GOP mapping out waves of attacks over health law

Anecdotal content by consumer woes to fuel strategy

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WASHINGTON -- The memo sent to House Republicans this week was concise and blunt, listing talking points and marching orders: "Because of Obamacare, I Lost My Insurance." "Obamacare Increases Health Care Costs." "The Exchanges May Not Be Secure, Putting Personal Information at Risk." "Continue Collecting Constituent Stories."

The document, a product of closed-door strategy sessions that began in mid-October, is part of an increasingly organized GOP attack on the Affordable Care Act, President Barack Obama's signature legislative initiative. Republican strategists say that over the next several months, they intend to keep Democrats on their heels through a multilayered, sequenced assault.

The idea is to gather stories of people affected by the health care law -- via social media, constituents' letters or meetings during visits home -- and use them to open a line of attack, sustain it until it enters the public discourse and forces a response, then quickly pivot to the next topic.

"Yeah, there is a method being followed here," said Rep. Michael C. Burgess, R-Texas, who is involved in the effort, "but, really, these stories are creating themselves."

First, it was the malfunctioning website,, then millions of insurance policy cancellation notices sent to individuals with plans that did not meet the health law's requirements. Earlier this week, the House aired allegations that personal data is insecure on the Internet-based insurance exchanges.

At a congressional field hearing set for Friday in Gastonia, N.C., the attack will shift to rate shocks expected to jolt the insurance markets in the next two years. Coming soon: a push to highlight people losing access to their longtime physicians and changes in Medicare Advantage programs for older people.

The effort has its roots in a strategy developed last spring, when House Republican leaders -- plagued by party divisions thwarting legislative accomplishments -- refocused House committees on oversight, rather than on development of new policies.

That aggressive campaign, which produced numerous hearings on the attacks in Benghazi, Libya, as well as on IRS scrutiny of conservative groups, is now increasingly consumed by the health care fight.

House Majority Leader Eric Cantor, R-Va., and Rep. Cathy McMorris Rodgers, R-Wash., another leadership member, have also leaned on all 231 House Republicans. A 17-page "House Republican Playbook" walks members through "messaging tools" such as talking points, social media tactics and "digital fliers"; details lines of attack; offers up a sample opinion article for local newspapers; and provides an extensive timeline on the health care law and an exhaustive list of legislative responses that have gone nowhere.

A single message is given to GOP members at the start of each week, Ms. McMorris Rodgers said. A "Call to Action" email chain distributes relevant breaking news. A new website,, is collecting anecdotes from each member. The goal, she said, is to use all the "Republican voices we have in the House, the media markets in all the districts we represent, to take our message all over the country. It penetrates," she said. "It's powerful."

To Democrats, especially in the White House, the GOP effort's power stems from using anecdotes to paint a fundamentally misleading picture.

"There's been so much noise and so much misinformation, and this incredible organized effort to block the notion that everybody should have affordable health care in this country," Mr. Obama told health care law supporters this month, "that I think it's important for us to step back and take a look at what's already been accomplished, because a lot of times it doesn't make news. Controversies make news."

Republicans on the House and Senate floors have told constituent stories of soaring premiums or yawning new deductibles.

But the White House Council of Economic Advisers released a report Wednesday showing that health care spending had grown by 1.3 percent since 2010, the year the law passed. It said that is the lowest rate on record for any three-year period and less than a third of the average since 1965.

Jason Furman, the council's chairman, said much of that slowdown was attributable to structural changes in the health care economy ushered in by the health law, such as accountable care organizations, which band general practitioners, specialists and hospitals together to plan out a patient's care, not play off one another to raise their billing. And insurance premiums on plans offered through the exchanges are lower than expected.

Congressional Democrats are trying to use such information and their own anecdotes to counter Republican attacks.

Under the rubric of "This Is Obamacare" -- with its own website,, created by the Democratic National Committee -- Democrats have been sharing "Affordable Care Act success stories" of ailing constituents getting health coverage for the first time, people being able to keep their adult children on their insurance or consumers finding markedly cheaper insurance plans on the exchanges.


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