Then they look into their own camp — and get nervous.
There’s no Republican plan yet. No Republicans leading the charge who have coalesced the party behind them. Their message is still vague and unformed. Their natural allies among insurers, drug makers and doctors remain at the negotiating table with the Democrats.
So Republicans now worry the party has waited so long to figure out where it stands that it will make it harder to block what President Barack Obama is trying to do.
“I thought we would have been much farther along than we are,” said Rep. Michael Burgess (R-Texas), a physician who started the Health Care Caucus this year and wrote a 29-page “primer” for his colleagues. “Senator [John] McCain, for all his faults, had a program a year ago. People became pretty comfortable with McCain carrying the load on that and when he wasn’t successful in November, it left a big void.”
Nobody on the GOP side is waving a white flag. They think some of Obama’s ideas, including a government-run health insurance plan, will be such non-starters with the American people that they can recover in time to stop them.
But they also know the clock is ticking, as key Republican senators engage in bipartisan talks and House rank-and-file meet privately to develop alternative proposals. The House Republican Health Care Task Force will release a “solid” platform within the next month, said a spokesman for its leader, Rep. Roy Blunt (R-Mo.).
The void on the right has been so vast that a millionaire health care entrepreneur named Rick Scott stepped into it as the unlikely face of Republican opposition. His record isn’t spotless, having lost control of Columbia/HCA, then the country's largest hospital company, in 1997 amid a Medicare investigation. (Scott was not charged with any wrongdoing.) But he is the only one so far to put up money.
Now running a chain of urgent care clinics in Florida, Scott plans to spend at least $5 million to push a limited-government, free-market approach to medicine. He has assembled a staff of 12, hired the Virginia public relations firm that assisted Swift Boat Veterans for Truth, bought six weeks of radio and TV ads, and commissioned a poll by Republican strategist Tony Fabrizio.
He shared the data with members of Congress last week, and visited Grover Norquist’s Wednesday meeting of conservatives the week before to screen segments of a forthcoming documentary on the Canadian and British health care systems.
Even Scott is anxious for other groups with funding to step out front with him.
“A lot of people are waiting to see a bill and there is no bill yet,” Scott said in an interview. “So that will supposedly be the first part of June. My personal concern is that might be too late because it appears this is all going pretty fast. If you wait to get started until there is a bill you don’t like, you are going to have a tough time.”
The organizational strength behind Obama’s plan is enormous. The House speaker, the Senate majority leader and the committee chairmen have agreed to work together, minimizing the turf wars that doomed former President Bill Clinton’s effort in the 1990s. The major labor unions have teamed up with business groups. An umbrella group for liberal organizations, Health Care for America Now, is spending $40 million on the fight.
None of this guarantees success, and the ultimate bill could provide plenty for critics to challenge. Former House Speaker Newt Gingrich said in an interview that, following Obama’s intervention in the auto and financial industries, he sees voters recoiling from a government-eavy health care plan.
But anxiety is setting in among some Republicans that they aren’t ready.
“That is a definite concern,” said an aide to a senior congressional Republican, who spoke on the condition of anonymity to talk candidly about his party. “There is catch-up in terms of us talking about it in public. There is a good core of ideas, but we haven’t talked about the issue as much as Democrats. We are playing catch up. We are running against the wind. They have a lot of momentum.”
To be sure, there has been no shortage of discussion in recent months.
At least three different GOP groups are studying the issue in the House – Blunt’s leadership-appointed task force, the conservative Republican Study Committee, and the moderate Tuesday Group.
There is also a group of 13 Republican physicians, including Burgess, Rep. Tom Price (R-Ga.) and Rep. John Shadegg (R-Ariz.), who share ideas among themselves while participating in other groups. Rep. Dave Camp (R-Mich.), the ranking member on Ways and Means, and Rep. Paul Ryan (R-Wis.), the ranking member on Budget, are also expected to take a lead.
Republicans are fielding strategic and policy advice from a familiar lineup, including Gingrich, Scott, pollster Bill McInturff, Galen Institute president Grace-Marie Turner, and Heritage Foundation health policy expert Robert Moffitt. All were involved in the health care debate in the early 1990s.
The advice so far? Republicans cannot just oppose a bill, and they cannot simply recycle the old ideas like health savings accounts and tax breaks.
“We could have come out with the same health care principles that we have always talked about,” Blunt’s spokesman Nick Simpson said Friday. “This group wants to come up with fresh solutions and not just party rhetoric – and that takes some time.”
But a Republican consultant said the party needs to present its vision quickly -- while Democrats are still debating.
"I am shocked they haven’t to this point. This has been out there for so many years," the consultant said. "There is a genuine mixture of fear and reluctance and indifference on the part of many Republicans towards the issue of health care, and they better get over it fast."
Historically, Democrats hold the advantage. Voters have consistently viewed them as better able to handle health care since the early 1990s, according to the Pew Center for the People and the Press. The margin has rarely been close, with Democrats often beating Republicans on the issue by more than 20 points.
The chasm grew last year, as Obama bombarded McCain with health care advertising. The Democrat spent $113 million, or eight times that of his rival, POLITICO reported in October. Running almost 200,000 commercials to McCain’s 11,300, Obama painted the Republican’s plan as the “largest middle class tax hike ever” for lifting the tax deduction on employer-based health insurance – an idea Democrats are now considering.
David Merritt, project director at Gingrich’s Center for Health Transformation, said the lopsided debate last fall highlighted the need for Republicans to develop a comprehensive health care strategy.
“Just look at when things really turned: in August and September, when health care was the hammer that then-candidate Obama used over the McCain campaign,” Merritt said. “The response from the McCain campaign was to talk about tax credits and financing. They didn’t talk about families.”
By February, 58 percent of Americans had little or no confidence in congressional Republican to do the “right thing” for health care, ranking just ahead of insurers and corporations, according to the Kaiser Health Care Tracking Poll. Thirty-eight percent expressed confidence in the GOP, compared to 72 percent in Obama and 57 percent in congressional Democrats, the poll fund.
Burgess wrote his “Health Care Primer for Members” to nudge his Republican colleagues to embrace the issue, saying it was time to "step out of the shadow" of Democrats.
“Too often Republicans are criticized for their lack of enthusiasm or knowledge when it comes to talking about health care," Burgess wrote. "Whether that critique is fiction or contains a kernel of truth, the fact remains that we must overcome this perception.”