Back in the summer, physician and former Republican Rep. Brad Wenstrup and Trump-aligned pollster John McLaughlin offered coaching to House Republicans on how to talk about health care: Lean in.
Republican strategists say the party has treated the topic as Democratic turf for years, and such advice may sound counterintuitive a year after Republicans passed $1 trillion in federal health care budget cuts.
But some GOP lawmakers are taking it, running ads on targeted health care subjects in swing districts in states like Iowa, New York and New Jersey, where candidates and strategists recognize they need an affirmative response — especially as open-enrollment season opens this month for millions of Americans.
Wenstrup and McLaughlin explained why in briefings to the National Republican Congressional Committee and the Republican Study Committee that offered polling data that pegged health insurance costs as voters’ leading health care concern.
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The data also suggested ways to push back. One McLaughlin & Associates survey of 2,000 likely voters commissioned by Americans for Health Excellence, which Wenstrup leads, said 65% of voters were more likely to vote for a Republican candidate who supports cracking down on fraud, waste and abuse by insurance companies.
“Our polling shows common-sense pocketbook solutions have support from more than eight in ten voters, including strong majorities of Republicans, Democrats and Independents,” Wenstrup said in a statement to The Washington Sun. “That is not just good policy. It is winning ground for candidates and smart to work on behalf of patients.”
While campaigns are likely making their own decisions, such ideas are being promoted in competitive districts.
Rep. Mike Lawler of New York has highlighted affordability in his ads. Rep. Mariannette Miller-Meeks of Iowa pledged to take on “Big Insurance” companies, as did Rep. Ashley Hinson, who is running for Senate. Rep. Tom Kean Jr. of New Jersey has focused on ensuring patients have equal access to physical and mental health care through their insurance coverage.
For Republicans in competitive districts, campaigning on health care offers an opportunity to reach beyond their usual voters, said Kristin Davison, a national Republican consultant at Axiom Strategies.
“It’s also something that gives a permission slip to someone that’s not used to voting Republican to consider you because you’re talking about an issue that Republicans haven’t necessarily dominated in the past,” Davison said.
Rob Burgess, CEO of Connector, Inc. and a national Republican strategist, described the shift as Republicans becoming more willing to compete on the issue.
“Here is the pivotal shift: Republicans have stopped playing defense,” Burgess said. “For years our side treated health care as the other team’s turf and hoped the subject wouldn’t come up.”
Burgess argued that the pressure starts with candidates hearing about affordability in their districts.
“Those members aren’t following a memo. They’re following their voters, and the party is catching up to what they already know,” he said.
Sarah Chamberlain, the president of the Republican Main Street Partnership, also said the new messaging on health care is not a broader Republican strategy but reflects more of a district-by-district approach. She pointed to Kean, who has publicly discussed his own mental health struggles, as an example of a candidate whose personal experience shapes his health care priorities.
Lawler, who has long discussed health care, told The Sun in an interview that he helped block proposals to reduce the federal government’s share of Medicaid funding and negotiated an extension of New York’s tax on managed care organizations, which he said preserved $1.2 billion for the state’s hospital system.
Lawler was also one of four Republicans who signed a discharge petition to force a vote to extend enhanced Affordable Care Act marketplace insurance subsidies for three years. The bill passed the House but ultimately stalled in the Senate.
Such efforts and ads, however, are running into some on-the-ground reality that millions of Americans are about to encounter as the annual process of updating insurance choices starts later this month.
Open enrollment for Medicare recipients starts Oct. 15. Shopping for ACA health plans in the federal marketplace begins Nov. 1, and an analysis by the health care research organization KFF found those shoppers will face median proposed premium increases of 15%. Many people who get insurance through work will also start seeing in October and November how much more will come out of their paychecks next year.
And while the GOP polling may have identified some winning messages, a new KFF survey released Tuesday suggests voters are not really absorbing them. The poll of more than 1,000 Americans found Democrats holding a 42% to 22% edge over Republicans for which party they trust more to handle health care costs. That is a dramatic jump since April, when Democrats had a 37% to 26% lead.
Liz Hamel of KFF told The Sun that Republican messaging on fraud, waste and abuse has resonated with voters but doesn’t necessarily translate to a belief that prioritizing fraud will lower their costs.
She added that Republicans’ historical advantage on the economy had sometimes extended to health, even as voters favored Democrats on programs such as Medicare and Medicaid. But that has recently changed.
“We’re finding that Democrats even have an edge on health care costs among voters,” she said.
Whether Republicans can turn their health care pitches into greater voter trust remains an open question, even if there is not much time left before the midterm elections. Burgess said that trust ultimately depends on results.
“Parties do own issues, but ownership isn’t a deed. It’s a lease, and it renews on performance,” he said.
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