WASHINGTON ― In 2017, now-Arizona Sen. Martha McSally really, really wanted to repeal Obamacare. McSally, then a congresswoman, reportedly stood up in the middle of a GOP conference meeting and urged her colleagues to vote for a bill to gut the signature Democratic domestic policy achievement of the past decade, telling them to get this “fucking thing” done.
McSally, who later lost a Senate race for one of Arizona’s seats before being appointed to the other, now has a different outlook. “It’s not about government-run health care or about repealing Obamacare in its entirety,” she said in a campaign video earlier this month. “It’s about bringing the cost down.”
McSally is denying her change in tone marks a significant shift ― she said it was “fake news” when an interviewer asked her about it on Friday. But her new rhetoric, which comes after years of support for a full repeal of Obamacare and after a vote for a plan that would have increased costs and weakened protections for people with preexisting conditions, is representative of how Republican senators up for reelection in 2020 are approaching the law.
Health care remains the No. 1 issue for voters, according to public opinion polling, and Republicans remain on the defensive following a Democratic midterm romp.
“For the last two years, Republicans promised to protect preexisting conditions while trying to gut them. For the next two years, they may pretend to abandon health care repeal, but they’re doing everything they can to repeal, sabotage and overturn it,” said Jesse Ferguson, a top Democratic strategist. “If they were serious about stopping health care repeal, they would be doing something to stop Trump’s Department of Justice from trying to strike down the entire law.”
Democrats are hopeful the Trump administration’s lawsuit, which a federal appeals court is expected to hear sometime in July, keeps health care front and center in the minds of voters. Depending on court rulings and timing, the Supreme Court could rule on the lawsuit in the summer of 2020, not long before voters head to the polls. Democrats also note top Republicans have said the party will make another attempt to repeal Obamacare, given the chance.
The battle could play a key role in determining control of the Senate in 2020. McSally, for instance, is facing a stiff Democratic challenge from former astronaut Mark Kelly, who is married to former Rep. Gabrielle Giffords. Democrats need to pick up at least three seats to gain control of Congress’ upper chamber and have any hope of enacting the party’s agenda.
Asked to clarify her position on Obamacare last week, McSally told HuffPost she believed “the way Obamacare did it was not the way to do it.” However, she quickly acknowledged the changed politics surrounding the law and its impact on the country’s health care system, arguing it ought to be fixed rather than repealed outright.
“We’re now almost 10 years into it, so I deal with the world we’re in, and so let’s figure out an offramp that addresses some of the underlying issues about the cost of health care while also providing more access to health insurance for people on the individual market that still can’t afford health insurance that have preexisting conditions,” McSally said.
Republican congressional leaders have essentially given up on repealing Obamacare ― at least in this Congress. Senate Majority Leader Mitch McConnell (R-Ky.) made clear earlier this year that he has no intention of leading his conference into another fight over the law, despite Trump’s vow to turn the GOP into “the party of health care.” The Kentucky Republican is instead focusing on retaining his majority next year by hammering Democrats over “Medicare for All,” a government-run health care proposal he says will put the country on a dangerous path to socialism.
The GOP’s hope is that by focusing on Medicare for All, they can instead portray Democrats ― even those who don’t support the proposal ― as the extremists hoping to blow up the health care system.
Republicans have offered a number of bills intended to show their commitment to protecting people with preexisting conditions ― a move designed to blunt Democratic attacks over health care in 2020.
Sen. Thom Tillis (R-N.C.), one of the most vulnerable GOP incumbents facing reelection, introduced one such measure this year, allowing him to say he stands with Trump on Obamacare repeal while maintaining his support for the health care law’s most popular provisions.
“It’s gotta be replaced,” Tillis said of Obamacare last week, before brushing off the coming onslaught of health care ads against him in 2020. The North Carolina Republican warned Democrats and their allies planning on taking him on that they would do so “at their own peril because the fact of the matter is the Affordable Care Act is not popular.”
The public still holds largely partisan views on the health reform law, and opinions have remained relatively unchanged since the Republican efforts to repeal it. But according to recent Democratic polling, the electorate still prefers Congressional Democrats’ approach to the issue over congressional Republicans’ approach by a double-digit margin.
And as much as Republicans point to Tillis’ bill as evidence of their desire to protect people with preexisting conditions, it has little chance of passing in a divided Senate. Moreover, experts say it would allow insurers to exclude coverage of some preexisting conditions anyway, calling its provisions a “mirage.”
Other Republicans who are facing a competitive reelection fight are similarly choosing their words carefully when discussing Obamacare.
“I was never really a repeal-and-replace guy. I wanted to fix things,” Sen. David Perdue (R-Ga.), who voted to repeal Obamacare in 2017, told HuffPost. Like other Republicans, Perdue views Obamacare as fundamentally “broken,” calling it a “disaster.” But he, too, talked up the need to maintain some of its core elements.
“Preexisting conditions have to continue to be solved,” Perdue said. “We have to figure out a way that people don’t lose their insurance when they lose their job, and then we have to get after the real causes of health care costs.”