Once fervent, critics of health care law mostly low-key now

Members of Congress returning home for the July 4 recess last week were met with rallies, sit-ins and Independence Day demonstrators, as activists on the left intensified their push to defeat Republican legislation to repeal and replace the Patient Protection and Affordable Care Act.

The groups on the right that once fueled the party’s fervor against former President Barack Obama’s health care law have not re-established a presence.

“Not too many are focused on health care currently,” said Levi Russell, a spokesman for Americans for Prosperity, a group founded and funded by the billionaire industrialist Koch brothers.

Instead of health care, he said, the organization’s state chapters were holding townhall-style meetings about veterans’ concerns during recess week. Two other major groups, FreedomWorks and the Tea Party Patriots, said they were planning rallies in August and September that would push for an overhaul of the tax code; Americans for Prosperity was already running ads toward that.

The shift in priorities is remarkable. Since summer 2009, when Tea Party activists angrily confronted Democrats who were drafting the Affordable Care Act, the Republican Party has been driven and defined by anger over it. But now, with the Republican health care legislation hanging in the balance, President Donald Trump and congressional leaders are getting little support from what were once the loudest voices against the law.

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 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 Sen. 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, 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These activists want the subsidies that help people buy insurance repealed, not just reduced.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,’” Bozell said.

While Republicans have become more lukewarm on their party’s efforts, Democrats are more fiercely defending the Affordable Care Act, polls show.

“There’s definitely an enthusiasm gap,” said Liz Hamel, 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.”

Advertising, too, has been one-sided against the Republican legislation. Groups from Planned Parenthood to 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 Sen. 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 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, 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.”

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.

Zupan had hoped to confront Sen. Rob Portman over the recess to demand that he and his fellow Republicans push for a full repeal. Portman has expressed concern that the Senate bill would roll back Medicaid too far, particularly jeopardizing treatment for opioid addiction. But Zupan gave up after being unable to figure out where Portman would be.

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.