House Republican leaders are committed to passing an Obamacare alternative before the November elections, but even proponents of the effort are skeptical that it will produce anything beyond a set of policy principles.
Senior Republicans charged with writing health care legislation to replace the Affordable Care Act are grappling with two major challenges: Drafting a package that can attract enough GOP votes to clear the House and crafting policy that doesn't undermine the party's politically effective criticism of Obamacare. To avoid those roadblocks, Republicans are signaling that they might delay plans for comprehensive legislation in favor of passing a set of narrowly targeted reforms.
House Majority Leader Eric Cantor, R-Va., is running the process, with an assist from his leadership deputies and top committee chairmen. Rank-and-file Republicans familiar with their work describe it as a diligent attempt to develop workable, conservative health care policy that jettisons what Americans dislike about Obamacare while addressing the problems with health insurance that have lingered since the law was enacted in 2010. Nothing is likely to be ready for consideration before July.
“House Republicans will offer our own solutions that focus on patient-centered care, while reducing costs through increased competition, improving outcomes and expanding choices and coverage,” Cantor told the Washington Examiner in a statement provided by his office. “Repealing Obamacare is a prerequisite, but we will also share our alternative approach with working middle-class families being harmed by that law.”
According to Republican sources, Cantor at the very least wants to craft a midterm campaign agenda for health care that can be used as the basis for legislation next January, in the event that the GOP wins control of the Senate and is in a position to send legislation to President Obama's desk.
Rank-and-file House Republicans are doubtful Cantor will achieve much more than that before Nov. 4. Contributing to the skepticism that a sweeping Obamacare alternative will receive a floor vote is the heated political season — now fully underway — and House Republicans’ recent history of repeated failures to unify behind big-ticket legislation. The caucus is roughly split over what to do, and not along the usual conservative-Establishment lines.
Half of the House majority is aligned with leadership and supports passing a comprehensive alternative to the Affordable Care Act before the Nov. 4 elections. Among them are some of the staunchest conservatives in the House who especially bristle at Democratic charges that they have no ideas for how to reform health care other than repealing Obamacare.
The other half of the caucus also agrees that Republicans should offer an Obamacare replacement. But they prefer to wait until after the midterms, when doing so might be less politically hazardous and not run the risk of distracting voters from the ongoing problems with the Affordable Care Act.
The division, predicted one House Republican who spoke on the condition of anonymity, means that the caucus probably will have to settle for passing a “milquetoast” piece of legislation, or, more likely, releasing a broad list of health care principles.
“The discussions still are going on that are, politically, would we be smart to put out an alternative plan or not? That’s what the debate is about right now,” Rep. Mike Simpson, R-Idaho, said. “You don’t want to give your opponents something to shoot at, and any alternative people are going to be able to shoot at in some way or another.”
House Republicans have reviewed an extensive amount of public and private polling about Obamacare since its rocky rollout began Oct. 1.
Even though the Affordable Care Act’s consistently low approval ratings have positioned the GOP to gain House seats and flip control of the Senate in November, House Republicans have concluded from the data that simply vowing to repeal Obamacare is not enough to capitalize on voters’ disenchantment with the law. To win seats, House Republicans believe they must pair their criticism with a proactive health care agenda of their own.
The latest NBC News/Wall Street Journal poll lends credence to the Republicans' conclusions. In the national survey, only 35 percent of respondents said they thought “President Obama's health care plan” was a “good idea.” And yet, 48 percent said they would be more likely to vote for a Democrat in November who supports “fixing and keeping” the law; 47 percent were more inclined to vote for a Republican who backs “repealing and eliminating” it.
A recent survey jointly conducted by Democratic and Republican pollsters for America's Health Insurance Plans, an industry lobbying group, revealed similar findings. Overall, only 34 percent of respondents expressed support for the law and voters motivated by their disapproval of the statute are more likely to vote this year. But by a margin of 54 percent to 28 percent, they favored “fixing” Obamacare over “totally eliminating” it.
That is why, even after the Republicans' victory last week in Florida in a closely watched special House election fought largely over Obamacare, normally cautious GOP political consultants are recommending that House Republicans develop a health care agenda they can campaign on. One GOP strategist focused on House races said Republicans don't need to pass legislation, but need to be able to tell voters what they would put in place of Obamacare.
“The priority for us, our candidates and especially our members is that they have the ability to talk about what they’re for when it comes to health care,” the strategist said. “Democrats saying we would put the insurance companies back in charge has the capability to resonate."