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Inside House Leadership's 2014 Obamacare Strategy

Conservatives want a replacement bill, but GOP sources say Boehner's looking for a small package of poll-tested health provisions for the election-year agenda.



House Republicans will try to coalesce around a health care strategy when they huddle behind closed doors this week, but whatever emerges almost certainly won't be the comprehensive "alternative" to Obamacare that conservatives have long been agitating for.

Speaker John Boehner said recently that members would devote significant time to discussing health care at their annual conference retreat, and predicted House Republicans would "come forward with a plan to replace Obamacare" upon returning to Washington. But the speaker's words were met with skepticism by conservative lawmakers and aides, who have long feared Boehner's team would snub a pair of sweeping Obamacare replacement plans that have widespread support in the House GOP.


Now, as Republicans head to rural Maryland for their three-day getaway, those fears are about to be realized.

According to multiple lawmakers and staffers familiar with the situation, House GOP leadership will not endorse either of the comprehensive bills—one written by Rep. Tom Price of Georgia, and the other crafted by Rep. Phil Roe of Tennessee and a working group convened by Republican Study Committee Chairman Steve Scalise. Instead, Boehner's team is expected to survey the conference in search of the most popular and poll-tested individual policies, assemble them as a hodgepodge health care package, and spend the election season emphasizing those specific ideas rather than pushing a full substitute.

This cautious approach reflects a fundamental desire among top Republicans to keep the focus on the troubles that have surrounded Obamacare's rollout and not distract from the law's shortcomings by hawking what would certainly be a polarizing alternative. Just as important, though, are the internal dynamics. Republicans can't count on Democratic support for a health care package, so whatever they bring to the floor must have 217 GOP votes. And while both GOP measures are popular throughout the conference, neither is a safe bet to win such sweeping support.


"My suspicion is that that support is not as broad as either my bill or the RSC bill," Price, who meets regularly with leadership about health care strategy, recently told National Journal. He added: "We don't get any help from the other side. So the question is: Where is the sweet spot for our conference to be able to rally around the common themes and common denominators for health care?"

In conversations with Price and other Republicans, several policy proposals emerged as the likeliest to garner near-unanimous support in the House GOP. These ideas are nothing new: Purchasing health insurance across state lines, expanding access to Health Savings Accounts, and limiting the scope of medical malpractice lawsuits are popular, poll-tested health care policies that conservatives have long advocated.

These proposals, and perhaps others, could be neatly packaged and promoted as the House GOP's targeted set of health care solutions. Lawmakers could rebut President Obama's assertion that they lack ideas of their own by promoting relatively safe, inoffensive policies that don't distract from Obamacare. It's the preferred route for Republicans who fear that putting forth a complex health care alternative—especially one that covers far fewer Americans than does Obamacare—could damage the GOP's chances of winning back the Senate in November.

"The best way to achieve conservative policy goals is to hold the House and take over the Senate," one House leadership aide said.


But House conservatives may not be satisfied with such a small-ball approach. Some have spent months, if not years, crafting comprehensive solutions and lobbying leadership to strike a bold contrast against Obamacare. In their view, 2014 presents an ideal opportunity to do so.

"I say the election year is the perfect time to do it. We run in two-year cycles. There's always going to be some excuse not to do something," said Scalise, who has promised to push the RSC plan this weekend. "We didn't run for Congress—I sure didn't run for Congress—to sit back and be afraid of getting involved in the debate. I'm excited about the things we stand for. I want to put them on paper. And I want to have votes on the House floor so people have to pick a side."

A trio of Republican senators this week introduced their alternative to Obamacare, a plan predicated on consumers shouldering a higher share of their health care costs. Of course, House Republicans understand that whatever solution they coalesce around in Cambridge, Md.—if any at all—will take on greater national definition because of their ability to put legislation on the floor for a defining, election-year vote.

This article appears in the January 30, 2014 edition of NJ Daily.

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