For seven years, few issues have animated conservative voters as much as the repeal of the Affordable Care Act. But with President Barack Obama out of office, the debate over “Obamacare” is becoming less about “Obama” and more about “care” — greatly complicating the issue for Republican lawmakers.
Polling indicates that more Republicans want to make fixes to the law rather than do away with it. President Trump, who remains popular on the right, has mused about a replacement plan that is even more expansive than the original. The conservative news media are focused more on Mr. Trump’s near-daily skirmishes with Democrats and reporters, among others, than on policy issues like health care. And the congressional debate, as well as the paid advertisements on both sides, is centered on the substance of the law rather than its namesake, draining some of its toxicity on the right.
As liberals overwhelm congressional town hall-style meetings and deluge the Capitol phone system with pleas to protect the health law, there is no similar clamor for dismantling it, Mr. Obama’s signature legislative accomplishment. From deeply conservative districts in the South and the West to the more moderate parts of the Northeast, Republicans in Congress say there is significantly less intensity among opponents of the law than when Mr. Obama was in office.
“I hear more concerns than before about ‘You’re going to repeal it, and we’re all going to lose insurance’ because they don’t think we’re going to replace it,” said Representative Mike Simpson, a Republican who represents a conservative district in Idaho.
But it was not until now, with the Republicans taking control of the federal government, that the debate fully shifted from the theoretical to the tangible. It was easy for conservatives to rally against a law identified with a president they despised when he was capable of vetoing any repeal. Now that he is gone and the law’s benefits appear to be on the chopping block, the people who stand to lose the most are the most vocal.
“I’ve heard from constituents who have been harmed by the Affordable Care Act over the course of its being in existence,” said Representative Leonard Lance, Republican of New Jersey, whose affluent district Mr. Trump narrowly lost last year. “More recently, because of our discussions on repairing it, I’ve heard from those who do not wish to have the act amended. More recently, that is the preponderance of those who have contacted me.”
It is a longstanding rule of politics that rallying opposition to a proposal is usually easier than galvanizing support. And never is this more the case than when a widely distributed benefit is at risk of being taken away.