Chris O'Meara / AP

Butch Otter, the outgoing Republican governor of Idaho, didn’t attract nearly as much attention for his big announcement on Tuesday as President Donald Trump did when he pledged to issue an executive order ending birthright citizenship.

But Otter’s endorsement of a ballot initiative to expand Medicaid in one of the nation’s most conservative states explains as much about the GOP’s situation in the 2018 midterm election as Trump’s legally implausible gambit; in fact, Otter’s move helps explain Trump’s.

In the final days of the midterm campaign, Trump and other Republicans are focusing their closing arguments on cultural confrontations, from immigration to the bitter confirmation fight over Supreme Court Justice Brett Kavanaugh. Otter’s announcement illuminates one key reason the party is placing so many chips on culture: GOP candidates appear to have lost faith that they can win the argument with voters over the key policies in their economic agenda, especially the longtime effort to repeal the Affordable Care Act and the huge tax cut Trump signed late last year.

“They are ending up on the culture war because we have blunted them on taxes and they can’t talk about health care,” Democratic pollster Ben Tulchin said. “So they are left with one card to play.”

Republican candidates are still claiming credit for the buoyant economy, and some polls show them holding a substantial advantage over Democrats regarding which party can best promote prosperity. But the specific Republican policy initiatives that most directly affect voters’ economic circumstances haven’t proven nearly as popular.

While Republicans first expected the tax cut to anchor their midterm campaign, the public reaction to it has soured over the election year. An early October CNBC survey found that while 54 percent of Americans believe that the law provided “a lot of” benefits to large corporations, and 52 percent think that it similarly benefited the wealthy, the share who believe that it helped other groups is much smaller: 15 percent saw such gains for small business, 11 percent for average taxpayers, and a measly 8 percent for themselves personally. In campaigns across the country, Democrats have directly attacked the tax cut as a giveaway to the wealthy that will eventually compel Republicans to cut Social Security and Medicare.

The GOP’s relationship with the ACA is even more tenuous. For four consecutive elections, from 2010 through 2016, the vast majority of Republican candidates at every level ran on promises to repeal the ACA. But after Republicans gained unified control of Congress and the White House in 2016 and sought to repeal the law, they faced unexpected institutional and public resistance. Almost every major medical organization opposed repeal. And after years that saw more Americans opposing than backing the law, public opinion during the repeal fight tilted toward support, where it has remained ever since. In polling by the nonpartisan Kaiser Family Foundation, individual elements of the law have proven even more popular.

Kaiser’s polling has found that nearly three-fifths of adults living in states that have not expanded Medicaid under the ACA support doing so. Even more emphatically, about three-fourths of all Americans back the law’s requirement that insurers cover patients with preexisting conditions at no surcharge.

Eliminating those protections was not an ancillary part of the GOP’s repeal legislation. It was an expression of the bill’s core philosophical argument: that the ACA compelled younger, healthy people to buy more insurance than they needed to subsidize consumers who were older or had greater health needs. Undoing that subsidy—or, more technically, disaggregating the risk pool—was the GOP plan’s central mechanism for lowering insurance premiums for the young and healthy. But the price of that was always reducing the affordability and availability of coverage for those who are old and sick.

One unequivocal message of the 2018 campaign is that the public rejects this trade. That clear consensus has compelled backflips from Republicans. Perhaps no one has become more contorted than Representative Martha McSally, now the GOP’s Senate candidate in Arizona. According to multiple sources, McSally, a former Air Force fighter pilot, rallied her colleagues with Top Gun swagger just before the repeal vote: “Let’s get this f-ing thing done,” she declared as legislators moved toward the floor. Now, in her television advertising, she insists that she’s “leading the fight” to “force insurance companies to cover preexisting conditions.” To borrow from her military career, that would define “leading the fight” as flying in precisely the opposite direction from the target.

McSally has plenty of company in shifting course. Trump, despite all evidence to the contrary, regularly insists that Republicans are more committed than Democrats to protecting consumers with preexisting conditions, even as his administration has joined a lawsuit to invalidate the ACA’s provisions doing exactly that. And while some Republican gubernatorial nominees continue to oppose Medicaid expansion (most prominently, Ron DeSantis in Florida and Brian Kemp in Georgia), others are hedging against Democratic opponents or wholeheartedly embracing it. In Ohio, GOP nominee Mike DeWine, after questioning the state’s Medicaid expansion during a Republican primary, endorsed it once he reached the general election. In Idaho, Lieutenant Governor Brad Little, who’s running to succeed Otter, has dodged a position on the ballot initiative but has promised to respect the will of the voters.

The fizzling of the tax bill and the backlash on health care help explain the GOP’s turn toward cultural confrontation in the campaign’s final turn. An even larger factor may be Trump’s apparent belief that he forges his strongest connection to the party’s preponderantly white base when he speaks to its anxieties about cultural and demographic change.

That instinct has manifested in a glut of polarizing cultural signals from Trump over the past few days. These include sending the military to the Southwest border to resist what he calls “an invasion” of a convoy of Central American migrants; the hastily floated pledge to end birthright citizenship for the children of undocumented immigrants; and eliminating the transgender legal category under Title IX, which bars gender discrimination in education. Running like a backbeat through this policy flurry has been Trump’s stout defense of Kavanaugh, who faced multiple allegations of sexual assault, and the president’s warnings that men have been unfairly targeted by the #MeToo movement against sexual harassment.

Individual Republicans have dissented from some elements of Trump’s cultural offensive. (Most notably, House Speaker Paul Ryan dismissed Trump’s claim that he could end birthright citizenship through executive order.) But few Republicans are stepping off the train as Trump lurches even further to the right on immigration and other social issues. Even Ryan, while rejecting Trump’s means, didn’t express an opinion on his ends of terminating birthright citizenship. (That didn’t stop Trump from attacking him in a tweet on Wednesday.) Others, like South Carolina Senator Lindsey Graham, loudly echoed Trump’s call. By contrast, when the GOP platform in 1996 endorsed ending birthright citizenship for the children of undocumented immigrants, Bob Dole, as the party’s presidential nominee, publicly repudiated it.

All this follows the collapse of Republican skepticism on Trump’s border wall and the party’s turn toward opposing both illegal and legal immigration. Although proposed cuts in legal immigration didn’t pass Congress this year, about twice as many Senate Republicans supported it as they did in 1996, the last time Congress seriously debated the issue. Throughout the primary season, more mainstream Republican candidates fought off challenges from the Trump-inspired right by moving toward his racially infused nationalism, particularly through opposition to immigration.

Trump’s immigration-centered closing arguments show how thoroughly he believes that the GOP base is motivated not by rolling back government (through tax cuts or repealing the ACA) but by resisting cultural and demographic change. New national polling this week from the nonpartisan Public Religion Research Institute supports his instinct. That survey asked Americans whether they believed it was mostly positive or negative for the nation that minority groups will reach a majority of the U.S. population by 2045. While nearly two-thirds of all Americans and four-fifths of Democrats said that the change was mostly positive, slightly more than three-fifths of Republicans described it as mostly negative.

One of Trump’s most profound effects on American politics has been widening existing divides and accelerating ongoing trends. Long before he arrived, the parties were undergoing an overlapping demographic and geographic realignment, with Democrats mobilizing a “coalition of transformation” centered on the voters and regions most comfortable with racial, cultural, and even economic change, and Republicans countering with a “coalition of restoration” centered on the groups and places most resistant to it.

As Trump more overtly identifies the GOP with racial resentments and anxieties, this election seems destined to harden the lines and widen the trench between those inimical coalitions. The GOP’s final message in 2018 shows that it is relying more than ever on the cultural grievances of blue-collar white America in order to amass the political power to pass an economic agenda aimed primarily at those in the upper income brackets.

And yet the GOP appears at far greater risk next week of losing upper-middle-class voters on cultural grounds than it does of losing working-class voters for economic reasons. The major exception is a few midwestern industrial states, such as Michigan, Wisconsin, and Ohio, where Democrats appear to be clawing back into contention among working-class whites.

Trump’s closing emphasis on culture may, in fact, represent a kind of triage for the GOP that effectively concedes large suburban losses in the House, but tries to protect more rural and blue-collar districts, as well as GOP Senate candidates in states fitting the latter description. “That’s not an unreasonable interpretation of it,” Republican pollster Whit Ayres said. Trump’s cultural messaging, he added, “may help in some rural blue-collar districts, but it sure doesn’t help in the suburban districts that are so important to help keep the House.”

This re-sorting will push the GOP even further toward Trump’s politics of racial and social backlash, because in next week’s election it may doom many of the moderate suburban House members who most resist his direction. After November, the GOP caucus in both congressional chambers will almost certainly tilt even further toward predominantly white, heavily blue-collar, and religiously traditional places where Trump’s insular messaging resonates. The paradox that the final stage of the 2018 election reveals is this: As more upscale voters who benefit from the GOP’s economic agenda flee Trump’s racially infused definition of the party, Republicans will become even more dependent on stoking the cultural grievances of their working-class base.

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