of immigration and Muslims to victory in 2016 and hopes to do it again. Fear of four more Trump years motivates people. So does uncertainty about health care. Fully 56 percent of Americans worry they or someone in their family will lose coverage. By a margin of 19 points, Americans trust Democrats over Republicans to lower prescription drugs. Democrats should emphasize what they have done, including passing a drug bill. Democrats should also stoke fear by relentlessly emphasizing the Trump administration’s support of the appellate court ruling that will eliminate all protections for preexisting conditions.

How to raise $150 million for this campaign? If the billionaires who hate Trump began by pledging 1 percent of their income to making a turnout campaign seem real and impactful, I — and many other Americans who loathe Trump — would pledge 1 percent too. But it has to start now.

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If there is enough money for a campaign to cover the six states, it should expand to states with vulnerable Republican senators. Prime targets include Susan Collins of Maine, who has voted with Trump more than two-thirds of the time, and Cory Gardner of Colorado, who votes 90 percent with Trump. Republican Senators Thom Tillis of North Carolina and Martha McSally of Arizona are in states already targeted for the presidential election.

Democrats should stop being paralyzed by dread of November. We should focus on turnout, getting Americans registered and to the voting booth. If we do, then Trump loses and democracy wins.

Dr. Ezekiel Emanuel is vice provost of Global Initiatives and codirector of the Healthcare Transformation Institute at the Perelman School of Medicine and the Wharton School at the University of Pennsylvania. He is also a senior fellow at the Center for American Progress and venture partner at Oak HC/FT.