Republicans are not well-equipped for the coming fight over health care, widely viewed as strong Democratic turf.
Mitt Romney arrived at the House Republicans’ late-January retreat to a room that hardly needed a pep talk. Their vote against the Democrats’ Economic Recovery Act had revved them up; all Romney needed to tell them was that they “stood strong,” and that their fellow Republicans stood proud. Romney, who’d testified at the sole House Republican hearing on the stimulus, urged them to take one step further.
“We remain the confident voice of limited government and free enterprise,” said Romney. “These principles are going to face another test when it comes to health care. We should be first to propose a Republican plan to bring health insurance to all Americans, one based on market dynamics, free choice, and personal responsibility. Whatever direction we take, let’s not simply react to what the Democrats do.”
The House Republicans took Romney’s advice. Six days after his speech the party announced the formation of the House GOP Health Care Task Force, an ad hoc group of 16 members that would, in the words of Rep. Roy Blunt (R-Mo.) craft “real solutions to improve our health care system by putting patients before paperwork and frivolous lawsuits.”
As the stimulus debate winds to a close, it would appear that House Republicans are picking up their playbook and taking what they need for the coming battle over health care reform. But based on conversations with Republicans inside and outside of Congress, the right does not expect the strategy to work with health care, an issue that all consider strong Democratic turf. The Romney concept of “pre-empting” Democrats is a rearguard effort, something that will produce a list of Republican health care policies that the party can point to when Democrats charge them with obstruction, as they did with their for-show versions of a stimulus package. Republicans, who have developed a consensus about the virtues of tax cuts, have not done that same work on health care.
“Republicans have been absolutely dreadful on health care,” said John Goodman, the president of the National Center for Policy Analysis, who devised the first Health Savings Accounts in the 1980s and who helped craft Sen. John McCain’s health care policy in the 2008 campaign. “They’re always on defense, they always let the Democrats take the initiative, then they scramble to come up with alternatives.”
While the Republicans’ stimulus working group came out of the gate with a media strategy, a public hearing (with guests Romney and former eBay CEO Meg Whitman) and an uncontroversial package of tax cuts, the health care group is operating below the radar and concentrating on message before policy. At their first meeting, Republicans did not meet with heads of the health care industry or with policy wonks, but with Dave Winston of the Winston Group, a polling firm that does the bulk of its work for the GOP. The second meeting brought in Steve Burd, the CEO of Safeway, the supermarket chain that has donated a total of $18,498 to members of the task force, according to Opensecrets.org.
Reached by TWI Thursday, Winston confirmed that he showed Republicans polling data on whether Americans favor “private” or “government” solutions for health care. “By an overwhelming margin, people prefer private over government-run health care,” said Winston, “but you have this big group who say [they] want some combination of private and public solutions. And of course, that’s what we have now.”
Winston recommended that Republicans pull their plans off the shelf and “modernize them,” while warning them that their disadvantage on the issue is steep—Americans trust Democrats over Republicans on health care by anywhere from 15 to 30 percentage points.
Some critics of the House Republicans speculated that the health care task force was a vehicle for spin, not a sweatshop where ideas would be hammered out. The fact that the effort is headed by Blunt, the former whip whose portfolio has shrunk since handing that job to Rep. Eric Cantor (R-Va.), perplexed some analysts who consider the less senior members of the task force, such as Rep. Ryan, more serious about health care.
“Paul Ryan is a real force in that conference,” said Len Nichols, the director of the Healthy Policy Program at the progressive New America Foundation, and the senior health care adviser for the Office of Management and Budget during President Clinton’s 1993-1994 push. “Ryan ought to be chairing this. But the Republicans don’t ask me what to do.”
Brendan Buck, a spokesman for task force member Rep. Tom Price (R-Ga.) disputed the idea that Republicans were “reactionary” on health care. “He has a comprehensive bill that’s he’s introduced every Congress,” said Buck. “That’s not reactive.”
Since the last significant health care reform, the 2003 passage of the Medicare Prescription Drug, Improvement and Modernization Act, other Republican members in the House—not just Price—have introduced health care bills that propose reforms such as a refundable tax credit for health insurance and letting consumers purchase health care plans across state lines. But According to Goodman and other free-market health care reform advocates, the party has never taken reform seriously enough to come up with an agenda that can compete with the Democratic agenda.
“I don’t like it,” said Robert Moffit, the director of the Center for Health Policy Studies at the conservative-leaning Heritage Foundation, “but there are people who mouth things about choice and free markets and don’t know what they’re saying.”
The Republicans’ stimulus playbook will be harder to apply to health care because the Senate, where Democrats had to work to broker a stimulus deal, is a softer sell on health care reform. Even after the losses of 2006 and 2008, the Senate includes several senior Republicans from safe seats who have been breaking bread with Democrats over health care. Sen. Ron Wyden (D-Oregon), a dark horse candidate for Secretary of Health and Human Services, has collected five Republican co-sponsors for his Healthy Americans Act, which would cover uninsured Americans through, among other policy changes, employer taxes. Sen. Bob Bennett (R-Utah), a veteran of the 1993-1994 health care battle who wanted to make a deal with Democrats, is Wyden’s chief co-sponsor.
“He’s smart as hell,” said Nichols of Bennett, “and he wants some sort of bi-partisan reform.”
In their battle against the stimulus, Republicans could count not just on party unity, but ideological unity—few members of either House agree with the Democrats’ Keynsian approach to the economic crisis. On health care, the GOP’s message is far from figured out. While January’s stimulus working group ran a tight press shop that connected reporters to its members, calls to several of the health care task force members went unreturned while Rep. Dave Camp (R-Mich.) postponed an interview.
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