You are quite correct. The republicans had years and years where they could have taken the lead on this subject, but they seemed to think it would just....go away.
well, it didn’t and now we have this unholy mess.
If you go back to the early 1970s....Nixon (before the troubles)...had the idea of some type of national healthcare policy for the lesser of the nation to sign onto. It would have been cheap....but also limit your options and rely upon high deductibles.
Carter also brought this up about half-way through his four years....only to find Kennedy all disturbed and upset about it not being his pet project. It never went anywhere.