WASHINGTON — Republicans are abandoning their long crusade to repeal the Affordable Care Act, making the 2022 election the first in more than a decade that won’t be fought over whether to protect or undo President Barack Obama’s signature achievement.
The diminished appetite for repeal means the law — which has extended health care coverage to millions of people and survived numerous near-death experiences in Congress and the courts — now appears safer than ever.
With slightly more than a month before the next election, Republicans in Congress and on the campaign trail aren’t making an issue of Obamacare. None of the Republican Senate nominees running in eight key battleground states have called for unwinding the ACA on their campaign websites, according to an NBC News review. The candidates scarcely mention the 2010 law or health insurance policy in general. And in interviews on Capitol Hill, key GOP lawmakers said the desire for repeal has faded.
“I think it’s probably here to stay,” said Sen. John Cornyn, R-Texas, a close ally of Senate Minority Leader Mitch McConnell, R-Ky., and a former chair of the GOP’s campaign arm.
The new “Commitment to America” from House Minority Leader Kevin McCarthy, R-Calif., which outlines the agenda of a potential GOP majority, makes no mention of the ACA, issuing vague calls to “personalize care” and “lower prices through transparency, choice and competition.”
At least one Republican running in a contested race this fall has praised core components of the far-reaching health care law, which passed with only Democratic votes.
“I’m opposed to repealing the Affordable Care Act,” said Joe O’Dea, the Republican candidate facing Democratic Sen. Michael Bennet in blue-leaning Colorado. “There were real problems with Obamacare the way it was originally enacted, but a lot of those problems have been addressed by Congress and the courts, and the ACA’s protection for individuals with pre-existing conditions was one of the most important reforms passed in a generation.”
Sen. Rick Scott, R-Fla., the party’s campaign chief, avoids the ACA in his otherwise aggressive governing agenda. Asked whether he wants to undo the 2010 law, Scott said, “I don’t think about any one bill out there.” He said Republicans should do “a variety of things” about health care, like reining in Medicare spending.
Even the most hard-core conservatives, who still want to roll back parts of the law, want to reframe the debate away from the ACA, a major shift after years of leaning in to such rhetoric.
“No offense, that’s an old question,” Rep. Chip Roy, R-Texas, a member of the hard-right Freedom Caucus, said when he was asked about repealing Obamacare.
“Why don’t we go on offense as Republicans and not get trapped into the question about repealing the ACA? Our health care system was garbage by government regulation before the ACA. The ACA just made it worse,” Roy said.
A budget plan released in June by Rep. Jim Banks, R-Ind., who chairs the conservative Republican Study Committee, proposes to “unwind the ACA’s Washington-centric approach” and consider other solutions for pre-existing conditions. But when asked whether repealing the law should be part of the Republican agenda if the party recaptures the House this fall, Banks said, “I’ll defer to leader McCarthy on what that agenda will look like.”
Rep. Mike Gallagher, R-Wis., a member of the Republican Study Committee, was blunter when he was asked whether he expects a new Republican House majority to pursue ACA repeal.
“I don’t think that’s on the table,” he said.
Gallagher said the “lesson” from Democrats' passage of the ACA in 2010 and the failed GOP attempt to repeal it in 2017 — both of which generated public backlash — “is to not do comprehensive” health care bills and instead focus on narrow, “targeted” changes.
The pivot away from Obamacare comes after Republicans suffered a backlash in 2018 for trying to undo popular provisions, like protections for people with pre-existing conditions. Donald Trump ran on repealing Obamacare in his winning presidential 2016 campaign and in his unsuccessful 2020 re-election bid.
But Republicans did achieve one goal in a separate 2017 bill: neutering the individual mandate, which required people to have health insurance, by zeroing out the tax penalty.
As of March, 55% of U.S. adults had favorable views of the ACA, while 42% had unfavorable views, according to the nonpartisan Kaiser Family Foundation tracking poll.
Still, Democrats say they are taking nothing for granted.
“We also thought Roe v. Wade was here to stay,” said Sen. Chris Van Hollen, D-Md. “So my view is: Always remain vigilant.”
Sen. Raphael Warnock, D-Ga., who faces re-election this fall, argued that the ACA hasn’t been fully implemented as some Republican-led states block Medicaid expansion, which the Supreme Court made optional. “Georgia needs to expand Medicaid," he said.
“What I have done is to try to create a path for the 600,000 Georgians who are in the coverage gap. They are political pawns for being forced to subsidize health care in other states,” Warnock said. “The Affordable Care Act is the law of the land. And it’s past time for the folks in states like mine to benefit from that law.”
Rep. David Schweikert, R-Ariz., who sits on the Ways and Means Committee and is making a bid to become the chair of its health subcommittee, said he wants to move past the ACA repeal conversation.
He instead called for promoting new technologies and automation to lower the cost of health care, which might mean “replacements of substantial portions of the ACA to legalize alternative plans” — but with a focus on delivering care, not financing insurance.
“We’re screwed unless we change the cost of health care,” he said.
Rep. Claudia Tenney, R-N.Y., narrowly lost her upstate New York seat in 2018 in the backlash to Trump and ACA repeal before she won it back in 2020. Asked whether she favors another attempt at repealing the ACA under a Republican majority, Tenney gave a terse response.
“Oh, God,” she said. “Let’s see if we’re in the majority.”