Back to the drawing board for Obamacare foes
By: Jennifer Haberkorn
November 26, 2012 04:22 AM EST

President Barack Obama’s reelection has ensured that Obamacare is the “law of the land,” as House Speaker John Boehner declared, and it’s forcing Republicans on Capitol Hill to rethink their years-long opposition to the health care reform law.

The election has forced Republicans to acknowledge a harsh truth: The president’s signature law won’t be repealed in the next four years. By then, millions of Americans will be getting tax subsidies — and those will be really hard to take away.

Republicans in the House and Senate still hate the law — they say it’s bad health policy and bad budget policy — and their support for full repeal isn’t going anywhere. But they also realize the short-term strategy has to change.

The opposition plan is now centered on three main pieces, according to conversations with House and Senate Republicans: Focus on piecemeal repeal where it might be possible to pick up a few Democratic votes; use the House majority to conduct investigations into the implementation of the law; and be ready to act when the law crumbles, as they argue that it will.

In a Cincinnati Enquirer op-ed last week, Boehner acknowledged a new strategy focused on investigations and state opposition to setting up the law. “The tactics of our repeal efforts will have to change. But the strategic imperative remains the same,” Boehner wrote. “We need to repeal Obamacare.”

But Republicans now readily and publicly admit that repeal is impossible in the next four years unless something outrageous happens — such as Obama doing a 180-degree flip on health care policy.

It’s a dramatic shift in tone from a few months ago, when most Republicans wouldn’t be caught admitting that kind of defeat on Obamacare, fearing backlash from outside advocacy groups.

“We’ll continue to work on full repeal, but the political realities are that this is not going to happen legislatively because the president isn’t going to sign that,” said Rep. Tom Price (R-Ga.), one of the House’s strongest advocates for repeal. “It clearly doesn’t happen with the president unless he wakes up and wants to be responsible on health policy.”

Sen. Jim DeMint (R-S.C.), another top supporter of repeal, said his focus will turn to trying to allow states to implement the law as they want.

“As Republicans, we have to say we’re going to repeal this as soon as we can,” DeMint said. “Until then, we’re going to do everything we can to allow the states that want to, to do this the right away. If we can do that, we’ll have accomplished a lot given the political climate.”

South Dakota Sen. John Thune, chairman of the Republican Conference, said opposition to the law isn’t going away, even if full repeal isn’t possible.

“Given the political dynamics we’re dealing with, it’s going to be more difficult, obviously, to do that,” Thune said. “It’s a work in progress.”

But he pointed out several pieces of the law that he feels could garner Democratic support for repeal: a tax on medical devices, the Independent Payment Advisory Board and the individual mandate. While the House could pass bills repealing all of these pieces, Democrats in the Senate seem unlikely to take them up — especially if they could put Democrats in a tight spot back home if they oppose them.

Rep. Phil Gingrey (R-Ga.) said he doesn’t expect the House to hold many more votes on full repeal of the law “unless really it’s a messaging vote.”

“I think we should concentrate our efforts on trying to repeal the most egregious parts [of the law],” he said.

In the House, Republicans have already ramped up their oversight of the law. In the past two months, both the Oversight and Government Reform and the Ways and Means committees have sent subpoenas to Health and Human Services Secretary Kathleen Sebelius demanding information and documents that committee leaders said she was not providing.

Republicans are expected to continue sending letters and, when warranted, more subpoenas to the agency.

“I’ve long maintained there are three possible routes to repeal of ObamaCare: the courts, the presidential election, and our constitutional responsibility for oversight,” Boehner wrote in a letter to House Republicans earlier this month. “With two of them having come up short, the third and final of these becomes more important than ever.”

Republicans insist that they’ll keep up their opposition to the law until repeal becomes a possibility again — when Obama leaves office in 2017. But by then, America will have been living with the law’s biggest pieces in place for more than three years. The tax subsidies, individual mandate and insurance exchanges will have been in effect for three years, assuming they are enacted on schedule in 2014.

And some in the party concede that taking a government benefit away from people is extremely difficult.

“The question is going to be, can you mount an effort to change this law after its taken effect, and that’s very difficult to do,” said Sen. Mike Johanns (R-Neb.). “At the end of the day, elections have consequences.”

But other Republicans say the law is such flawed policy that it will eventually fall apart.

“It will collapse of its own weight over a period of time,” Price said, repeating a phrase many Republicans are using. At that point, the public will clamor for repeal, they argue.

“When you start seeing hospitals go out of business, they’re going to come up here and say this is a quality of care issue,” said Rep. Phil Roe (R-Tenn.), a physician.

He expects the federal law to take a path similar to the Tennessee health reform plan, TennCare. The program had ambitious goals of greatly expanding coverage by expanding Medicaid, but eventually it collapsed and more than 200,000 people were kicked off the program.

“It took about 10 years for this thing to implode under its own weight,” Roe said. “In 10 budget years, we had tripled the spending on Medicaid in our state. … My prediction is it will be 10 years or less that this will implode.”

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