Would House Republicans be rushing to repeal the new health law if they thought they might succeed? Forgive me for being skeptical, but I think not. Democrats have already done the dirty work and heavy lifting, and taken the political hits, for things that we all know must happen. It's hard to believe Republicans would want to start all over again.
Oh sure, they'd like you to believe the Affordable Care Act is a 2,000-page crap sandwich
, as our incoming House speaker once described the 2008 bank bailout bill (and that was only 451 pages). It is big, there's no disputing that. It's got many, many new regulations. And there are certainly things about it that are worth debating. The individual mandate requiring most people to buy health insurance is one of them. The impact on business is another.
But is it really debatable that we must find ways to curb health costs? At a time when a couple with average income will draw Medicare benefits that cost three times as much as they paid in
, does the GOP want to repeal the law's 10-year plan to cut the growth of Medicare costs by $500 billion? It's got to be done, as many Republicans have recognized
in the past. Erasing the Democrats' work just means they'll have to come up with something on their own, with all the political risk that entails.
And how about all those pilot programs designed to test cost-cutting ideas? Do Republicans want to kill them? There are dozens, including home-based care for the chronically ill, transitional care for people leaving hospitals, penalizing hospitals with high infection rates, paying medical teams a set fee for all services related to an operation, offering hospice services along with aggressive treatment (a combination that research suggests could reduce treatment costs and at the same time prolong life
). The nonpartisan Congressional Budget Office declined to include the pilots in its cost projections, but the ones that work and spread could have major impact
Then there are the benefits that people already are experiencing
-- preventive care with no co-pays, savings on Medicare prescriptions, insurance companies barred from rejecting or dropping people who have existing medical problems or develop new ones, young people without insurance from jobs allowed to stay on their parents' plans. It is not hard to picture Republicans scurrying to reinstate all of those provisions, because they are good politics and good ideas (some of them in fact Republican ideas). But how will insurance companies keep prices down if people only buy policies after they get sick? That's the scenario without an individual mandate.
There have got to be some Republicans looking at public opinion polls without distorting lenses. The exit polls from Election Day showed just about an even split
on the health law. And recent research suggests it may be misleading to conclude that the public wants the law gone. A CNN poll last month
found Americans opposed the law 54 percent to 43 percent. But it turns out some of the opponents -- probably backers of a public health insurance option cut from the bill -- thought it wasn't liberal enough. The upshot: 56 percent said they supported the law or wanted it to be more liberal.
Repeal would be most pleasing, one would assume, to the 37 percent who said they opposed the law because it's too liberal. When Republicans talk about what Americans want, they apparently are referring to that 37 percent slice of tea partiers and other conservatives.
I have heard House Republicans complain that they weren't allowed to offer amendments on the House floor. I've seen Politifact's conclusion (relatively early in the process) that it's "barely true
" that the health law incorporates Republican ideas. Yet it's also true that House and Senate committees considered rafts of GOP amendments, and voted most of them down -- simply a fact of life in a duly elected Democrat-dominated House.
Even more fundamentally, Democrats incorporated many one-time Republican ideas into the bill before and outside of the committee process. A partial list would include the individual mandate
, insurance plans sold across state lines, adult children
allowed to stay on their parents' plans, pilot programs to limit malpractice awards and lessening favorable tax treatment
for health benefits offered by employers.
Substance aside, there are many indications that we are still in campaign season. The repeal bill scheduled for a House vote Jan. 12 is entitled "Repealing the Job-Killing Health Care Law Act" (rhetoric reminiscent of Republican press releases last year that would, for instance, routinely refer to Illinois' Democratic Senate candidate as "mob banker Alexi Giannoulias"). Never mind that one (admittedly liberal) think tank says the law will create millions of jobs
and it is already helping more small businesses offer insurance
So many Republicans ran so hard on repealing the health law that the repeal vote was inevitable. Just as inevitable, however, is that the Senate is 95 percent certain to block any wholesale repeal and Obama is 100 percent certain to veto anything of the sort should it reach his desk. As Rep. Rosa DeLauro (D-Conn.) said Tuesday, "This repeal of health care by the Republicans is political theater. It is a kabuki dance."
Democrats have never argued that their law is perfect, and some have stressed that follow-up fixes and changes are a given for every major piece of legislation. So it's likely there will be some constructive proposals from the GOP. But -- as some Republicans no doubt know but can't say -- wholesale repeal isn't one of them.
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