"Well, you know, the focus of the attacks ads is 'Thom Tillis is against having some sort of safety net for preexisting conditions, and for kids under 26 years old being on their [parents'] policy," Tillis, the Speaker of the North Carolina House of Representatives, told TWCN. "Republicans have made those proposals before. It's not about that. It's not about everything else in Obamacare that doesn't work. So we do need health care reform. We don't need something as large and complex and costly as the Affordable Care Act because it can't work."
"Republicans do need to communicate that we agree that there are serious health care issues among the American people that we need to solve," he said. "But we need to do it in a way that's sustainable, that's prudent, and that doesn't put other programs like Medicare at risk."
The remarks illustrate the fine line Republicans are walking now that Obamacare has taken effect. They want to support the popular parts of the law, such as protections for sick people and children, but without the unpopular parts that fund them and make them sustainable. And they're pressured to toe the official party line of full repeal. They lack unity on a replacement proposal, and most don't want to take unambiguous policy positions.
That's in part because Republicans' attacks on Obamacare have narrowed their policy space to come up with a viable health care alternative.
The dilemma is similarly on display in a new ad supporting Senate Minority Leader Mitch McConnell (R-KY), by the U.S. Chamber of Commerce, which says the GOP leader is "leading the fight to fix this Obamacare mess." No mention of repealing the law -- or what to put in its place.
Democrats claim Tillis' only plan is to wipe out Obamacare. "Speaker Tillis is trying to hide that he would let insurance companies deny North Carolinians with pre-existing conditions coverage," said Ben Ray, a spokesman for the North Carolina Democratic Party. "North Carolinians deserve to know what Thom Tillis’ stance on health care is. Why is he hiding?"
On balance, political scientists say Obamacare isn't likely to be a core factor in the 2014 elections. The law remains unpopular, particularly among conservatives, and could work against red-state Democrats who supported it and haven't yet faced voters -- like Sen. Kay Hagan, whom Tillis is vying to unseat.