With the presidential primary heating up, and the governor’s race starting to pick up steam, few folks interested in health policy are watching the 2011 election.  This year, local elected officials, from hospital districts to the county council, are on the ballot.  The normal legislative elections occur on “even” years – 2012, 2010, etc. – with the local races on odd years.

But if you talk to the big money donors that fund gubernatorial elections, they are watching this year very closely.

The reason is that often local races can serve as an indicator of the mood for the electorate, much in the way a poll can.  So, while Jay Inslee and Rob McKenna aren’t on the ballot this year, there may be trends that appear this fall that can grow with the infusion of resources in 2012.

Here are two general trends to keep an eye on.

1.  Snohomish County Executive Race:  Reardon (D) vs. Hope (R).

This race pits a two-term conservative Democrat against perhaps the most moderate Republican office holder in Snohomish County.  With about 700,000 residents in the county, the third largest population of counties in the state behind King and Pierce, Snohomish has always been an important electoral county for a statewide run.  However, it increasingly appears to be a swing county in 2012.  When Dino Rossi ran against Chris Gregoire in 2004 in the first open governor’s seat since 1996, he picked up support in some key Democratic precincts, effectively tying Gregoire there.  In future years, after his sheen had worn off, Rossi did less well there.  But the point is that Snohomish County is both key to a Democrat winning statewide, and that it’s not to be taken for granted.

Enter this year’s election.  Polls according to both campaigns, though not released publicly, put this race pretty close.  The primary hinted as much with a 52-48 Reardon win, down considerably from his 65% four years ago against a weak candidate, but matching the 2003 race also at 52-48%.

A tight race where a conservative Democrat just gets by bodes well for Rob McKenna.  Weakness among the liberal bloc in Snohomish County means Inslee will have a lot of work to do, and that McKenna can look to move beyond Rossi’s 2004 numbers.

2.  Watch incumbents mayors, and city council members

Washington State has had a single party control the governor’s mansion longer than any other state in the union – since 1984 with John Spellman served.  There is a clear sense of voter fatigue with Democrats at the state level.  The problem is that there have been few credible alternatives proposed by the Republicans (2004 notwithstanding, and some would argue that result had more to do with a weak Gregoire campaign than a Rossi surge).

At the local level, generally there is not enough money in races to fully explain the vision of a candidate.  Often, votes are cast for local officials based on the following two questions.

1)  Do I know anything about this person?  Typically, no.

2)  How are things going in my community? For the most part, meh…

Given the high level of economic anxiety, and the surge in distrust among voters, we may see a “lean-anti-incumbent” election this year.

Bottom line: As goes Snohomish County in 2011, so to likely goes the Governor’s Mansion in 2012.  And, with it, the direction of health policy as we further implement federal reforms – either in the hands of one of the leading litigating opponents (McKenna) or in the hands of an important behind-the-scenes player in the reform conversation (Inslee).

Just sayin’.