Republicans expect at least "big changes" to the new health reform law as a result of their efforts, Sen. Lamar AlexanderLamar AlexanderThe Hill's Whip List: Senate ObamaCare repeal bill Trump administration pays June ObamaCare subsidies to insurers Republicans and the lost promise of local control in education 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 ObamaTrump breaks with tradition, forgoes Ramadan dinner Trump: 'Why no action' from Obama on Russian meddling? Dems look to defense bill to put pressure on Trump 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 BurrSenate intel panel to hold hearing on Russian meddling in Europe Overnight Tech: Uber CEO resigns | Trump's Iowa tech trip | Dems push Sessions to block AT&T-Time Warner deal | Lawmakers warned on threat to election systems | Overnight Cybersecurity: Obama DHS chief defends Russian hack response | Trump huddles on grid security | Lawmakers warned about cyber threat to election systems MORE (R-N.C.) and Bob CorkerBob CorkerPolicymakers forget duty to protect taxpayers from financial failures Overnight Defense: GOP chairman moves ahead with 0B defense bill | Lawmakers eye 355 ship navy | Senate panel seeks answers on shoot down of Syrian jet Overnight Cybersecurity: Trump tweetstorm on Russia probe | White House reportedly pushing to weaken sanctions bill | Podesta to testify before House Intel MORE (R-Tenn.), as well as Rep. Mark KirkMark KirkWhy Qatar Is a problem for Washington Taking the easy layup: Why brain cancer patients depend on it The Mideast-focused Senate letter we need to see 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 McCainFrustrated Dems say Obama botched Russia response Coats: Trump seemed obsessed with Russia probe The Hill's Whip List: Senate ObamaCare repeal bill MORE (Ariz.), did though suggest that the GOP is examining its options to sidestep a presidential veto in order to repeal healthcare law.