Republicans expect at least "big changes" to the new health reform law as a result of their efforts, Sen. Lamar AlexanderAndrew (Lamar) Lamar AlexanderGOP lawmakers want Trump to stop bashing Congress The Hill's Morning Report - Sponsored by CVS Health - A pivotal day for House Republicans on immigration GOP, Dem lawmakers come together for McCain documentary MORE (R-Tenn.) said Thursday.

Alexander, the third-ranking Republican member of the Senate, predicted that Republicans would be able to force major changes to the new healthcare system amidst pledges by many GOP candidates that they would seek to repeal the plan in its entirety. 

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The Tennessee Republican said he agreed with President Barack ObamaBarack Hussein ObamaThe true commander in tweet Meghan Markle's pre-royal 'finishing lessons' and an etiquette of equality Hannity on Acosta claim he was tough on Obama: 'Only thing missing were the pom-poms' MORE's assertion that the healthcare bill was a proxy for a debate over the role in government in the U.S.

"And that's the debate we're going to have this year, and it's going to define every congressional race," Alexander told the editorial board of the Chattanooga Times Free Press. "I think the healthcare bill will be the biggest symbol of it."

"As a result of that debate, I think there going to be at least big changes in the bill," Alexander added.

Healthcare is expected to be a central issue in this fall's campaign, and many Republicans have pledged to run on a pledge of repealing in whole the healthcare bill to have passed through Congress, which was signed into law by the president. 

But already, some Republicans have tempered their rhetoric on repeal, including Sens. Richard BurrRichard Mauze BurrSenate confirms Haspel to head CIA The Hill's Morning Report: Mueller probe hits one-year mark Divisions deepen as Mueller probe hits one year MORE (R-N.C.) and Bob CorkerRobert (Bob) Phillips CorkerTrump to hold Nashville rally amid efforts to boost GOP Senate hopeful Kim Jong Un surprises with savvy power plays Tax reform postmortem reveals lethal dose of crony capitalism MORE (R-Tenn.), as well as Rep. Mark KirkMark Steven KirkThis week: Trump heads to Capitol Hill Trump attending Senate GOP lunch Tuesday High stakes as Trump heads to Hill MORE, a Republican candidate for Senate in Illinois.

Those more measured pledges reflect the difficulty facing Republicans in their plans, even if they were to pick up the number of seats predicted in the most generous estimates of this fall's elections. Democrats would still be able to throw up procedural roadblocks in Congress, and Obama could veto any legislation to repeal his signature domestic policy.

At least one Republican, Sen. John McCainJohn Sidney McCainTrump's plan to claw back spending hits wall in Congress Defense bill moves forward with lawmakers thinking about McCain How House Republicans scrambled the Russia probe MORE (Ariz.), did though suggest that the GOP is examining its options to sidestep a presidential veto in order to repeal healthcare law.