GOP struggles to replace ObamaCare without losing voters

Just before Louisiana Gov. Bobby Jindal revealed his plan to replace ObamaCare last year, he sat down with 15 of Washington’s top conservative healthcare wonks to discuss it. They didn’t approve.

“Near the end, they said, ‘You make a good point, but what you’ve put forward, we just don’t think it’s politically viable,’” Jindal’s long-time adviser Curt Anderson recalled in an interview this week.

{mosads}To his surprise, he said the group agreed the next GOP nominee couldn’t entirely roll back ObamaCare for fear of losing votes from millions already with coverage. In other words, even ObamaCare’s toughest critics say that parts of the law are here to stay.

The 2016 election will mark the first time Republicans will be running against Obamacare since its biggest pieces have gone into effect, including billions of dollars of subsidies that have helped millions to gain coverage.

Already, GOP strategists are getting heartburn about how to fight against ObamaCare without turning away those who are benefitting.

“Obviously the biggest risk is being perceived as being the Grinch who stole someone’s healthcare,” said Josh Withrow, legislative affairs manager for the conservative group Freedom Works.

“We should be focusing on the fact that healthcare is too expensive. I know it’s not as easy a message to sell as, ‘We’re going to make sure everyone has a plan, but it’s an attempt that has to be made,” he added.

It’s a particularly tough test for a party that remains bitterly divided about how to replace the healthcare law even five years after its passage.

Many in the GOP believe that healthcare offerings in 2016 need to offer specific sweeteners for voters already reaping rewards from ObamaCare. But others, led by Jindal, are outraged by anything that might resemble ObamaCare.

“It’s like the Republican party is basically saying, ‘Well we lost on this, we’ll just come up with our own entitlement program and we’ll run it better.’ They think it’s too late,” Anderson said.

That divide within the GOP became clear this week as Jindal voiced harsh criticism for the healthcare vision laid out by Wisconsin Gov. Scott Walker, even as it received praise across Washington.

Blasting Walker’s plan as “ObamaCare lite,” Jindal said his rival’s healthcare ideas were so liberal that they were dishonoring the Fourth of July. “When did conservatism die?” he asked.

But Walker’s plan – which ditches ObamaCare for a system of age-based refundable tax credits – has been regarded highly by conservative healthcare consultants. He also proposes protections for people with pre-existing conditions and people with the lowest incomes – two of the most popular elements of the Affordable Care Act.

Walker’s plan eliminates all ObamaCare mandates and shrinks or eliminates many of the protections offered under ObamaCare, including stripping millions of dollars from programs like Medicaid. But it shows that Walker, like his GOP rivals, are paying attention to the politics of a post-ObamaCare world.

“Candidates are loathe to walk away from the idea of helping people with pre-existing conditions or providing subsidies to make insurance more affordable,” said Larry Levitt, vice president at the nonpartisan Kaiser Family Foundation.

The Wisconsin governor’s ideas are not new. Instead, he has stitched together the most popular parts of existing conservative plans – a move that’s likely to be echoed by other GOP candidates who want to keep their ranking, or move up, in the polls.

“Most of what other Republicans will say will be variations of [Walker’s]. They’re not going to fundamentally depart from this,” predicted Tom Miller, who advised former GOP nominee John McCain.

“Could you come up with other things? Yeah, but that’d be taking some risks,” added Miller, who is now an adviser for the American Enterprise Institute.

Strategists agree that as candidates put together their policy platforms, healthcare is one of the most difficult because it has been the most divisive.

“‘Politically viable’ – that phrase is something that you hear a lot in the healthcare community. It tends to shut down a lot of creative thinking in terms of the direction we should be going,” added Dan Holler, communications director for Heritage Action for America.

Holler said pushing back against ObamaCare was a weak point for former nominee Mitt Romney, and proven one reason for his loss in 2012.

“What hasn’t happened yet is that the Republican party, since 2008, hasn’t rallied around a singular big idea [on healthcare],” Holler said, though he said it was “premature” to offer specific feedback on 2016 candidates’ plans. 

Even voters who want it repealed can’t agree on what should replace it.

Of the 28 percent of voters who support a full repeal of ObamaCare, half think Congress should draw up a plan, while the rest say nothing is needed in its place, according to a poll by Kaiser Family Foundation released this week.

With the lack of clear mandate from voters, few presidential candidates are making it a priority to roll out their ideas for replacement.

Billionaire businessman Donald Trump, who is leading most national polls, recently said he would replace the law “with something terrific.” When asked about his plan, another candidate, Sen. Rand Paul (R-Ky.), recently said, “We could try freedom for awhile.”

The absence of healthcare debate on the campaign trail is providing fuel for Democratic presidential frontrunner Hillary Clinton.

Clinton’s campaign released a web video last week hitting her GOP rivals on ObamaCare – featuring both Trump and Paul’s comments – to attack the party for relying “primarily on repeal alone as their approach to health care.”