Nearly 14 months later, reminded of that day, Sen. John Cornyn (R-Tex.) broke into a knowing laugh, fully aware that Trump’s “party of health care” declaration went nowhere. Within days, Republicans gave up on trying to draft a replacement for the Affordable Care Act, and after some hesitation this month, the Trump administration plowed ahead with its effort to get the Supreme Court to rule the 2010 law unconstitutional even as no substitute is being drafted on Capitol Hill.
Now faced with a viral pandemic that has driven more than 36 million workers to file unemployment claims in eight weeks, Republicans find themselves heading into an election season still lacking any health plan.
Cornyn summed up the short-term approach as just hoping that the money Congress has poured into the social safety net over the past two months would keep people from falling through the cracks of the health-care system, an approach they may have to keep doing throughout the year.
“When you have a full-employment economy and everybody is working, you know that’s one thing. But now we don’t have that,” Cornyn said Thursday in an interview. “Obviously, we hope to get back there, but there may be some other things we need to do, just like we’ve done on spending $3 trillion to deal with the emergency to get people get through this.”
A small but vocal GOP bloc views the administration strategy as bad policy and even worse politics.
“I think it does make it difficult for us to have credibility when that is still out there. To me, we shouldn’t worry about that; we should be focusing on reforming the health-care system itself and not paying attention to the ACA,” Sen. Mike Braun (R-Ind.) said Thursday.
Elected in 2018, Braun previously ran a small auto-parts distribution company that offered insurance that protected those with preexisting conditions. That, along with trying to lower overall costs, should be the goal of Republicans, Braun says, not some constitutional argument against the foundation of a 10-year-old law that covers 22 million Americans
“I always thought that was an inherent contradiction, not only for the administration but most of my cohorts. I think that’s a waste of time,” he said.
That followed sharp criticism from Sen. Lamar Alexander (R-Tenn.) over the administration’s decision to push ahead with the legal fight after Attorney General William P. Barr tried to convince Trump’s inner circle against such a course. The foundation of the latest challenge to the law, already upheld twice by the Supreme Court, comes from the 2017 tax-cut legislation that removed a tax penalty against individuals who declined to get insurance.
“I thought the Justice Department’s argument was really flimsy,” Alexander said last weekend on NBC’s “Meet the Press. “What they are arguing was that when we voted to get rid of the individual mandate, we voted to get rid of Obamacare. I don’t know one single senator that thought that.”
Republicans were already on shaky political ground on the issue. In a December Quinnipiac University poll, 51 percent of voters said Democrats could do a better job on health care, while 38 percent favored Republicans, part of a steady double-digit margin for at least three years for Democrats.
Most Republicans acknowledge those numbers are now worse, with more than 87,000 dead Americans providing the backdrop for a looming Democratic campaign in which they go on offense on an issue with which they have struggled for years.
Cornyn found himself on the defensive after telling Texas media last weekend that the “good news” for those who lost jobs is that they might qualify for insurance through the ACA, despite his many votes and concerted effort to overturn the law.
On Thursday, he said he stands by his “pretty clear record” in opposing the law and was just stating fact for those Texans who lost jobs.
“If you’re qualified for Medicaid, you could get Medicaid. If you lose your job, you could qualify for the Affordable Care Act. And it’s simply a fact. I still wish we had more choices available to people at a price they could afford, rather than have younger people subsidize older people,” Cornyn said.
Republicans won back the Senate majority in 2014 with a full-frontal assault on the ACA, which had formally debuted in late 2013 amid a bungled bureaucratic rollout.
Senators in that class will soon face their first reelection, each after voting in July 2017 to repeal what they derided as Obamacare without having any law ready to replace it.
Most Republicans wanted to move on from the issue, but many GOP strategists blamed the loss of the House majority in the 2018 midterms on that failed repeal effort. In March 2019, that prompted Trump’s “party of health care” declaration, which most GOP senators promptly ignored.
Braun said he appreciated the White House push and there were some early ideas that could have provided a modest platform for fixing some key issues, but too many powerful Republicans did not want to confront the issue.
“It was mostly our party that was, you know, I think a little beholden to the health-care industry,” said Braun, who suggested too many Republicans were in “cahoots” with parts of the industry.
Republicans are heading into an election with almost every GOP candidate claiming to support guarantees of coverage for those with preexisting conditions, as the administration is trying to gut the entire ACA, including those same protections.
“It still put us in a clumsy position to be credible on health-care issues, because we weren’t really behind it,” Braun said. “Now, every Republican is for covering preexisting conditions, but we were late to the game and the discussion.”