Health care is on the ballot.

So proclaims Democratic senatorial candidate John Hickenlooper as he wisely creates a sense of distinction, between him and Colorado Republican Sen. Cory Gardner, people might really care about. Hickenlooper purports to favor health care, implying Gardner does not.

Health care is important. A recent survey shows Coloradans care about health care second only to the economy.

Most people want good, affordable health care for themselves and everyone else. Only a nihilist lacks concern for people who suffer illnesses and injuries without access to professional care.

To oversimplify the issue, Hickenlooper and other Democrats have developed a newfound affinity for the Affordable Care Act, aka Obamacare. They know average voters are not health care analysts or economists and simply associate the “Affordable Care Act” with affordable care. What’s in a name? Pretty much everything.

Anyone critical of Obamacare, therefore, opposes health care for all. Those who defend Obamacare must favor health care for all. It’s a simple, though vacuous, good vs. bad proposition.

The confused belief that Obamacare helps everyone explains why Senate Democrats spent most of the Amy Coney Barret confirmation hearings trying to scare the audience about losing Obamacare. Without much to uphold their claim, Democrats asserted, implied and outright accused Barrett of having an agenda to kill Obamacare.

No one knows how the new justice will rule on a nuanced challenge to the Affordable Care Act. Barrett did not tell us because she does not know. Real judges decide cases on the merits of law, not how they feel about the law. Barret, we should hope, will judge without passion or prejudice. She will determine whether Obamacare is legal in a constitutional context, not if the law is effective and helpful or even doing harm. Those are legislative concerns. For Barrett, those political and pragmatic issues should have no relevance.

By stark contrast, voters should consider the value of Obamacare when deciding between candidates who suddenly love it and those who plan to overturn or improve the law. It is not a simple matter of Obamacare good, its detractors bad.

Before running for Senate, Hickenlooper was not a big Obamacare fan. Only three years ago, he teamed up with then-Ohio Gov. John Kasich, a Republican, to propose an Obamacare alternative because too many Coloradans continued struggling with health care costs.

Hickenlooper was right to want massive improvements because the Affordable Care Act has done little if anything to make health care affordable.

The Kaiser foundation reports average family health insurance premiums have risen $7,967 since the inception of the Affordable Care Act in 2010. Because of the health care law, millions of Americans lost their doctors and private health insurance plans. Middle-class Americans with standard employee-earned health care policies are not better off. The law has put some health insurers out of business while enriching others.

Gardner wants a better health care plan and introduced a bill to protect preexisting conditions no matter what either party does to regulate health insurance.

The weird new assumption of the 2020 election cycle is that Obamacare works well, and Americans love it. Political lines are drawn between candidates who would protect the Affordable Care Act and those who would overhaul or eliminate it. Obamacare defenders want health insurance for Americans; critics of the plan do not.

Perhaps the most disconcerting report card on Obamacare, which Hickenlooper helped implement in Colorado with Medicaid expansion, comes from survey results released Tuesday by the Consumer Colorado Health Initiative and West Health Institute.

More than 1.7 million Coloradans — nearly one-in-three residents — have put off health care treatment in the past year because it costs too much. More than a million could not fill a prescription, and 675,000 blame the high cost of health care for the death of a relative or friend. The survey found 14% of Coloradans think health care is improving; 44% say it’s getting worse.

As masterfully articulated by former Colorado Republican Party Chairman Steve House, Obamacare is not the real problem. Instead, it is the flawed health care economy that provides a faulty foundation for the plan. Few others acknowledge or understand the crumbling foundation.

For politicians, health insurance and health care are the same. Tweaking with health insurance regulations, by “Obamacare” the “Affordable Care Act” or any name, serves as an expedient way for politicians to claim they give health care to constituents. They twiddle with insurance as the basement burns.

Until they fix the market — replete with perverse pricing incentives, shortages, protection rackets, barriers to access and a dearth of competition — Americans will not have a surplus of affordable health care. We cannot keep printing high-deductible health insurance cards and pretending we create health care. The Kaiser survey tells us the way it is. We can give the masses insurance, and they still lack adequate care.

Despite Hickenlooper’s catchphrase, health care is not on the ballot. He and other Democrats concocted a health care plan on an unstable substratum, and Republicans have no clear plan for fixing it. Until politicians give us one or more meaningful proposals, health care will not be on the ballot.

The Gazette Editorial Board