CQ TODAY PRINT EDITION
March 18, 2009 – 6:17 p.m.
GOP Tries to Reassert Itself on Health Care
By Drew Armstrong, CQ Staff
When a party loses the majority, it often goes “into the wilderness” to find itself and develop new policy ideas, anoint new political and intellectual leaders, and rebuild a brain trust to lead it back to power.
For House Republicans, that search is happening just as Congress and the administration are preparing for a full-scale overhaul of the nation’s health care system that would touch the lives of almost every American.
Democrats have spent years planning for health care’s moment, waiting for the political opportunity, and are preparing to put pen to paper.
The Republicans, meanwhile, have a different task.
On the Senate side, there are senior Republicans who have close relationships with their Democratic colleagues on the key committees. Charles E. Grassley of Iowa, Michael B. Enzi of Wyoming, Judd Gregg of New Hampshire and Orrin G. Hatch of Utah are all GOP members of the “board of directors,” a bipartisan group of Senate health care leaders heavily involved in writing legislation. The possibility of a filibuster in the Senate — and for now, the desire for bipartisanship — gives Senate Republicans a leg up in getting their ideas heard.
But the House is another matter. Republicans have lost key members to retirement and electoral defeat. Many of their ideas — such as price transparency or high-deductible health plans — were rejected in the market. Instead, they are in the process of rebuilding the GOP brain trust on health care.
“I think there’s a willingness on the part of leadership now to recognize that we have to address it,” Rep. Charles Boustany Jr. , R-La., said of health care’s prominence on the agenda.
“When I first got here in the 109th Congress . . . I had a high level of frustration that we weren’t tackling health care,” said Boustany, a retired heart surgeon. “That was a kitchen-table issue that every single American family cares about.”
Boustany is part of a House GOP health care task force created in February, led by former Minority Whip Roy Blunt , R-Mo.
Blunt dismisses the idea that Republicans have fallen behind in the health care debate, but he acknowledges that the issue needs to become a greater focus for the caucus. “One of the goals of our working group . . . is also to get our members in this discussion, both in Washington and in their districts,” Blunt said in an interview. “If we could get the same kind of engagement on health care from our conference that we got on energy last year, that in and of itself would be a great success.”
GOP Attends ‘Boot Camp’
The House Republican Conference has set up a weekly education series for aides, called Health Care Boot Camp. Experts from the Congressional Research Service and former Hill and administration staff members who are now at think tanks or in the private sector lecture on health policy. One recent session was a history of President Bill Clinton’s failed health care reform effort; another was to focus on how various proposals would affect existing insurance coverage.
The member-level task force has also been bringing in experts to help members build the knowledge they need to debate Democrats effectively.
For example, the Ways and Means Committee’s Republican side has been hurt by retirements and defeats. Ranking member Jim McCrery of Louisiana (1988-2009) retired after the last Congress. Just under half of the panel’s 17 Republican members in the 110th Congress are now gone.
“Clearly, we’ve lost some really good members, and we’ve lost them from the Ways and Means Committee,” said the panel’s ranking Republican, Dave Camp of Michigan, another member of Blunt’s task force. But, Camp added, “It’s not just about having the institutional knowledge on the legislative front, that can be acquired. . . . It’s about having knowledge of what’s happening in the real world.”
Still, there is a silver lining, Camp said. “We have some really good new members, and for the first time on the Republican side we have a doctor,” he added, referring to Boustany.
Camp also meets regularly with former Chairman Bill Thomas (1979-2007), now a strategic adviser with the law firm Buchanan, Ingersoll & Rooney. Aides to Camp joke that Thomas never really left, though, so frequent are his visits and calls.
Part of the struggle for Republicans has been finding ways to inject their point of view. “Clearly, the president has the bully pulpit, so his proposals have dominated the debate,” Boustany said.
A Battle of Rhetoric
Blunt acknowledges that in many areas, Democrats have co-opted the GOP message and internalized Republican criticisms of the 1993-94 Clinton legislative battle, like the concept that those who have insurance they like should be able to keep it.
The result is that on some issues, such as creating a requirement for all Americans to buy insurance, the discussion can be more about semantics than policy.
“I was in a meeting yesterday, and someone said, let’s just call it an ‘individual obligation,’ not an ‘individual mandate,’ and I was like —” said Camp, throwing up his hands in mock exasperation.
And in the course of developing new ideas, some older Republican proposals seem to be getting less attention.
There is less talk now of price transparency — the idea that patients would wade through complex cost data to pick an affordable doctor.
Nor is there much ongoing discussion of health savings accounts and high-deductible or other “discount” health plans. They were another idea that was meant to bring market forces to bear but that never really took flight. Instead, they became a temporary insurance of last resort, often used to fill gaps between employer-sponsored insurance. These bare-bones plans that offer limited benefits have given rise to the new class of the “underinsured” — those who have insurance, just not enough of it to get them through a real health crisis, or who have a policy that eats deeply into their savings before kicking in.
Instead, there is a realization that new ideas are needed.
“There is a concern that we have not been aggressive enough on health care and espoused that as a Republican core issue,” said Boustany. “I, for one — and I can speak for others — am determined to change that. I think what you’re seeing is a sea change in opinion about the importance of health care reform, and the importance of Republicans dominating in this debate.”
Comments
The Republicans can go on ad naseum about the evils of "socialized medicine," or the need for "market-based" reforms. However, they won't get that far until they come up with a plan that covers people who are sick and struggle to pay their bills.
`I hope that Republicans and Democrats alike can take their outrage about AIG and other financial conglomacorps and channel it productively toward properly regulating another financial industry - the health insurers. For-profit health insurers are BUSINESSES first, responsible to shareholders first. That is their nature. It is up to the government to regulate these entities properly; and where lives are at stake, significant regulatory power is completely appropriate. Please, Republicans, do not fall back on the tired old lines about the free market when it comes to making sure the insurers conduct business fairly and transparently. Some things transcend the market, and the health of you, your family, and your constiuents is one of those things.
Competition and the free market still work, but the govt is already so heavily involved in our health care that the system could use a good retooling. Health care is not a right--like life, liberty, free speech, etc.--it's a need and someone must pay and must provide that need. Employers shouldn't be in the business of providing health insurance--controlling health care. You don't get car or homeowner insurance from your employer. Tax benefits that go to employers who provide health insurance coverage should go to individuals through tax restructuring, and health insurance should be attached to the person--whether that person is employed, unemployed, self-employed, etc.
Tom Rooney seems to have a handle on the needs of the 16 th congressional District .I am pleased he is our Congressman.Mike
I'm glad the Republicans have moved healthcare reform front and center but, I doubt they'll be able to come up with any new significant ideas. Why? Because what they espouse in all sectors of life is "rugged individualism." i.e. The government shouldn't be involved in your life. Get your own healthcare coverage. That ideology won't move them very far forward in solving this problem -- or any other problem.
From this article with the threat of filibuster constantly hanging over negotiations, it seems that GOP is gearing up for obstructionsim rather than health care.
The Republicans have what they want for health care,very few with poor have health care and in their minds that cheapest. HMO's and PPO's administration costs are ten times greater then Medicare and yet republicans love HMO's and PPO's. The republicans complain,through their media outlets that a single payer system would choose your provider,well thats what HMO and PPo's do,where is that outrage! Listen to the vocal leaders of the republican party,they constantly defend the system in place now!!! Instead of training aids to defend the "broken" system now in place,try to come up with something new with all that times being spent teaching our government employees how to argue,we can get that with limbaugh.
Wrong Cookie: a decent standard of healthcare is a right in a civilized society, and it's partly duty to provide it for the 48 million uninsured people in your country. Why do Americans continue to glory in the enormous social inequality they have in their country, and pretend there is more social mobility there than in Europe - when this is transparently and obviously false?
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