The shift in priorities is remarkable. Since the summer of 2009, when Tea Party activists angrily confronted Democrats who were drafting the Affordable Care Act, the Republican Party has been driven and defined by outrage over it. But now, with the Republican health care legislation hanging in the balance, President Trump and congressional leaders are getting little support from what were once the loudest anti-Obamacare voices. The lack of grass-roots enthusiasm will make it even harder for the party’s Senate leaders to line up votes for their troubled bill when they return on Monday.
Activists on the right said they felt betrayed by the Republicans they helped elect, who pledged that when they had a Republican president they would repeal the act “root and branch,” as Senator Mitch McConnell, the majority leader, once declared.
“This is not anywhere close to that, and I think it has left a number of conservative activists saying I’m not advocating for this,” said David Bozell, the president of ForAmerica, an organization founded in 2010, the year the Affordable Care Act was passed, to help spread conservative ideas on social media.
These activists want the subsidies that help people buy insurance repealed, not just reduced. They want the Medicaid expansion eliminated, not slowed.
“You’re not going to get a grass-roots activist to spend their valuable time calling their senator because, ‘Well, this is better than nothing,’” Mr. Bozell said.
Public opinion polls show support for repeal-and-replace slipping among the very groups that once demanded it. Support for the Republicans’ efforts among Trump supporters, while still a healthy 55 percent, dropped 14 percentage points since May, according to a Kaiser Family Foundation poll in mid-June. Among Republicans over all, support had dropped 11 points, to 56 percent. Just 8 percent of Republicans polled thought repeal should be the top priority of Congress and the president.
While Republicans have become more lukewarm on their party’s efforts, Democrats are more fiercely defending the Affordable Care Act. Fifty-three percent of Democrats in the Kaiser poll had a “very favorable” view of the health care law, while 21 percent of Republicans had the same view of their party’s plan to repeal it. In May 2010, two months after the law passed, 30 percent of Democrats had a very favorable view of it. Republicans were heatedly against it: 69 percent had a “very unfavorable view.”
“There’s definitely an enthusiasm gap,” said Liz Hamel, the director of public opinion and survey research for Kaiser, a nonpartisan research group. “It’s not that they’re not interested in repeal,” she said. “They just have other priorities.”
In the June poll, 74 percent of Republicans said their families would be better off without the health care law. But a majority expressed support for its major provisions: 59 percent want the federal government to continue prohibiting insurers from charging more to people with pre-existing conditions; 52 percent said the federal government should continue to require insurance plans to cover a list of “essential health benefits,” like maternity care and treatment for drug abuse.
Advertising, too, has been one-sided against the Republican legislation. Groups from Planned Parenthood to the AARP have bought television and radio spots in states with wavering Republicans imploring them to vote against the plan. Groups on the right were mostly silent; FreedomWorks has run digital ads in Tennessee alone, showing Senator Bob Corker, who has criticized his fellow Republicans for proposing to eliminate the act’s 3.8 percent tax on investment income, cozying up to President Barack Obama.
Like Republican lawmakers, some of the groups have found that fixing complex legislation is far more challenging than opposing it. “It’s easier to generate a crowd when you don’t have to be in on the sausage-making,” said Adam Brandon, the president of FreedomWorks.
“The Democrats, their strategy is outrage,” he said. “I get that strategy. I lived that strategy. It’s a unifying strategy to be outraged at the other guy. The hard part is when you get in and have to deliver.”
Jenny Beth Martin, the president and co-founder of the Tea Party Patriots, said the group’s email blasts against Obamacare still trigger hundreds of responses from activists angry about it. The group helped make more than 100,000 phone calls over 48 hours when the House was voting on its bill in the beginning of May to repeal and replace.
But, she said, “We’re not yet on the yes side with what the Senate is doing.”
Grass-roots activists like Pat Daugherty, who once marched on Washington against Obamacare, now sound as disgusted with Republicans in Congress as they were in the early days of the Tea Party, when they helped primary challenges against lawmakers they derided as “Republicans in Name Only.”
“Every Republican in Congress ran on repealing Obamacare,” said Ms. Daugherty, a retired university administrator in Athens, Ga. “Why do we suddenly have a hard time repealing Obamacare when Republicans are in the majority?
“I know a lot of conservatives who are more upset with Republicans than with Democrats,” she said.
David Zupan helped organize Tea Party groups in Ohio against the Affordable Care Act, which he blamed for driving up health care costs and forcing him to shutter his technology support business. Before the law, he said, he paid $910 per month to insure him and his wife, with a $750 annual deductible. When he renewed his policy last year, he said, the rates had increased to $2,845 per month, with a $3,500 deductible.
Mr. Zupan had hoped to confront Senator Rob Portman over the recess to demand that he and his fellow Republicans push for a full repeal. Mr. Portman has expressed concern that the Senate bill would roll back Medicaid too far, particularly jeopardizing treatment for opioid addiction. But Mr. Zupan gave up after being unable to figure out where Mr. Portman would be.
Mr. Zupan, too, expressed a certain resignation with Republicans.
“Nothing they’re going to do to this bill is going to make it better,” he said.
“I honestly don’t believe that the majority of the people in the House and the Senate want limited government,” he said. “They’d rather have the government in there controlling the 17 percent of our economy that is health care. It means more money over all that they get to control.”
Some groups, including the Tea Party Patriots, are supporting a proposal by Senator Ted Cruz of Texas that would allow insurers to offer plans without the full complement of essential health benefits, which Republicans believe will lead to cheaper premiums, as long as they offer at least one plan that covers those benefits.
And some activists endorsed a tweet from Mr. Trump on June 30 encouraging Republicans to scrap the current bill attempting to replace the Affordable Care Act and resurrect one from 2015 that just repealed it. That bill won almost unanimous support from Republicans, but was vetoed by Mr. Obama.
Mr. Brandon, at FreedomWorks, said activists were beginning to think that Republicans had voted for that bill only because they knew Mr. Obama would block it. That suspicion — “they were just being political” — fosters apathy now, he said.
“You think of the origins of the Tea Party and the origins of why Donald Trump won,” he said. “People are sick of the political show.”
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