FAIRMONT — Democrats regained control of the U.S. House of Representatives last fall by focusing on the issue of health care in swing districts.

Democrats listened to Americans’ fears about rising health care costs and expensive insurance coverage, then leveraged what they learned into a political victory.

Minnesota Congressman Jim Hagedorn faced one of those Democrats in challenger Dan Feehan. While other Republicans fell on election night, Hagedorn managed a narrow win to begin his first term.

But the issue of health care has not gone away. If anything, it’s gaining steam.

President Donald Trump has been emphasizing health care lately, reiterating Republican support for protecting people with pre-existing conditions. And on Thursday, Trump called for an end to “surprise medical bills,” which are incredibly high charges patients face when someone on their medical team is not in their insurer’s network.

Hagedorn can expect another tough fight in 2020, when Democrats will again target Minnesota’s First Congressional District as a tossup race. And they will renew their push on health care.

In fact, the battle has already begun.

On Thursday, Hagedorn voted against a Democrat-sponsored bill titled the “Protecting Americans with Pre-existing Conditions Act.” The Democratic Congressional Campaign Committee immediately criticized him, saying Hagedorn is letting insurers “gouge” 276,300 Minnesotans with pre-existing conditions.

“With so many seniors and hard-working families struggling with the rising cost of health care, it’s alarming that Washington Republicans like Jim Hagedorn keep voting to put big health insurance company profits ahead of Minnesotans,” said committee spokesperson Brooke Goren.

Hagedorn counters, saying Democrats are playing games with a deceptively named bill.

“I voted ‘no’ on this bill because it gives a new definition to the term ‘bait and switch,'” he said. “The legislation does not protect Americans with pre-existing conditions, but it would prevent states like Minnesota from dealing with Obamacare’s skyrocketing premiums and deductibles.

“Rather than addressing Obamacare’s failures, the same Democrats who promised you could keep your doctor, keep your plan and save $2,500 per year are making new false promises and playing a new round of political ‘wordsmith’ games.”

Hagedorn said that even if the bill became law — unlikely given a Republican-controlled Senate and Trump in the White House — it would not immediately affect Minnesota. This is because Minnesota is one of seven states that has created its own reinsurance program, thanks to a federal waiver. He said Minnesota is seeing lower premiums because of this.

“However, the legislation [passed by the House would] deny 43 states the ability to join Minnesota in creating innovative programs to decrease premiums while ensuring pre-existing condition coverage,” Hagedorn said.

He also criticized the bill because it would not be relevant to most Americans, including those who have private-sector coverage, those on Medicare and Medicaid, and those who receive care through the Veterans Administration.

As for his preferred solution, Hagedorn favors the establishment of high-risk pools to protect Americans with expensive and pre-existing medical conditions, particularly the estimated 5 percent of patients who consume about 50 percent of all medical care dollars.

He says his proposal would ensure timely care, protect against bankruptcies and drive down the cost of health insurance premiums for private-sector consumers.