SPOKANE, Wash. — Cathy McMorris Rodgers got an earful about health care on a recent Friday afternoon knocking on doors in the suburban Balboa neighborhood of Spokane. McMorris Rodgers, the top-ranking Republican woman in the House facing the toughest reelection contest of her career, heard one resident complain his wife’s monthly insurance premiums have swelled to over $700 per month. Another agonized about affording long-term care for her elderly mother. Yet another worried whether Medicare would go bankrupt.

In past election cycles, the seven-term lawmaker might have had an easy talking point: Repeal and replace Obamacare. But like other Republicans who suddenly find themselves on the defensive on health care, she avoids mentioning her party’s long-standing pledge to eliminate the 2010 law.


McMorris Rodgers is not just another endangered Republican facing a tough race. She’s No. 4 in the House Republican leadership — and the only woman. The fact that she’s now steering clear of one of the GOP’s core tenets about repealing Obamacare shows just how treacherous the health care issue has become on the campaign trail. A mother of three, including a child with Down syndrome, McMorris Rodgers is often portrayed as a softer, more compassionate face of a party that’s tacked harder right in the age of Trump. But she’s also the sole Washington state lawmaker to have voted to repeal Obamacare last year.

Now, she faces attack ads spotlighting that vote, not to mention lawn signs imploring voters to “repeal McMorris Rodgers, not our health care.” And while McMorris Rodgers talks about the importance of insurance protections for people like her son who have pre-existing conditions, she voted for a bill that health experts largely agree would have eroded those protections.

“She’s still defending that vote,” said her Democratic rival Lisa Brown, a former state Senate majority leader with health care bona fides, including helping to start a medical school in eastern Washington. “She’s still saying, ‘Well, people just didn’t understand our vision.’ It’s so much not in the best interests of this region and the whole state of Washington that I had to conclude she’s either really out of touch with the district … or has just decided to choose the party over the district.”

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McMorris Rodgers counters that Obamacare failed to deliver on its stated goals, including that nobody would lose their health insurance and that insurance costs would decrease significantly. Instead, premiums have skyrocketed across the country, including an average jump of 13.8 percent for next year in Washington.


“It was well intentioned, but it has not fulfilled its promises,” she said during a break between visits to a new behavioral health clinic in the district and a nonprofit agency that serves refugees. “We continue to need health care reform in this country. We need to address what’s driving the cost of health care.”

Notably, she touts a 10-year extension of the children’s insurance program, more funding for medical education and her work to combat the opioid crisis among the health care accomplishments on her website, but makes no mention of Affordable Care Act repeal or a GOP replacement plan.

When pressed on health care on the campaign trail, she promises to ensure that vulnerable people, including those with pre-existing conditions, get the care they need, even though the Trump administration is asking the courts to throw out Obamacare’s insurance safeguards.

“Let’s make sure we keep what’s working well and build upon that,” McMorris Rodgers told POLITICO.


Washington is one of the epicenters of the Democrats’ fight to flip 24 House seats to retake the chamber: Besides McMorris Rodgers’ seat, they see pickup opportunities in the seats of Reps. Dave Reichert, who is retiring from a district stretching from the Seattle suburbs hundreds of miles to the east, and Jaime Herrera Beutler in the southwest corner of the state.

McMorris Rodgers’ district, which sprawls across the eastern part of the state and borders Canada and Oregon, carries historic symbolism that makes it an irresistible target for Democrats. When the Gingrich revolution led a Republican takeover of the House in 1994, the most prized scalp was that of former House Speaker Tom Foley, who held the seat for three decades and became the first sitting speaker to lose reelection since the Civil War.

“There’s not a single Democrat in that district that has forgotten that history,” said Tina Podlodowski, chairwoman of the Washington State Democratic Party.

The seat has been held by Republicans since Foley’s ouster, and President Donald Trump won the district by 13 points in 2016. Most analysts peg McMorris Rodgers as a slight favorite, and Republicans are voicing confidence.

“The 5th is the one I’m probably most optimistic and bullish on,” said Caleb Heimlich, chairman of the Washington State Republican Party, speaking of the state’s three competitive House contests. “At the end of the day, she’s going to win by 6 to 8 points.”

But Democrats believe Brown is the candidate who could turn the district blue again. She spent two decades in the state Legislature, rising to Senate majority leader before becoming chancellor of Washington State University’s Spokane campus. In both roles, she helped create a new medical school at the college, which enrolled its first class last year, cementing Spokane’s status as a regional health care hub.

On a recent afternoon, Brown touted her work establishing the medical school during a candidate forum on the Colville Indian Reservation, about two hours north of Spokane. “The health care issue is probably the most important issue I hear about as I travel through the district,” she told the audience.

Andy Joseph Jr., a member of the Confederated Tribes of the Colville Reservation who’s been active in trying to increase funding for the Indian Health Service, thinks the new medical school could help lure doctors to parts of eastern Washington that struggle to attract health care providers. He lauds Brown for working closely with the tribe on that process.


“We’re really tired of burying our people at a very young age,” Joseph said. “The opioid issue that’s going on, that’s been in Indian country for a long, long time.”

Brown, like other Democratic candidates this cycle, frequently criticizes Republicans for threatening insurance protections for pre-existing conditions, which a recent POLITICO-Harvard poll found is an overwhelming concern for Democrats. The Trump administration’s decision to support a lawsuit from 20 conservative states that would gut Obamacare’s protections has been a political gift for Democrats and a messaging challenge for Republicans.

McMorris Rodgers accuses Democrats of using “scare tactics” to confuse voters, claiming that Republicans “will take action” to protect patients if the courts rule against Obamacare.

“Protecting those with pre-existing conditions is fundamental to any health care reform for me, and I have made that a priority,” she said.

In a column she wrote last month for The Spokesman Review, she said that neither Obamacare nor “the system we had before” have worked for the people of eastern Washington.

But while she says her opponent is focused “on attacking my record and not offering her own ideas,” McMorris Rodgers said she’s advancing “real solutions,” endorsing general principles such as “more choice and greater competition to lower health care costs,” “ensuring the most vulnerable get the care they need” and “leveraging technology.”

But those principles ring hollow to Democrats, who say Republicans have proved they can’t come up with a viable replacement for Obamacare.



“By trying to dismantle it and not having anything to put in its place, clearly that’s in jeopardy,” Brown said. “It’s the distance between the rhetoric and the reality.”

This story was produced with the support of the Dennis A. Hunt Fund for Health Journalism, a program of the USC Annenberg School of Journalism’s Center for Health Journalism.

