While addressing a group in Iowa last week, U.S. Sen. Ted Cruz said that conservatives should not approve funding for any government agencies unless the federal Affordable Care Act, commonly known as Obamacare, is defunded.
“We can defund Obamacare if conservative leaders who tell their constituents they’re conservative stand up and act like they’re conservative,” he said, according to the Des Moines Register.
Critical statements of the health reform law are not unusual for Cruz and his fellow U.S. senator from Texas, John Cornyn, who have positioned themselves as prominent opponents of it. While some political observers say they could be opposing the law merely to advance their agendas, staff members say the senators are merely drawing attention to what they say is incredibly flawed policy.
Elements of the law are scheduled to roll out in the coming months — the federal health insurance exchange will open Oct. 1, and the individual mandate requiring Americans be insured will take effect in January. And Cruz and Cornyn have continued their calls to defund or dismantle the health care law.
On July 11, Cruz introduced a bill in the Senate that would completely defund the Affordable Care Act. In June, the National Football League declined to promote the insurance exchange after receiving a letter that Cornyn, the Senate’s minority whip, had co-signed with Senate Minority Leader Mitch McConnell, R-Ky., discouraging the league from promoting the health care reforms.
The opposition to Obamacare isn’t new: Cornyn was among those who voted against the Affordable Care Act when it passed the Senate in 2009, and one of Cruz’s first acts in office this year was to file a bill that would repeal the law. Cruz attempted to add an amendment to legislation in March that would have defunded the law, an amendment Cornyn also backed.
But with the Democratic majority in the Senate, attempts to weaken the law through that body remain unlikely to pass.
Cruz and Cornyn “want to keep the pressure on because they think there is a slight national majority against the act,” said Bruce Buchanan, a government professor at the University of Texas at Austin who specializes in public policy and American institutions. Buchanan suggested that the Affordable Care Act has become a lens for a more existential debate within conservative and moderate branches of the Republican Party.
“They want to be seen as leading the charge,” Buchanan said.
Even on the state level, criticizing the Affordable Care Act can be an effective way of positioning for primaries in Texas, said Gregory Thielemann, a professor of political science at the University of Texas at Dallas who specializes in Texas politics. Because the Republican Party is better organized in the state, appealing to more conservative primary voters can be a winning strategy, he said.
“The reason they’re saying this really doesn’t have anything to do with the Affordable Care Act,” he said. “They don’t like it, that’s true, but they don’t like anything that has [President] Obama’s signature on it. It’s a symbol.”
As talk of a possible 2016 Cruz presidential campaign builds, the junior senator could be using the Affordable Care Act as “a way of strengthening the position for the primaries” by positioning himself as a hard-line conservative, Buchanan said.
Catherine Frazier, a spokeswoman for Cruz, said she “would wholeheartedly disagree” with any implication that statements calling to repeal the law are politically motivated.
“Republicans have been talking for over two years — three years now — about how this is terrible legislation. We need to take every effort possible to defund it,” she said. Frazier said the law would have a "stranglehold on the economy" and discourage employers from hiring people.
Cornyn, who faces re-election in 2014, is reportedly preparing for the possibility of a serious primary challenge. Vocal criticism of the law could endear him to conservative voters.
But Megan Mitchell, a spokeswoman for Cornyn, said he and other Republican senators are criticizing the law because it is "bad policy," adding that she believes it will drive up the cost of insurance plans.
"This is a very, very serious issue, and this is health care for millions of Americans," Mitchell said.
Whether premiums will increase or decrease when the law takes effect remains a regular point of contention, though no conclusive evidence either way has emerged.
White House officials “have a responsibility to work with Congress to come up with a plan for a failed health care system,” Mitchell said.
Stacey Pogue, an analyst at the left-leaning Center for Public Policy Priorities, said focusing on repealing or weakening the law is misguided, because it has already been upheld by all three branches of the federal government.
“Continuing to engage in ‘I wish this had never happened, I wish it would go away’ — that ship has sailed,” she said. Pogue said looking to repealing the law distracts from discussions on how to implement it effectively.
"What we have through the Affordable Care Act is a real, meaningful option to get a good proportion, maybe half of our uninsured, coverage if we work on implementing the Affordable Care Act fully," she said, pointing out that about a quarter of the state’s population is uninsured, the highest rate in the country.
But though “there are things in the Affordable Care Act we need to fix,” attempting to eliminate it is counterproductive, Pogue said. She posited that discussion about repealing the legislation could die down after it begins to take effect in the coming months and “the public can see it, touch it and feel it.”
Buchanan suggested discourse about repealing the law could diminish if Republicans such as Cruz and Cornyn no longer see it as an effective way to connect with voters — if they conclude debating the law "is not going to help them win elections."
But he said it's possible other concerns could lead to Cruz and Cornyn continuing to search for ways to weaken the law, even if it is not politically productive to do so.
"This is a party — the wing we’re discussing is heavily ideologically driven," he said.
This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.