Ted Cruz has a plan to finish off Obamacare. It could also finish off GOP majorities in Washington if Democrats are able to shift the blame for failures in the nation’s health care system — again pitting Cruz’s own political interest against leaders in his party.
Once a reliable campaign issue that helped Republicans build majorities in the House and Senate, health care politics have changed drastically for both parties since the 2016 election.
Top Republican strategists say it’s no longer a winning message for their party — and a potential liability if they continue making changes that aren’t successful. Democrats, meanwhile, call it their most compelling argument for the 2018 election, thanks in part to changes Cruz pushed his party to pursue.
“I don’t think anybody who was paying attention to the repeal effort in 2017 concluded that Republicans got what they wanted out of that deal. It didn’t work,” said Josh Holmes, a GOP strategist who engineered health care politics for years as chief of staff to Senate Majority Leader Mitch McConnell.
“What we’re left with in the country is Obamacare in some form or fashion … we have moved beyond it as an issue for the center of the electorate,” he added.
Cruz, who faces a well-funded challenge from Democrat Beto O’Rourke in November, sees the politics differently.
He’s working behind the scenes on Capitol Hill to rally colleagues around changes to the law in the coming months — something GOP Senate leaders have expressed zero interest in taking up.
Cruz is also encouraging a more drastic effort to gut the law through the court system.
That effort took on additional significance with Supreme Court Justice Anthony Kennedy’s retirement in June — providing Democrats new political fuel as they head into the midterms.
“There are a lot of ideas right now on Obamacare that I think could get 50 votes if we could unite as a party,” Cruz told supporters in Waco this month. “The big question is: Is our leadership going to take up a vehicle [to allow it].”
Cruz made his name pushing his party out of its comfort zone to fight Obamacare in 2013. He then turned around and used the platform to fuel a strong bid for the GOP presidential nomination less than two years later.
He’s since worked hard to mend fences with party elders.
But he’s still prodding his party toward an aggressive strategy to get rid of Obamacare — even as polls show voters in both parties now believe the GOP is responsible for any problems with the law.
“Obamacare continues to be a disaster, it continues to drive up the cost of premiums and make healthcare unaffordable to millions of Texans and millions of Americans,” Cruz told the Star-Telegram in an interview this week.
“We should be pursuing regulatory avenues, we should be pursuing legislative avenues, and I’m glad the state of Texas is pursuing judicial avenues” to get rid of it, he added.
That last option, a Texas-led lawsuit with other GOP-led states, is a particularly alarming to Cruz’s fellow Republicans.
If successful, it could effectively gut the law in its entirety. To get there, it takes aim at one of the law’s most popular provisions, requiring health insurers to cover people with pre-existing conditions.
A June survey from the non-partisan Kaiser Family Health found 60 percent of Americans claim to live in households with someone who has a pre-existing medical condition. Majorities of voters in both parties, as well as independent votes, said maintaining that piece of the health law was “very important” to them.
“Everybody I know in the Senate — everybody — is in favor of maintaining coverage for pre-existing conditions,” McConnell told reporters on Capitol Hill.
Regardless, Republicans in Washington are now intertwined with the case’s fate — thanks in large part to Cruz, who single-handedly orchestrated the basis for Texas’s argument last year.
After party leaders proclaimed health care dead on Capitol Hill, Cruz rallied his colleagues to gut Obamacare’s individual mandate though the GOP’s tax bill. It passed last year on a party-line basis.
“That’s something I led the fight to do, back in last fall nobody in Washington thought we had a prayer of getting that done,” Cruz told the audience in Waco. “We went from six or seven senators, to in December, all 52 Republicans standing together and repealing the individual mandate.”
Democrats are now eagerly seizing on that vote to tie Republicans nationwide to Texas’ lawsuit.
“The ban on insurance companies kicking people off the health insurance just because they’re sick, just because of their pre-existing condition, just because of their medical history, is working its way up to the Supreme Court,” Sen. Amy Klobuchar, D-Minn, told reporters on Capitol Hill. “People think that Americans don’t care about the court, well they do care about their right to health care.”
The case alleges that without the individual mandate, Obamacare’s pre-existing coverage provision is invalid — ultimately unraveling the rest of the law as well.
“We’re asking for the entire Affordable Care Act to be declared unconstitutional,” said Robert Henneke, general counsel and director of the Center for the American Future at the conservative Texas Public Policy Foundation, which joined Texas’s lawsuit. “The very concept of the pre-existing condition mandate doesn’t exist without the individual mandate.”
That argument becomes much more powerful if President Donald Trump’s Supreme Court nominee Brett Kavanaugh joins the bench this fall. Democrats are already using the Texas lawsuit to frame his confirmation as a vote to take away pre-existing condition coverage.
Cruz says his attention is on Texas, where a July survey from the non-partisan Kaiser Family Foundation showed Texans rank health care as their top financial concern, above all other basic necessities.
“I agree Obamacare is a major issue in this election,” Cruz told the Star-Telegram. “Today the average family’s premiums have increased over $5,000 a year. That is hurting millions of Texans.”
Speaking to supporters in Waco, Cruz didn’t mention the lawsuit in his plans to continue the fight on health care. Instead, he ticked off legislative changes like expanding health savings accounts and repealing the law’s employer mandate.
“I’ll make the case to my colleagues, let’s get some big victories on Obamacare now,” said Cruz, who presented his ideas at a GOP caucus lunch earlier this summer. “If we come back next year and we’ve picked up three, four, five, Senate seats … that’s when we can come back and finish the job.”
Republicans control 51 seats in the Senate following a special election loss in bright red Alabama last year. Democrats control 49 seats.
O’Rourke, who is running against Cruz to flip that chamber, is pitching solutions embraced by national Democratic leaders.
“The best way to address [rising premiums] is universal, guaranteed quality health care,” O’Rourke told the Star-Telegram Thursday. He also pointed to bills he’s signed onto that he said would provide an “interim step.”
One would allow states to expand Medicaid with the same incentives states were given when the law was first passed — a move requiring help from Texas Republicans in Austin. The second would introduce Medicare as a public option on the exchanges in under-served areas.
Andrea Drusch is the Washington Correspondent for the Fort Worth Star-Telegram. She can be reached at email@example.com or on Twitter @andreadrusch.