The January 5 runoff elections in Georgia that will determine control of the Senate are shaping up as a test of how the health care issue works politically for the Democrats. It’s not so much the coronavirus response that Democratic candidates are emphasizing but the broader issues of health care access, quality, and affordability connected to federal government regulation and subsidies.

Covid-19 and the larger health-care issues are related. Some voters have lost their employer-provided health insurance amid the pandemic. Others worry about the risk of unexpected large medical bills related to a Covid-19 hospitalization.

Traditionally, these politics have been perilous. First Lady Hillary Clinton’s attempt to reshape health care helped cost Democrats control of Congress in 1994. In 2010, after President Obama pushed ObamaCare through Congress on a party line vote, voters punished him by handing control of the House of Representatives to Republicans. President Trump won the presidency in 2016 in part on a promise to repeal and replace ObamaCare. His failure to keep that promise may have factored into his failure to win reelection.

Rather than steering clear, both Georgia Democrats running for Senate are emphasizing health care. Jon Ossoff’s campaign website has it prominently on the home page: “Why I’m Running.” The answer? “I’m running to ensure every Georgian has great health care…”

A December 5 campaign press release from Mr. Ossoff about an Atlanta joint rally with the other Democratic Senate candidate, the Reverend Raphael Warnock, quotes Mr. Ossoff: “This is a movement for health, jobs, and justice for the people,” Mr. Ossoff said. “That means every family in Georgia has the health care that we need.”

A recent Warnock campaign commercial features the candidate saying, “I’ve been fighting for health care reform, saying it really is a moral mandate.”

Republicans are responding by depicting the Democrats as radical socialists. “Reverend Warnock, in your writings and your teachings you’ve repeatedly praised Marxism and the redistribution of income. Can you here and now for all Georgians renounce socialism and Marxism?” Republican Kelly Loeffler asked during a debate, accusing Reverend Warnock of “taking away the private insurance that you get at your jobs and replacing it with government-run healthcare, turning your doctor’s office into the DMV. He would … give free healthcare to illegal immigrants.”

“Listen, I believe in our free enterprise system, and my dad was a small business owner,” Reverend Warnock replied. He also cited the Christian Bible: “I’m a Matthew 25 Christian, that’s what I am. … I was sick and you visited me. Love your neighbor, and for me that means you don’t get rid of your neighbor’s healthcare particularly in the middle of a pandemic.”

Reverend Warnick went on, “I’m a pastor, and so when I think about these issues I think about the people that I’ve had to stand with in the critical care units while their loved one was dying or between life and death. And not only are they concerned about the sickness they’re wondering how in the world are they going to pay for it?… Tell everybody you know to make a vote plan because healthcare is on the ballot.”

Democrats can’t seem to find a way to campaign for health care without demonizing the companies that provide it under the present system. “Why is it that we can’t pass legislation to make prescription drugs affordable, to get everybody covered with great insurance? Why does David Perdue and politicians like him, they’re a dime a dozen, vote to rip care away from people with preexisting conditions? It’s because of corruption, the power of the insurance companies,” Jon Ossoff said in a campaign appearance.

“For too long the insurance and pharmaceutical companies have had their say in Washington,” the Warnock campaign web site says.

The likelihood that a Democrat-controlled Senate and House would combine with President Biden to produce additional health reform that meaningfully increases quality, access, or affordability seems slim to me. More likely would be gridlock, or gradual changes with unintended consequences.

Republicans, though, are not blameless. Ordinary Americans, even those with excellent coverage, are swamped by the complexity of health-care-related paperwork — the blizzard of bills, the explanations of benefits, the experience of having the first encounter at every doctor’s office be signing an open-ended promise to pay whatever insurance does not reimburse, the referrals required for specialists, procedures that cost less out of pocket at the end of a calendar year than at the beginning because of deductible caps, figuring out what is “in-network” and what is “out of network.”

Neither the Republicans nor the free market have so far succeeded in fixing these issues. They present problem-solving opportunities for entrepreneurs and also, Reverend Warnock and Mr. Ossoff are betting, for politicians.