Tuesday’s debate is being hosted by the Cleveland Clinic, which is appropriate given that COVID-19 deaths have been averaging close to 1,000 a day during the last several weeks.
It’s also fitting because polls have Donald Trump and Joe Biden in a dead heat in the state. And that’s because Ohio finds itself in an identity crisis.
The state has far less manufacturing than it used to, is more outbound than inbound in terms of migration, has 4 cities in America’s top 20 in terms of poverty, and is ranked 40th of the 50 states in job growth.
And all of this has taken place under a Republican governor and legislature, following a sizable 2016 victory in the state for Donald Trump (he won by 8 points), and former governor John Kasich endorsing Biden. Ohio has not been made great again by Republicans.
Robert Alexander, a professor of political science at Ohio Northern University, says, “In 2016 it was an anti-Washington election and it still is. . . . [T]he primary problem for Trump now is that he is now Washington, and we’re seeing that as being an issue in Ohio.”
Take the issues facing the Cleveland Clinic itself. The Cleveland Clinic isn’t just single hospital, it’s an $8 billion, healthcare network which employs more Ohioans than any other business in the state. It’s Cleveland headquarters alone occupies 165 acres of the city.
And it’s still expanding, both in Ohio and far, far away. The Cleveland Clinic is building a new hospital in the suburbs east of Cleveland, as well as a seven-story cancer center in Abu Dhabi, and in two years will open a 185-bed hospital in London.
But what is happening in Cleveland itself is pulling the hospital in different directions.
Cleveland was recently ranked as the nation’s most poverty ridden city, yet there exists the perception among Ohioans that the Cleveland Clinic is more concerned with middle-east royal family heart surgery than in treating the poor who live next door to its main campus.
The Cleveland Clinic—like the rest of the healthcare sector—is caught in the tension between public policy and private markets. They want some form of Obamacare but not “Medicare for All.” They want the Medicaid and Medicare money, but not too many regulations.
And the voters feel this tension, too: They want benefits, but not higher taxes.
There are other reasons the race has closed in Ohio. The state’s population has gotten older and the household income is still about 10 percent below the national average. The promises Trump made about more manufacturing jobs haven’t been kept in the state and following Governor Kasich’s expansion of Medicaid, there are now about 4.4 million Ohioans on Medicare and Medicaid—36 percent of the population
And the numbers are especially high in Ohio counties that are rural or suburban, the strongholds where Trump beat Hilary Clinton handily.
Another way to understand a change in Ohio from 2016 to 2020 is to realize not all suburbs are the same. There are the older suburbs around Cleveland (with homes built directly after WWII), and newer suburbs around Columbus. Some have more foreign-born academic researchers, some have more retired auto factory workers. Some live in 20-year-old huge houses with pools in the back, some live in little 70-year-old homes on postage-stamp sized lots.
In 2016, Trump had a number of things going for him in Ohio. The state’s electorate was 57 percent non-college white—a dozen points higher than the nation as a whole. Only 16 percent of Ohio’s voters were nonwhite, which was less than the national average.
In 2016, white Ohioans without a college degree picked Trump by a 31 percent margin. The latest polls show him up by only 18 points with this demographic.
In 2016, college-educated white Ohioans split 50-50 between Trump and Clinton. Polls show Biden with a +7 edge with this group.
Lake County, just east of Cleveland, is an interesting case study.
The county has a population of 230,000 and is 92 percent white and has seen little growth since 1980.
Historically, Lake County has been tightly contested. In 2004, George W. Bush carried Lake County 51-48. In 2008, Barack Obama carried it 49-48. In 2012, Lake County flipped to Mitt Romney 49-48.
Then, in 2016, Trump beat Clinton in Lake County 55-40. This margin shocked pretty much everyone. And since then, no one has figured out why it changed so drastically.
So was 2016 an outlier in Lake County?
We’ll see. The average age in Lake County is now 43.7 years (about 5 years higher than the national average). About 14 percent of Lake County is over 65 and Trump won seniors by 13 points, nationally, in 2016.
But recent polling shows Biden with tremendous strength among seniors. If that holds in Ohio, then the state is going to be very close.
And the underlying issue matrix is good for Biden. Most Ohioans did not approve of Trump’s handling of the pandemic (51 percent to 46 percent) and 51 percent said they didn’t trust information from the president.
And then there are face masks: 78.4 percent Ohioans are in favor of the state regulation that facemasks be worn in public. It’s hard to look at these numbers on the top issue and think that late-deciding voters will break for Trump.
This is not to say that Trump will lose Ohio. The Democratic power of big cities such as Cleveland and Youngstown has waned in recent decades, partly because of population loss and partly because of the decline in union membership (half as much now as it was in 1980).
And Trump got a good poll on Monday, with SurveyMonkey showing him up by 51 percent to 47 percent, with jobs and the economy as the top issue followed by health care.
But the aggregate polling also shows Trump is unlikely to have a commanding win here as he did in 2016. RealClearPolitics has Biden with a narrow 3.3 point lead with about a month left.
What’s interesting is that even as polls have tightened in Ohio and the Biden campaign has started spending money on the airwaves, Trump has been pulling out of the state. In early summer, Trump spent $18 million on ads in Ohio, but the the polls kept moving against him. In recent weeks, Trump’s campaign cut spending in the state.
In a state like Michigan, this might be seen as a concession that the race was out of reach.
But in Ohio it’s probably more of an acknowledgment of reality: If Ohio is so close that Trump has to wage an all-out battle to hold it, then it means he’s probably losing so badly everywhere else—Wisconsin, Michigan, Pennsylvania, Arizona, North Carolina—that a victory in Ohio won’t help.
In other words: If Trump can’t take Ohio for granted, then the race may already be over.