GOP seeks health care reboot after 2018 losses

Republicans are looking for a new message and platform to replace their longtime call to repeal and replace ObamaCare, after efforts failed in the last Congress and left them empty-handed in the 2018 midterm elections. 

Republican strategists concede that Democrats dominated the health care debate heading into Election Day, helping them pick up 40 seats in the House. 

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President TrumpDonald John TrumpMark Kelly clinches Democratic Senate nod in Arizona Trump camp considering White House South Lawn for convention speech: reports Longtime Rep. Lacy Clay defeated in Missouri Democratic primary MORE hammered away on immigration in the fall campaign, which helped Senate Republican candidates win in conservative states but proved less effective in suburban swing areas, which will be crucial in the 2020 election. 

While Trump is focused on raising the profile of illegal immigration during a standoff over the border wall, other Republicans are quietly looking for a better strategy on health care, which is usually a top polling issue.

“Health care is such a significant part of our economy and the challenges are growing so great with the retirement of the baby boomers and the disruption brought about by ObamaCare that you can’t just cede a critically important issue to the other side,” said Whit Ayres, a Republican pollster.

“Republicans need a positive vision about what should happen to lower costs, expand access and protect pre-existing conditions,” he added. “You’ve got to be able to answer the question, ‘So what do you think we should do about health care?’ ” 

A recent Associated Press-NORC Center for Public Affairs Research poll showed that 49 percent of respondents nationwide said government should tackle health care as a top priority, second only to economic concerns.

During his 2016 presidential campaign, Trump vowed to lower prescription drug costs, but the Republican-controlled Congress over the past couple of years focused on other matters. House Democrats who are now in the majority say they are willing to work with the White House on drug pricing, but it’s unclear if Republicans will take on the powerful pharmaceutical industry, long considered a GOP ally. 

Republican candidates made the repeal of ObamaCare their main message in the 2010, 2012, 2014 and 2016 elections. But after repeal legislation collapsed with the late Sen. John McCainJohn Sidney McCainMark Kelly clinches Democratic Senate nod in Arizona Prominent conservatives question Jerry Falwell Jr. vacation photo NRCC poll finds McBath ahead of Handel in Georgia MORE’s (R-Ariz.) famous “no” vote, the party’s message became muddled and Democrats went on the offensive. 

Some Republicans continued to work on alternative legislation, such as a Medicaid block grant bill sponsored by Sens. Lindsey GrahamLindsey Olin GrahamThe Hill's Campaign Report: Even the Post Office is political now | Primary action tonight | Super PACS at war Graham leads Democratic challenger Harrison by 1 point in South Carolina: poll The Global Fragility Act provides the tools to address long-term impacts of COVID MORE (S.C.) and Bill CassidyWilliam (Bill) Morgan CassidyStimulus checks debate now focuses on size, eligibility On The Money: GDP shrinks by record amount in second quarter amid virus lockdowns | Jobless claims rise for second straight week | McConnell tees up fight on unemployment benefits GOP senators propose stimulus checks of ,000 for both adults and children MORE (La.), but it failed to gain much traction and the GOP health care message was left in limbo. 

“We should be the guys and gals that are putting up things that make health care more affordable and more accessible,” said Jim McLaughlin, another Republican pollster. “No question Democrats had an advantage over us on health care, which they never should have had because they’re the ones that gave us the unpopular ObamaCare.”

“We need to take it to the next level,” he added. “You can’t get [ObamaCare] repealed. Let’s do things that will make health care more affordable and more accessible.” 

Senate Health Committee Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderNegotiators hit gas on coronavirus talks as frustration mounts Chamber of Commerce endorses Ernst for reelection Pelosi huddles with chairmen on surprise billing but deal elusive MORE (R-Tenn.), a close ally of Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellTrump's election delay red herring On The Money: Unemployment debate sparks GOP divisions | Pandemic reveals flaws of unemployment insurance programs | Survey finds nearly one-third of rehired workers laid off again OVERNIGHT ENERGY: Trump signs major conservation bill into law | Senate votes to confirm Energy's No. 2 official | Trump Jr. expresses opposition to Pebble Mine project MORE (R-Ky.), says finding an answer to that question will be his top priority in the weeks ahead. 

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Alexander will be meeting soon with Sen. Patty MurrayPatricia (Patty) Lynn MurrayPelosi huddles with chairmen on surprise billing but deal elusive House approves two child care bills aimed at pandemic GOP, Democratic relief packages B apart on vaccine funding MORE (Wash.), the top Democrat on the Health Committee, as well as Sens. Chuck GrassleyCharles (Chuck) Ernest GrassleyOn The Money: Unemployment debate sparks GOP divisions | Pandemic reveals flaws of unemployment insurance programs | Survey finds nearly one-third of rehired workers laid off again Unemployment debate sparks GOP divisions Tensions flare as GOP's Biden probe ramps up  MORE (R-Iowa) and Ron WydenRonald (Ron) Lee WydenTensions flare as GOP's Biden probe ramps up  Frustration builds as negotiators struggle to reach COVID-19 deal On The Money: Unemployment benefits to expire as coronavirus talks deadlock | Meadows, Pelosi trade criticism on stalled stimulus talks | Coronavirus recession hits Social Security, Medicare, highway funding MORE (D-Ore.), the leaders of the Senate Finance Committee, to explore solutions for lowering health care costs. 

“I’ll be meeting with senators on reducing health care costs,” Alexander told The Hill in a recent interview. “At a time when one-half of our health care spending is unnecessary, according to the experts, we ought to be able to agree in a bipartisan way to reduce that.”

He recently announced his retirement from the Senate at the end of 2020, freeing him to devote his time to the complex and politically challenging issue of health care reform without overhanging reelection concerns. 

Alexander sent a letter to the center-right leaning American Enterprise Institute and the center-left leaning Brookings Institution last month requesting recommendations by March 1 for lowering health care costs.  

In a Dec. 11 floor speech, Alexander signaled that Republicans want to move away from the acrimonious question of how to help people who don’t have employer-provided health insurance, a question that dominated the ObamaCare debate of the past decade, and focus instead on how to make treatment more affordable.  

He noted that experts who testified before the Senate in the second half of last year estimated that 30 to 50 percent of all health care spending is unnecessary. 

“The truth is we will never have lower cost health insurance until we have lower cost health care,” Alexander said on the floor. “Instead of continuing to argue over a small part of the insurance market, what we should be discussing is the high cost of health care that affects every American.”

A Senate Republican aide said GOP lawmakers are prepared to abandon the battle over the best way to regulate health insurance and focus instead on costs, which they now see as a more fundamental issue. 

“There’s no point in trying to talk about health insurance anymore. Fundamentally, insurance won’t be affordable until we make heath care affordable, so we have to do stuff to reduce health care costs,” said the aide. 

“There are lots of things that can be done to reduce health care costs that aren’t insurance, that aren’t necessarily partisan,” the source added. 

“We’re looking at ideas that aren’t necessarily partisan and don’t advance the cause of single-payer health care and don’t advance the cause of ‘only the market’ but are about addressing these drivers of health care cost and try to change the trajectory.” 

Another key player is Cassidy, a physician and member of the Health and Finance committees, who has co-sponsored at least seven bills to improve access and lower costs. 

One measure Cassidy backed is co-sponsored by Sen. Tina SmithTina Flint SmithCook Political Report shifts several Senate races toward Democrats On The Money: GOP mulls short-term unemployment extension | White House, Senate GOP strike deal on B for coronavirus testing Senate Democrats call for support for pork producers in coronavirus aid package MORE (D-Minn.), and would develop innovative ways to reduce unnecessary administrative costs.

Another measure Cassidy co-sponsored with Sens. Maria CantwellMaria Elaine CantwellThe Hill's Coronavirus Report: Mike Roman says 3M on track to deliver 2 billion respirators globally and 1 billion in US by end of year; US, Pfizer agree to 100M doses of COVID-19 vaccine that will be free to Americans Overnight Energy: Supreme Court reinstates fast-track pipeline permit except for Keystone XL | Judge declines to reverse Dakota Access Pipeline shutdown OVERNIGHT ENERGY: Watchdog accuses Commerce of holding up 'Sharpiegate' report | Climate change erases millennia of cooling: study | Senate nixes proposal limiting Energy Department's control on nuclear agency budget MORE (D-Wash.) and Tom CarperThomas (Tom) Richard CarperHouse committee requests hearing with postmaster general amid mail-in voting concerns Senators press Postal Service over complaints of slow delivery Barrasso nuclear bill latest GOP effort to boost uranium mining MORE (D-Del.) would allow individuals to pay for primary-care service from a health savings account and allow taxpayers enrolled in high-deductible health plans to take a tax deduction for payments to such savings accounts.

He is also working on a draft bill to prohibit the surprise medical billing of patients. 

McConnell signaled after Democrats won control of the House in November that the GOP would abandon its partisan approach to health care reform and concentrate instead on bipartisan proposals to address mounting costs, which Democratic candidates capitalized on in the fall campaign.

Asked about whether the GOP would stick with its mission to repeal ObamaCare, McConnell said “it’s pretty obvious the Democratic House is not going to be interested in that.”