With the Republican health care plan continuing to earn negative headlines and unfavorable poll numbers, House GOP lawmakers returning to Washington this week have a public relations challenge of epic political proportions.

They succeeded — barely — at passing their health care bill. Now they need to sell it.

Some members tried to do that over recess. A handful held in-person town halls, with New Jersey Rep. Tom MacArthur, the architect of the amendment that resurrected the plan, taking questions for nearly five hours. Others hit the media circuit or wrote op-eds in their local newspapers. 

But the effort is disjointed at best, with one major outside group shouldering the burden of a TV advertising campaign to respond to the liberal groups attacking the plan. Many conservative outside groups are holding off, knowing that the legislation will change in the Senate.

“The reality is, it’s hard to litigate what this policy will be until we see what the final product is,” one GOP operative said.

But in the meantime, as public opinion shapes, the mass confusion is enough to concern some Republicans worried about holding onto their majority in 2018.

“Republicans have done a terrible job explaining the AHCA to voters. No one has any idea what is in the bill besides the controversial items that are going to cause real political harm to members,” said one GOP strategist, referring to the bill by its abbreviation. “Outside groups are doing the best they can with this s— sandwich.” 

Talking to constituents

Despite being vilified by the left, MacArthur has tried to be the empathetic face of the bill. So how does he think his party should educate voters about it?

“You don’t do it up here,” he said, pointing to his bald head. “You do it here,” he said, tapping his chest. “People have to know what our intentions are, they have to see our heart on the issue,” MacArthur said, hours before his town hall in Willingboro, New Jersey.

But when he faced the crowd that Wednesday night, angry constituents accused the second-term Republican of talking about his daughter’s death too much, to the point of politicization.  

“I’m not looking for sympathy,” MacArthur told them. “I’m trying to convince people I get it.”

MacArthur said members like him should be back in their districts talking to their constituents, but he refused to criticize his colleagues who weren’t holding town halls. 

Only a handful of members who could have tough re-election races faced their constituents in person last week. Those that did were looking to correct the record on what they saw as lies being spread about the bill.

Iowa GOP Rep. Rod Blum attempted to explain that the law would only affect a small portion of the population who participate in the individual exchanges. Other Republicans took a similar tactic, saying their states would not apply for waivers allowing insurers to opt out of essential health benefits requirements. Some lawmakers suggested senators would fix unpopular parts of the House bill.

But convincing Americans who are afraid of losing their health insurance is no easy task. Even MacArthur, who intentionally held his town hall in a Democratic stronghold in his district, didn’t have much hope of persuading many of those constituents about the plan.

“Look, do I hope to convince some people? Sure. But that’s not really the objective,” he said before the town hall. “I think a lot of people are very settled on their views on health care, and I’m not likely to change them.” 

Taking to the tube

MacArthur is especially upset about outside spenders messaging against the GOP bill.

“They’re intentionally confusing people because it whips them up,” he said. “It’s our job to clarify.” He sees that as the responsibility of members, the party and outside groups.

But so far, only one outside group is on air backing the plan. The American Action Network, the issue advocacy organization tied to GOP leadership, has spent $2.5 million since the bill’s passage; they’re planning to spend at least $7 million over 60 days to defend the plan.

The day after the bill’s passage, the National Republican Congressional Committee released a digital ad about House Republicans keeping their promise to voters. But the committee won’t disclose where the ad is running or how much money is behind it. When it comes to messaging on the plan, the NRCC is in a difficult spot since some of its most vulnerable members voted against it. 

President Donald Trump may have invited GOP lawmakers who voted for the legislation to the Rose Garden, but the optics of that celebration resulted in even more negative headlines. And there’s been almost no effort from pro-Trump outside groups to sell the plan in the days since. America First Policies, the pro-Trump group that spent $3 million targeting 12 Republicans before the bill passed, is watching the legislative process to see what happens.

“We are focused on making sure the repeal and replace of Obamacare gets signed into law,” said Brian O. Walsh, the group’s president. He said the group may “engage in some activity” before the Senate takes up the bill, but that’s not certain. 

The Club for Growth, which backed the latest iteration of the bill, released an ad thanking MacArthur. But that spot has since gone off the air, and the group has no plans for additional spending until it sees what happens in the Senate.

Staying on defense

Having passed a plan in the House, the GOP conference is on defense. Even Republicans who voted for the bill admit it’s always easier to be against something than it is to be for it.

That’s a reality Democrats know all too well, with some in the party faulting former President Barack Obama for not adequately selling his signature 2010 health care legislation.

But some Republicans say the GOP can and should still be on offense against the 2010 law, which is still the law of the land. 

Part of that thinking, of course, is that repeal and replace is unfinished business and things will change in the Senate. “We are losing the argument when we are litigating a single piece of legislation,” the GOP operative said.

But that strategy is also about highlighting why Republicans felt the need to do away with the 2010 health care law in the first place — a crusade that helped them win congressional elections for the past seven years. The NRCC’s digital spot, for example, is really a contrast ad that shifts to a much darker musical score to characterize the “status quo.”  

“We need to be louder and more aggressive reminding the American people how bad the current situation is,” the operative said. That allows the “alternative to simply be better,” he said.

Bridget Bowman contributed to this report.