In her first House bid in 2014, Rep. Barbara Comstock (R-Va.) said her campaign was about growing the economy, creating jobs and “repealing and replacing Obamacare.” She’s not talking about that anymore.
For the first time in nearly a decade, Republican candidates across the country find themselves bereft of what was once their favorite talking point: repealing and replacing President Barack Obama’s Affordable Care Act — and all the havoc they alleged it has wreaked.
That is because the GOP failed dramatically in its efforts last year to roll back the ACA as its first big legislative delivery on the promise of single-party control of Washington from Congress to the White House. That defeat has quickly turned attacks on Obamacare from centerpiece into pariah on the campaign trail, a sudden disappearing act that Democrats are looking to exploit as they seek to regain power in the midterms.
“Yeah, we probably can’t talk credibly about repeal and replace anymore,” said Rep. Tom MacArthur (R-N.J.), a key negotiator of the House-passed version of an ACA rollback that failed in the Senate.
The “repeal and replace” mantra was a mainstay of Republican campaigns for four straight election cycles, propelling the GOP into the House majority in 2010, the Senate majority four years later and in 2016, helping to keep Republicans in power and elect President Trump. Getting rid of Obamacare was a proud theme for the GOPand conservative , which spent hundreds of millions of dollars beating Democrats over the head with charges the law was unaffordable. Trump repeatedly touted permanent elimination of the bill during the campaign and his first year in office but doesn’t often now mention it.
Eighty-four percent of Republican-affiliated health-care ads in 2014 attacked the ACA, while only 11 percent of Democrat-affiliated ads touted it, according to research by the Kaiser Family Foundation and Kantar Media. Out of 849 unique ads that referenced the ACA that year, 87 percent of them backed a Republican candidate and opposed the law.
But since the dramatic defeat of an ACA rollback bill in the Senate last July, many Republican candidates don’t have much to say about health care at all.
Instead, if they do talk about health care on the campaign trail, it is only to say they have been able to change pieces of Obamacare — repealing the individual mandate as part of their 2017 tax overhaul, for instance, and the Trump administration’s push to allow plans to be sold that fall short of ACA standards.
“If I were running, I’d tout that,” said retiring Sen. Jeff Flake (R-Ariz.), referring to the end of the individual mandate.
The problem for the GOP is that a majority of the public wants to move toward more government control of health care. A Washington Post-Kaiser Family Foundation poll released Friday found 51 percent of all Americans, including 54 percent of independents, support a national health plan.
Armed with such evidence, Democrats are eager to seize the moment after years of defending Obamacare, trying to sell it to a somewhat skeptical public and weathering criticism as premiums spiked and insurers dropped out of the marketplaces. And there is evidence that voters see health care as a top issue heading into the midterms, with a HuffPost-YouGov poll showing that most voters picked health care as one of their top two issues in 2018.
Now, the Democrats don’t have to sell Obamacare. Instead, they can target the widely unpopular repeal-and-replace bills passed by the House and tanked by the Senate, which included banner items like curtailing Medicaid expansion in states that adopted it under the ACA.
“We see health care as one of the defining issues of this midterm election,” said David Bergstein, a spokesman for the Democratic Senatorial Campaign Committee. “Voters are incredibly frustrated and angry at how Republicans have sabotaged the health-care system.”
In October, for instance, the Democratic Congressional Campaign Committee ran ads on MSNBC and CNN targeting now outgoing House Speaker Paul D. Ryan (R-Wis.) and his conference for trying to loosen protections for those with preexisting conditions, allow higher insurance premiums for older Americans and ease lifetime limits on coverage.
The DCCC ran radio ads around the same time in 11 GOP-held House districts also charging Republicans’ health-care approach would “gut Medicaid and treatment for opioid addiction.”
In Florida, where Gov. Rick Scott recently announced his challenge to Democratic Sen. Bill Nelson, the DSCC is going after Scott for reversing his stance on expanding Medicaid under the ACA. “Self-serving Scott doesn’t keep his word,” says one of several Google search ads funded by the campaign arm. “He broke his promise to expand health care. Get the facts.”
Disputes over Obamacare were also prominent in the 2017 Virginia gubernatorial race, where Democrat Ralph Northam stressed his hopes of expanding the state’s Medicaid program and ended up beating his Republican opponent Ed Gillespie by a wide margin.
Now Sen. Tim Kaine (D-Va.), up for reelection in 2018, is punctuating his campaign speeches with support for a government health-care plan as a way of further expanding coverage for Americans. “My campaign is focused on a Virginia that works for all — jobs for all, health care for all, education for all, security for all, equality for all,” Kaine said in Charlottesville earlier this month.
GOP advisers say Republicans should promote their efforts to limit Obamacare, pitching themselves as the party that will lower health-care costs. But they stress that Republicans need to come up with a new health-care playbook.
“If you’re an elected official, you have to come to the table with more than just that 2016 messaging,” a GOP strategist said.
The National Republican Congressional Committee is betting that some Democrats are moving too far to the left on health care, and ran digital ads against vulnerable Democrats in eight states last August attacking them for supporting a single-payer system.
And other vulnerable Republicans are still arguing they can deliver on the repeal-and-replace promise if voters only sent a few more of their party to Washington.
Sen. Dean Heller (R) is in a tough reelection race in Nevada and ultimately voted for the Senate rollback bill. He argued that the slim Republican Senate majority hamstrung Republicans’ efforts to eliminate Obamacare.
“I think at the end of the day we end up with 53, 54 seats,” Heller told the Nevada Republican Men’s Club on April 3. “If we can do that, then we can repeal and replace and change the ACA as we know it today.”
When asked last month whether ditching the law is still a realistic possibility for Congress, Sen. Ted Cruz (R-Tex.) insisted that it is.
“It’s a promise virtually every Republican made to voters,” said Cruz, who is also facing an unusually serious challenge from Democratic Rep. Beto O’Rourke (Tex.). Cruz has made Obamacare opposition a signature issue, even forcing a government shutdown in 2013 over defunding it. Cruz said that he will “absolutely” keep hammering on Obamacare. “We need to finish the job,” he argued.
Stu Sandler, a campaign consultant for Bishop who no longer features a repeal promise on his website, dismissed those changes, too, by saying the new issues page reflects the congressman’s accomplishments. He said Bishop’s position “has not changed” on replacing the ACA. “This new website reflects an update for a congressman who has served for two terms and has worked on several pieces of legislation that have been signed into law and are helping the community,” Sandler said.