Republicans should shit or get off the pot on health care

Why keep the spotlight on an issue that plays terribly for the party ahead of the midterms?

By: Rachael Bade

“A pipe dream on magic mushrooms.” 

That’s how one senior House GOP aide recently described to me the odds of Republicans passing a health care bill in 2026. 

So, here’s the real question the party should be asking itself: Why on earth are they keeping this issue in the spotlight during a contentious midterm year?

In the Senate, bipartisan negotiators have been saying for months — seriously, months! — that they’re “close” on a bipartisan health care deal. Meanwhile, Speaker Mike Johnson (R., La.) has floated the idea of Republicans drafting their own partisan bill via reconciliation in the House.

But behind closed doors, most Republicans I’ve spoken with are exasperated, calling this political malpractice — or even outright idiocy. Given the GOP’s razor-thin House majority — not to mention the deep ideological divides over how to reform the system — the prospect of passing anything is slim to none, if we’re being honest.

So why drag out an issue that overwhelmingly benefits Democrats, allowing the opposition to keep pounding away at Republicans as the midterms approach — especially with the odds of success so remote?

“This is insane… Are we taking crazy pills?” a second senior GOP aide told me. “If we’re talking about health care or reconciliation, we are screwed. Nobody really wants to be talking about health care.”

If Republicans go down this road, it promises to be a months-long, Sisyphean slog. The two parties are at loggerheads over abortion restrictions, while Democrats — who know they have the upper hand in polling — are in no mood to compromise. 

And if Republicans try to go it alone? Mark my words: It will be even messier. I covered the last GOP health care push in 2017, and for anyone who doesn’t remember, it wasn’t pretty. How many times did the bill flatline at the hands of then-Freedom Caucus Chair Mark Meadows (R., N.C.) or the late-Sen. John McCain (R., Ariz.)? And that — mind you — was with a much bigger majority. And by the way? It never passed.

Complicating things further, any health care debate will take place during the primary season, when intraparty compromise becomes even more difficult. 

“I just don’t know how we get there. Conservatives want to repeal Obamacare; moderates want to extend subsidies,” the aide with the colorful “pipedream” quote continued. “It was hard enough in 2017, and now we have even less room for error — and a more diverse conference on this issue.”

“It’s a losing issue,” another GOP operative told me. “Nothing will pass. All we’re doing is keeping it alive.”

Consider how potent this issue has been for the GOP in the past. In 2018, Republicans bled more than 40 House seats after the party failed to repeal and replace Obamacare. More recently, Democrats were able to dodge the bulk of the blame for the weekslong government shutdown by hugging health care as an issue — even though Democrats themselves 100 percent caused the shutdown. 

The polling isn’t any kinder and has shown time and time again that health care is kryptonite for the GOP. In a recent study by American One Policies, shared privately with Senate Republicans recently, only 31 percent said the GOP does a better job on the issue (46 percent chose the Democrats). Just as bad: 36 percent blamed Republicans for rising insurance costs; just 26 percent blamed the actual architects for today’s genius system.

The anxiety — and the split over strategy — runs deep through GOP leadership circles in both chambers, but especially the House. Some senior Republicans are quietly arguing that it’s time to move on, redirect attention to prices and affordability, and just remind voters that the broken system was the grand scheme of the Democrats.

One of those frustrated lawmakers is the very man who would have to take the lead writing a second reconciliation bill: Ways and Means Chairman Rep. Jason Smith (R., Mo.), who’s been clear about his skepticism publicly. 

“There’s simply no path to pass a second one,” Smith told NOTUS this week. “I’d love to, but the reality is it won’t ever happen.”

(I’m told Smith has been even more vocal in private lately.)

Skeptical Republicans have been baffled that Speaker Johnson is even entertaining this fraught debate despite knowing the impossible odds. They know he’s motivated by conviction, and some speculate that he’s pursuing health care because he thinks it’s what members want. 

But others worry the party is simply keeping the talking point alive for fundraising purposes. Only at some point, they argue, donors will expect results – and Republicans won’t be able to deliver. 

Skeptical Republicans argue that if GOP leaders were serious about health care, they should have acted six months ago.  They also point out that the party has done little to message what they’ve already passed. In the House, for example, members are still smarting that the rollout of their December health care bill was a disaster. They felt blindsided and couldn’t get an answer from the speaker’s office about what was in the bill and the strategy at play. And they still don't feel like they have guidance on how or whether to be talking about the legislation at all.

“Why would we do health care again when the first one was a nightmare?” one senior GOP aide asked me recently. 

Many Republicans think the party should have just left this issue in 2025. Behind the scenes, some have questioned why Johnson didn’t just placate the mods and allow a vote on the expiring Obamacare subsidies in December, as Thune did. That would, they argue, have staved off an embarrassing discharge petition effort and allowed the party to rip the band-aid off before the holidays — then start 2026 with a fresh slate. 

Instead, 17 House Republicans joined Democrats in voting last week to extend the Obamacare premium subsidies, reinvigorating Democrats’ talking points and embarrassing the leadership. 

The short of the story is this: Take all this health care chatter with a pound — not a grain — of salt.  

“A lot of people will throw things out there” in the coming days and weeks on health care, one top aide said. “But until we get serious and look at the art of the possible — actually write it down, present it to the president, and get on the same page — nothing’s happening. All of this? It’s just happy talk. It’s all bullshit.”

Rachael Bade is a contributor for The Washington Reporter and the author of the newsletter “The Inner Circle,” where she chronicles the buzz in Washington. Bade also co-hosts the morning political talk show “The Huddle” alongside Sean Spicer and Dan Turrentine. Click the links to subscribe to both today!

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