In first-past-the-post election systems, campaigning on fear is well established as the winning strategy. In this case the fear the D candidate is playing on - loss of health care access - is more fact-based than the fear the R candidate is playing on - xenophobia - but both campaigns know fear-driven turnout is the only way to win.

I hope ranked choice voting makes more inroads. I am under no illusion it would break the two party system (Australia has used it for eighty years and still has two main parties), but by making second choices relevant it gives a winning election path to a pro-cooperation, get-things-done style of campaign.