GOP may lose health care repeal battle, but war will rage on

McClatchy NewspapersJanuary 7, 2011 

WASHINGTON — The Republican-led House of Representatives will vote Wednesday to repeal President Barack Obama's health care law — and that will settle nothing. Rather, it will be but one more battle in a long political war that will go on for at least two more years, one which either side may win.

The Democrats won the first battle when they enacted the sweeping new law last year. The Republicans won the second, when they rode a backlash against the law to take over the House in November's elections. Democrats ultimately will win the third round, as the House vote to repeal the law will fail — either in the Democratic-majority Senate or with Obama's certain veto.

Yet the two sides will fight on — in legislative skirmishes for the next two years over whether to gut the law piece by piece; in court, over whether the law is constitutional; in campaigns for elections for Congress and the White House in 2012; and ultimately in political debates aimed at getting the divided American people to either clearly embrace the law's benefits or turn solidly against it.

Republicans think they have the momentum, coming off their takeover of the House. They credit their unified opposition to the law — not a single Republican voted for it on final passage — with their November gain of six seats in the Senate and 63 in the House.

"We made a commitment to the American people. We're listening to the American people," said House Speaker John Boehner of Ohio.

Mindful that this first effort to repeal the law is doomed to fail, Boehner said the Republicans will keep at it. First they'll use their power over government spending to try to deny the money needed to implement the law. Second, they'll hope to take over the Senate and seize the White House in 2012, which must happen if the law is to be repealed before it takes full effect in 2014.

"We're going to do everything we can over the course of however long it takes to stop this," Boehner said.

Despite Boehner's insistence that House Republicans are heeding the American people, the truth is that Americans are divided on the law. A clear majority may not swing in one direction or the other for several years, as the law is phased in and its impact is felt and understood.

A recent McClatchy-Marist poll, for example, found that 35 percent of voters think the law should be expanded to do more, 33 percent think it should be repealed, and 16 percent think it should be left the way it is.

Republicans think that the unpopular short-term consequences and requirements of the law will turn more people against it, such as increases in health insurance premiums this year, and the mandate, effective in 2014, that every American must buy insurance. According to the McClatchy-Marist poll, 2 out of 3 voters think the mandate is unconstitutional, and fewer than 1 in 3 think people should be forced to buy insurance.

"People don't like the mandate. And they think it's going to raise the cost of their health care," said Peter Brown, the assistant director of the Polling Institute at Quinnipiac University. "That will largely determine how they will feel about it."

But people do like some of the law's benefits.

The same McClatchy-Marist poll found that voters like being able to keep children up to age 26 on parents' insurance policies by a 68-29 margin. They like the requirement that insurers must cover pre-existing conditions by a 59-36 margin.

Analysts suggest the GOP is taking a big risk.

"I don't think Republicans appreciate what they're getting into here," said Steven Smith, the director of the Weidenbaum Center on the Economy, Government and Public Policy in St. Louis. "I know they got themselves elected by saying they would repeal, and there's no doubt their constituency favors this."

But Republicans won in November by pulling swing voters, and, "They may be misjudging those voters on health care," Smith said.

Democrats hope so. They think time is on their side, that people will grow to like the law ever more as they come to enjoy new benefits, as happened with Social Security and Medicare. And they'll fight over coming years to explain and dramatize those benefits — hoping they'll do a better job than they've done in the past year.

Obama for example, will use a retooled White House staff to try to explain better why people should like the health care law.

"He's hoping to communicate better," said Lee Miringoff, the director of the Marist Institute for Public Opinion at Marist College. "The potential is there for winning popularity. He does have a second chance to make a first impression."

The White House is already working to cite improvements in the economy, however modest, to counter arguments that the health care law killed jobs and portray it instead as a tool of growth.

"Since the president signed the Affordable Care Act into law last March, the economy has created over 1 million private sector jobs," White House spokeswoman Stephanie Cutter said on Friday. "At a time when our economy is getting stronger, repealing the law would hamper that important economic progress by increasing costs on individuals and businesses, weakening the benefits and protections that Americans with private insurance are already enjoying, and adding more than a trillion dollars to our deficits."

Democrats will strive to back him up, casting the law as a helping hand for ordinary Americans and framing the Republican effort to repeal it as mean.

"They're willing to double this year the cost of branding drugs for seniors who have high medicine costs," said Sen. Debbie Stabenow, D-Mich., of the GOP. "They're willing to add to the cost for families and their children who just want to talk to the doctor when they get sick instead of fighting with the insurance companies."

Said Rep. Debbie Wasserman Schultz, D-Fla.: "I was in the grocery store, and a woman came up to me and literally put her hands on my shoulders and said, 'Debbie, thank you for passing health care reform. You saved me $3,000 when I was able to put my two adult daughters back on my insurance plan.'"

Republicans maintain that they, too, want to retain some of the more popular provisions, such as the pre-existing conditions law.

But keeping only popular parts of the program begs a serious question, said Paul Ginsburg, the president of the Center for Studying Health System Change, an independent research group: How would they spread the risk? The Democratic-authored plan does it by mandating coverage.

How would Republicans pull enough healthy people into the system, Ginsburg asks, and how might they help lower-income people afford coverage?

Republicans say they'll offer alternatives that would spread the risk. And, they say, their still-unwritten proposals would bring down federal budget deficits — even though the nonpartisan Congressional Budget Office estimates that repeal would add $230 billion to the deficit over the next 10 years by eliminating savings.

"I do not believe repealing the job-killing health care law will increase the deficit," Boehner said. "CBO is entitled to their opinion."

He contends that Republican alternatives, such as changing the medical liability system to "reduce unnecessary and wasteful health care spending," and lowering health care premiums through increased competition, will lower deficits.

Bring it on, counters House Minority Leader Nancy Pelosi, D-Calif., and you'll find it's not that easy.

"You can't just say, I like the palatable parts of this," she said, "but I don't want the structural change that is required."

ON THE WEB

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Republican plan to reduce congressional budgets

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