Congress is highly unlikely to repeal the entire 2010 federal health care law this year. And it’s going to be difficult if not impossible to do it next year, even if Mitt Romney wins the presidency.
Republicans said Thursday that they’ll try hard to repeal the Patient Protection and Affordable Care Act starting with a July 11 repeal vote in the House of Representatives, where the party holds a huge majority. But they’d need 60 votes to get it through the Senate, and 67 to get past President Barack Obama’s certain veto. They have 47 seats in the Senate now.
The only faint prospect for repeal is a strong mandate from the 2012 congressional and presidential elections – a Republican landslide that does not now appear on the horizon. Polls suggest the public is not overwhelmingly opposed to the law, and the elections are more likely to be seen as a mandate for economic change, not an overhaul of health care laws.
To pass repeal next year, the House would have to remain in Republican hands, and the party probably would need 60 senators.
The odds are staggering. Twenty-three seats controlled by Democrats are up for election this year, compared with only 10 for Republicans. Independent analysts see at best a four- to six-seat Republican gain.
While Republicans may win a Senate majority, the chances the party will gain 13 seats are daunting. No party has had that kind of net gain since 1958.
Republicans’ best bet for change is likely to be an effort to dismantle the law piece by piece. They’ve already tried, and in some cases they’ve picked up dozens of Democratic votes.
Earlier this month, for instance, the House voted 270-146 to repeal a 2.3 percent tax on the sales of medical devices. Thirty-seven Democrats joined 233 Republicans in approving the measure, which is awaiting Senate action that is not expected anytime soon.
More such efforts are expected, particularly next year.
“What you’re looking at is a whack-a-mole approach rather than full-scale repeal,” said Ilisa Halpern Paul, managing government relations director at the Drinker Biddle & Reath law and lobbying firm.
Congress could try to deny funds for implementing the law, for instance, or reconsider the law’s Independent Payment Advisory Board, which will be making recommendations about Medicare cuts.
Senate Health Committee Chairman Tom Harkin, D-Iowa, would not rule out changes in the law. “I’ve often said that the . . . act is not like the Ten Commandments chiseled in stone. It’s like a starter home, suitable for improvement,” he said.
But he, like most Democrats, is a strong supporter of the law’s major provisions and is likely to resist serious changes.
For now, Democrats are trying to set a loftier tone, urging comity and a bipartisan focus on the ailing economy.
“With today’s announcement, it’s time for us to move forward, to implement and where necessary improve on this law,” said Obama.
Republicans wouldn’t go along, instead trying stoke the kind of public outrage they think will shift congressional votes.
“It is now in the hands of the American people to determine whether this disastrous law will stand,” said House Budget Committee Chairman Paul Ryan, R-Wis.
Presumptive GOP presidential nominee Mitt Romney on Thursday cast the effort to revoke the law as a crusade.
“If you don’t want the course that President Obama has put us on, if you want instead a course that the founders envisioned, then join me in this effort,” he said in a brief statement. “Help us defeat Obamacare. Help us defeat the liberal agenda that makes government too big, too intrusive, and is killing jobs across this great country.”
The crux of the Republican argument is that the health care law is big government, as well as an enormous tax burden.
The court’s 5-4 decision Thursday said Congress acted within its taxing authority when it passed the “individual mandate,” which requires nearly everyone to obtain health care insurance by 2014 or pay a penalty.
“We do not make light of the severe burden that taxation, especially taxation imposed by a regulatory purpose, can impose,” Chief Justice John Roberts Jr. wrote for the majority. “But imposition of a tax nonetheless leaves an individual with a lawful choice to do or not do a certain act so long as he is willing to pay a tax levied on that choice.”
The law also makes profound changes in how many Americans buy and receive health care coverage. Since it became law in 2010, its provisions have been gradually phased in – a method the authors designed as a means of slowly building support.
Already, children with pre-existing conditions cannot be denied coverage, dependents can remain on their parents’ policies up to age 26, and millions of Medicare beneficiaries are getting price breaks on prescription drugs.
Supporters argue that the more people learn to enjoy these benefits, the less the anger toward the more controversial aspects of the law.
Democrats on Thursday tried to move on, urging colleagues to focus on the nation’s ailing economy, and suggesting they won’t be entertaining changes to the health care law anytime soon.
Said Senate Majority Leader Harry Reid, D-Nev., “It’s time for Republicans to stop fighting yesterday’s battles.”