U.S. Sen. Patty Murray isn’t up for reelection next year, but she is nevertheless in a position to drive one of 2020’s key conversations.

As the ranking member of the Senate Committee on Health, Education, Labor & Pensions, Murray has in the past few years sharply increased the number of health care-related bills she has introduced.

Democrats are looking to make health-care issues a key part of the 2020 campaign, which begins in earnest Wednesday night with the first of two Democratic presidential debates. But it’s not just the White House at stake: 34 seats in the U.S. Senate — 22 held by Republicans and 12 held by Democrats — are up for grabs, as are all 435 seats in the U.S. House of Representatives.

Surveys and polls show that prescription-drug prices and other health-care costs, as well as women’s health in general, will be important to voters in 2020.

Many of Murray’s recent bills line up with these issues. This year alone, she has sponsored or co-sponsored 11 bills dealing with medical cost, access and women’s health issues, the same number she introduced during 2017 and 2018 combined (the two years covering the 115th Congress). She was tied to six such bills in the 114th Congress (2015-16) and seven in the 113th Congress (2013-14).

The uptick isn’t part of an official Democratic Party strategy, Murray said. But it does offer voters a well-timed glimpse into what Democrats’ priorities would be if they regained a majority in the Senate, which would make Murray the health committee chair.

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“I can’t go anywhere without people telling me personal stories,” the senator said of her constituents. “This is real.”

Focusing on health care has historically played well for Democrats, said Ashley Kirzinger, associate director of public opinion survey research at the Kaiser Family Foundation, a nonprofit focused on health information and policy.

During the 2018 midterms, Democrats used Republicans’ attempts to repeal the Affordable Care Act (ACA) to great effect, Kirzinger said. In that election, Democrats won control of the House.

Murray is walking a fine line in 2019. She’s a forceful critic of President Donald Trump and congressional Republicans on health-care issues, while also working with Republicans on the health committee to address some of those issues.

She and committee chair Lamar Alexander, R-Tenn., recently introduced the Lower Health Care Costs Act of 2019, and she sponsored the Second Look at Drug Patents Act of 2019 with Texas Republican John Cornyn. 

These efforts have come in addition to her buy-in on bills mostly supported by Democrats that would address things like insurance coverage and access to contraceptives.

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When she speaks about her bills from the Senate floor or in front of constituents in Washington state, Murray repeatedly employs the phrase “health-care sabotage” to describe the actions of Trump and other Republicans.

Murray’s tough rhetoric and spate of legislation help frame the debate for 2020, said Stewart Boss, national press secretary for the Democratic Senatorial Campaign Committee.

“It is Democrats who have been fighting for plans that would lower health-care costs, and protect people with preexisting conditions,” Boss said.

Trump is also looking to make health care a significant part of his reelection bid, in turn making it a big issue for his fellow Republicans.

Trump signed an executive order Monday to encourage transparency in the pricing of health-care services, which aligns with the Republican Party’s preference for costs to be determined by market forces driven by consumer choice.

On “Meet the Press” on Sunday, Trump said he and his party are “going to come up with great health care if we win the House, the Senate and the presidency in 2020.”

He also claimed that the ACA, also known as Obamacare, is still around because he decided to keep it around. A pared-down bill to repeal the ACA was narrowly defeated in the Senate in 2017 after three Republicans — John McCain, Susan Collins and Lisa Murkowski — broke ranks.

Murray said in a Tuesday interview that she has no problem balancing her strident stance against the Trump administration with her ability to work with Senate Republicans. It’s a matter of dealing with the political landscape, she said, and finding common ground to make progress where possible.

When Murray and Alexander introduced the Lower Health Care Costs Act last week, both senators touted the importance of bipartisanship. Alexander called it “one more example of that sort of cooperation” that Americans expect from their legislators.

While she echoed Alexander’s sentiments that day, Murray then took aim at the White House.

“The administration’s policies are undermining health care for tens of millions of people across the country,” she said.

Democratic presidential candidates are likely to echo those sentiments on the debate stage Wednesday and Thursday, when polls show voters will be more interested in hearing about health care than any other issue.