Republican town halls are erupting with protests as Americans fret over the future of their health insurance. But listen to Lamar Alexander for a few minutes, and you might think not a single bad thing will come of the GOP’s plan to rip apart Obamacare and stitch together a replacement.

The folksy Tennessee senator is quietly prevailing upon Republican lawmakers to take a deep breath when it comes to rewriting the health care law that controls a sixth of the American economy. His goal, in a nutshell: to reassure millions of Americans that Republicans aren’t trying to snatch away their health insurance.


His message: As long as we’re smart and deliberate, it will all be fine. It might take awhile, but we got this.

“There are a lot of generals in this administration … they’re taught in the war college to think it all the way through,” Alexander says. “We ought to do that as we try to repair the damage caused by Obamacare. We need to think all the way through to the end.”

Tamping down expectations about a quick fix — let alone delivering a solution — is a monumental task, of course. It’s one Alexander is most comfortable leading in private. If there’s a softer side to Republicans’ plans to gut the law, it’s best represented by Alexander, a lawmaker who so loves cutting a deal that he voluntarily left the top ranks of Republican leadership to better work with Democrats.

A former governor and two-time presidential candidate, Alexander stalks the halls of the Capitol with a small card filled with bullet points about the health care law, pressing it into the hands of Republicans to alert them to the scope of the problems with the nation’s insurance coverage. Just as he ran for governor by walking across the state in his trademark black-and-red checked flannel shirt, Alexander’s goal is to buttonhole enough GOP lawmakers until the whole party is on the same page.

It hasn’t been easy. Daily Senate Republican lunches regularly erupt in disagreement over strategy; it’s now mid-February without a clear path forward, after years of Republican show votes to repeal the law.

Which is fine by Alexander. Republicans came back to Washington in January ready to repeal Obamacare before Inauguration Day. The chairman of the Senate Health, Education, Labor and Pensions Committee was one of the first lawmakers to call on Republicans not to scrap Obamacare until a replacement is ready to go.

That’s now the GOP’s mantra.

“What I’m trying to do is to make sure that we think carefully,” Alexander said. “We’re moving from a position — repeal and replace — to governing. It’s a little more complicated.”

Still, it’s unclear how the GOP will respond to Alexander's more centrist approach. Conservatives inside and outside Congress have already grown frustrated with the GOP’s plodding pace toward repealing the law.

While the knives have not yet been turned on Alexander, it’s clear the party’s right flank is eager to follow through on its years-long vow to deep-six the health care law.

“We need to move expeditiously to honor the promises we made to voters,” said Sen. Ted Cruz (R-Texas). “This election in many ways was a referendum on Obamacare.”

But in a 30-minute interview with Alexander in his Capitol Hill office — packed with artifacts from early settlements in Appalachia, from animal pelts to Sam Houston’s walking stick — he talks instead about a “safe” approach. Implementing a replacement in full, he said, could take as long as four years.

Rather than use the GOP’s well-worn talking points, he has his own. Democrats and Republicans are fighting like the “Hatfields and McCoys,” he says, while relying on Obamacare will soon be like “having a bus ticket in a town with no buses running.”

He doesn’t throw out red meat, either, a quality that makes some Democrats open, in theory, to working with Alexander, even though the repeal vote will surely fall along party lines. They like that Alexander tried to be productive during the Obama administration and has carried his pragmatism into the Trump presidency.

“He’s one of the most thoughtful members we have,” said Sen. Tom Carper (D-Del.).

While they respect Alexander’s bipartisan bona fides, Democrats say his rhetoric about “building a bridge” from Obamacare papers over the reality of stripping health insurance coverage from millions of people.

Alexander is close with both Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer, which along with his committee chairmanship gives him clout with both parties.

“At a time when there is such tension in the chamber, Lamar is one of those people who can disagree with you without being disagreeable,” Schumer said.

Still, there are nearly 300 Republicans in Congress who want a piece of the debate, and many are already competing for attention over their own replacement plans.

Alexander doesn’t want to go that route. He says he won’t even introduce his own bill. Instead he wants to see what Trump and Health and Human Services Secretary Tom Price propose, then help craft a bill to reconcile the differences.

He also believes Republicans should focus on the biggest problems first. At the top of the list is flagging insurance exchanges, which are suffering from high premiums and low competition, even if they represent just 4 percent of those insured in the United States.

“That’s where we need to send in the rescue team,” Alexander says.

From there, he wants Republicans to turn to Medicaid expansion — which Republicans will keep and potentially even broaden, he says — before eventually addressing problems with the country’s patchwork of employer-sponsored health care plans. In essence, Alexander is trying to triangulate an approach that can become law.

One potential hurdle is Alexander’s lack of a relationship with President Donald Trump, whom he met for only the second time this month. But he has deep ties with Price and House Speaker Paul Ryan: During the interview, Alexander repeatedly stressed that the three of them are on the same page. Those relationships have given other Republicans confidence in Alexander’s role.

“That’s the key guy,” said Sen. John McCain (R-Ariz.).

Of course, Capitol Hill is a very turf-conscious place. Alexander’s committee has jurisdiction over only a small part of health care. The Senate Finance Committee controls the major levers, such as taxes, subsidies and Medicaid. The committees and their staffs have been working together — but Finance Chairman Orrin Hatch (R-Utah) is protective of his jurisdiction.

Sen. Lamar Alexander wants to see what President Donald Trump and Health and Human Services Secretary Tom Price propose, then help craft a bill to reconcile the differences. | M. Scott Mahaskey/POLITICO

“He doesn’t have much to do with it,” Hatch said of Alexander. “He takes a great interest in it, and I’m glad he does, and I want to get his best ideas.”

Hatch is urging the Congress to quickly repeal Obamacare’s taxes that fund subsidies for lower-income Americans on the exchanges. But here again Alexander urges caution: If Republicans repeal taxes now, how can they be sure they’ll have the revenue needed to pay for their replacement plan?

“Most Republicans are going to be reluctant to reduce taxes now and then raise taxes later,” he said.

With enough divisions among Republicans to fill a book, the GOP is starting with almost entirely partisan tactics. Alexander and other powerful Republicans want to use budget reconciliation to repeal and replace as much of the law they can on a party-line vote in the Senate, while looking to Price to write regulations to begin changing the law.

Once Republicans have settled their own issues, eventually they’ll need the cooperation of Senate Democrats to begin passing new insurance provisions. And the Senate is fraught with tension: Many Democrats are angry at Alexander for helping Trump confirm Betsy DeVos as education secretary, and there’s almost no appetite for collaboration on health care.

Alexander’s first hearing on the subject degenerated into a series of speeches. Democrats blasted Republicans for taking away peoples’ insurance. Republicans grandstanded about how bad Obamacare is.

“The witnesses were good, but the senators were not that good,” Alexander said. “It’s going to take awhile.”