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 TrumpTrump passes Pence a dangerous buck Overnight Health Care — Presented by American Health Care Association — Trump taps Pence to lead coronavirus response | Trump accuses Pelosi of trying to create panic | CDC confirms case of 'unknown' origin | Schumer wants .5 billion in emergency funds Trump nods at reputation as germaphobe during coronavirus briefing: 'I try to bail out as much as possible' after sneezes 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 McCainMeghan McCain says Steyer should drop out: 'I hate that guy' Sanders says idea he can't work with Republicans is 'total nonsense' GOP casts Sanders as 2020 boogeyman 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 Morning Report - Sanders takes incoming during intense SC debate Congress eyes killing controversial surveillance program Democrats duke it out in most negative debate so far MORE (S.C.) and Bill CassidyWilliam (Bill) Morgan CassidyThe Hill's Morning Report — AG Barr, GOP senators try to rein Trump in Overnight Health Care: Nevada union won't endorse before caucuses after 'Medicare for All' scrap | McConnell tees up votes on two abortion bills | CDC confirms 15th US coronavirus case Overnight Defense: Senate votes to rein in Trump war powers on Iran | Pentagon shifting .8B to border wall | US, Taliban negotiate seven-day 'reduction in violence' 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 AlexanderLawmakers raise alarms over Trump coronavirus response Bill Barr is trying his best to be Trump's Roy Cohn The Trump administration's harmful and immoral attack on children MORE (R-Tenn.), a close ally of Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellOvernight Health Care — Presented by American Health Care Association — Trump taps Pence to lead coronavirus response | Trump accuses Pelosi of trying to create panic | CDC confirms case of 'unknown' origin | Schumer wants .5 billion in emergency funds Push for national popular vote movement gets boost from conservatives To avoid November catastrophe, Democrats have to KO Sanders 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 MurrayLawmakers raise alarms over Trump coronavirus response Public health experts raise alarm as coronavirus spreads Overnight Health Care: Senate panel to hold hearing on US coronavirus response | Dems demand Trump withdraw religious provider rule | Trump Medicaid proposal sparks bipartisan backlash MORE (Wash.), the top Democrat on the Health Committee, as well as Sens. Chuck GrassleyCharles (Chuck) Ernest GrassleyMcSally unveils bill to lower drug prices amid tough campaign Ernst endorses bipartisan Grassley-Wyden bill to lower drug prices Overnight Health Care: Nevada union won't endorse before caucuses after 'Medicare for All' scrap | McConnell tees up votes on two abortion bills | CDC confirms 15th US coronavirus case MORE (R-Iowa) and Ron WydenRonald (Ron) Lee WydenHillicon Valley: Dems cancel surveillance vote after pushback to amendments | Facebook to ban certain coronavirus ads | Lawmakers grill online ticketing execs | Hacker accessed facial recognition company's database On The Money: Coronavirus complicates Fed decision on rates | Schumer wants .5B in emergency virus funding | Dems offer bill to reverse Trump on military money for wall Hillicon Valley: Democrats cancel surveillance vote over pushback to amendments | Lawmakers grill Ticketmaster, StubHub execs over online ticketing | 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 SmithDemocratic senators ask FDA to ban device used to shock disabled students Trump pick for Fed seat takes bipartisan fire Biden leads 2020 pack in congressional endorsements MORE (D-Minn.), and would develop innovative ways to reduce unnecessary administrative costs.

Another measure Cassidy co-sponsored with Sens. Maria CantwellMaria Elaine CantwellThree lessons from BIPA for data privacy legislation Swing votes steal spotlight in marathon Trump impeachment Q&A Hillicon Valley: UK allows Huawei to build 5G in blow to Trump | Lawmakers warn decision threatens intel sharing | Work on privacy bill inches forward | Facebook restricts travel to China amid virus MORE (D-Wash.) and Tom CarperThomas (Tom) Richard CarperOvernight Energy: Critics pile on Trump plan to roll back major environmental law | Pick for Interior No. 2 official confirmed | JPMorgan Chase to stop loans for fossil fuel drilling in the Arctic White House effort to roll back bedrock environmental law spurs strong opposition Where do we go from here? Conservation can show the way 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.”