By now, we know that Republicans in the Senate are having a tough time coming to agreement on a health care bill. Senate Majority Leader Mitch McConnell took the drastic step this week of cancelling at least the first two weeks of the August recess to round up the 50 votes he needs to pass a bill.

But, McConnell has more than just vote counting problems. He’s got a messaging problem. The story about health care is all about process (whip counts, what's in and what's out of the bill, and what rifts are still too large to bridge) and very little about substance.  Voters looking for a reason to support the GOP effort aren’t being given much.  As the Washington Post’s Paul Kane astutely noted: “In public appearances, and often in private GOP meetings, Republican after Republican outlines the reasons that they stand opposed to the legislation, as written, with almost no one taking up the mantle of defending a proposal that was unpopular from Day One.”

The President isn’t helping much either.  Delegating by tweet – he’s sent multiple mixed messages about the way forward. He wants the bill to be less “mean” than the House version. He’s advocated for an immediate repeal and replace later strategy. Most recently he chastised his own party for their lack of progress with these tweets:



But, here’s what else should worry Republicans, especially those up in 2018.  The forces opposed to the legislation are outspending those supporting the bill $5.8 million to $354,000.

Take a look at Nevada, for example, where Sen. Dean Heller publicly came out as opposed to the Senate legislation in late June. Since May 23rd, a combination of four groups – AARP, Planned Parenthood, Save My Care, and the Community Catalyst Action Fund – have run almost 5,000 ads at a cost of approximately $1.6M,  rging Heller to vote against the bill. On the other side, two ads (at a cost of $140), sponsored by the Trump campaign SuperPAC – America First Policies – urged Heller “to keep his promise” of repealing and replacing Obamacare. Those ads were pulled at the urging of Sen. McConnell.

Other GOP senators who have expressed hesitation about supporting the GOP bill – Shelly Moore Capito of West Virginia and Lisa Murkowski of Alaska, have been bombarded with ads that criticize the bill and urge them to oppose it. In West Virginia there have been over 1,700 ads attacking the bill at a cost of approximately $245,000. In Alaska, outside groups have spent over $277,000 on 3,881 ads urging Murkowski to vote against the bill. As for advertising that supports the bill – or even urges these two swing Senators to support it: a big fat goose egg. Nada. Nothing.

This is a significant change for earlier this spring as the House bill was making its way through the legislative process. The House bill was passed in early May. From March 1st until May 22nd there were 64,484 ads run that mentioned health care legislation, 43 percent were positive ads about the health care bill while 56 percent were negative.

Ad Spending Gap on Health Care Legislation

Source: Kantar Media

Almost all the advertising defending the GOP bill came from one source, the American Action Network, a GOP nonprofit aligned with Speaker Paul Ryan. Of the $10.2M spent on pro-AHCA ads like this one in the spring, $7.7M –or 76 percent– came from AAN. Other stalwarts of the GOP outside money world that have spent millions attacking Obamacare and calling for its repeal, like the Koch Brothers-backed Freedom Partners, were silent. The Club for Growth aired just 30 pro-AHCA ads earlier this spring.

Those outside groups remain on the sidelines today. Both the Koch Network and Club for Growth, have been publicly critical of the current Senate bill. It remains to be seen if they will ultimately support a final version. It will also be interesting to see what these groups do if the final version is something that they hate. Will they remain neutral? Will they openly attack the GOP bill? Will they urge the House to sink it? Will they withhold advertising/financial support for members who support it?

It’s unclear if Republicans will pass a health care bill. But, even if they do, they will still need to defend and define it. And, that is going to require money and effort: Money and effort that neither they nor their allies are currently shelling out.  

As I wrote a few weeks ago, Democrats spent a lot of political capital to get Obamacare across the finish line in 2010, yet spent very little actual money defending it. Instead, it was Republicans and those opposed to the legislation that spent heavily attacking it. Wary incumbent Republicans should rightly wonder if the cavalry will be there to give them cover when the arrows from the anti-GOP health care side are raining down on them. As it looks today, they are on their own.  



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