Will Republicans Repeal Obamacare?

Remember when Mitt Romney caught flak for saying he’d “repeal the bad and keep the good” in Obamacare? It looks like Hill Republicans are joining him on that point, if this Politico piece is accurate.  

If the law is upheld, Republicans will take to the floor to tear out its most controversial pieces, such as the individual mandate and requirements that employers provide insurance or face fines. If the law is partially or fully overturned they’ll draw up bills to keep the popular, consumer-friendly portions in place — like allowing adult children to remain on parents’ health care plans until age 26, and forcing insurance companies to provide coverage for people with pre-existing conditions. Ripping these provisions from law is too politically risky, Republicans say.

In response, Speaker Boehner put out a statement reiterating that nothing less than full repeal is acceptable, and leadership staff pushed back against the idea that they were preparing to cave. And I believe him! But should Republicans fail to achieve a majority in the Senate,  which will prevent  anyone who saw the writing on the wall had to see this coming: barring a clean sweep for Republicans in the Senate and the White House, a partial repeal was always the more realistic political end-game. The far likelier result is a situation where a President Romney signs a law that he claims will make Obamacare “more market friendly” as opposed to eliminating the whole thing and starting from scratch.

Phil Klein has gone through this before, step by step, demonstrating that repealing via the reconciliation process (the only option that’s feasible for Republicans) is likely to be difficult for a host of reasons, even if Republicans get to 50 seats plus the vice president:

Reconciliation is likely the only path to repealing Obamacare because the procedural maneuver only requires 51 votes in the Senate, rather than the typical 60. But it’s a complex process that would be impossible to tackle on “day two,” or January 21, 2013.

To start, before a health care reconciliation bill can be written, both chambers of Congress would have to pass a budget resolution. This is something that has never happened before April 1, and that usually occurs in May or June, if at all.

Once that happens, a reconciliation bill would have to go through congressional committees, and pass the House. And that’s just when the fun starts.

Once the bill moves to the Senate, the only provisions that could be repealed through reconciliation would be ones that would reduce the deficit, as determined by the Congressional Budget Office.

This means that Republicans may be able to repeal spending on expanding Medicaid and offering subsidies to individuals to purchase insurance on the new government exchanges, but they’d likely be unable to touch the onerous regulations or tax increases.

That’s a very heavy lift, and it’s why those of you who think anything less than full repeal is unacceptable are very likely to be disappointed. Politico notes that Republicans are already running down how they can reintroduce a host of aspects of Obamacare, including the Medicare prescription drug “donut hole”, in order to avoid any backlash from the populace. (The donut hole, of course, is one of the few sound actuarial aspects of the prescription drug plan, since it translates into a price signal… and don’t get me started on the slacker mandate.) Republicans understand, however, that the base won’t like anything less than full repeal:

But even with those insurance industry reforms — which poll well with the public — Republicans could run into resistance from conservatives, who want to repeal the entire health care law and leave nothing in its place. “I don’t want any vestige of Obamacare left in law,” Rep. Steve King (R-Iowa) said. “Not one particle of DNA.” Before they even put together a bunch of piecemeal health care bills, Republicans would have to overcome their own differences.

This situation is in part a byproduct of the fact that Republicans are more comfortable talking about entitlements than they are talking about the lack of a true marketplace for health care in America. As John Goodman has pointed out, John McCain’s 2008 reforms are just the most recent example of a plan Republicans are afraid to talk about.

Given this, I think a more moderate entitlement solution seems to be a more likely outcome – one which solves some problems with government programs, but leaves the bulk of the health care cost problem unsolved and the failed third party payer system intact. While Republicans are more confident arguing for Medicare and Medicaid-focused reforms today than they have been in the past, they still have a severe lack of knowledge and spine when it comes to making the case for unleashing the competitive marketplace for health insurance… which is a shame, since that’s the best path toward actually bringing down premium costs.

  1. BrentB67

    This is the same Speaker that said they were going to cut $100Bn from the budget and it worked out something like $0.34 right?

  2. Fake John Galt

    The house has the ability to stop it now and always has. Just stop funding it, a program without money will die. Once it is dead they can clean it up and wipe it out.

  3. Ben Domenech
    C

    I wish stopping funding would stop it all, but it would leave many aspects intact, unfortunately, resting dormant until a future Democratic administration could revive them.

  4. Bryan G. Stephens

    Anything less than full repeal is a betrayal of Republicans and the Nation. I understand that the pols all lie all the time, but this is one of those “read my lips” moments.

    The GOP with 50 votes in the senate can changes the rules to make getting rid of this monster something that gets an up or down vote. Just do it. Nancy Pelosi did not let one GOP bill come to the floor in her reign. Not. One.

    Play hardball guys. The Dems are out to destroy America as we know it. Fight like you mean it.

  5. Roberto

    It appears we have a few more RINOs who need to be primaried.

  6. The King Prawn

    Good plan, keep all the popular but costly things and get rid of the unpoupular things that made the whole house of cards seem plausible. It would result in the crash of the industry. We’d be left with nothing but bartering or government provided services. My understanding is that DocJay has enough chickens already.

  7. Sumomitch

    Welcome to the reality of entitlement state politics. I have watched Republican Presidents and Congresses come and go for 32 years, and the only substantial cuts in the federal budget were defense (after the Cold war was won).  Republicans can cut tax rates (with tax reform or the Bush tax cuts), but never (under Reagan, Bush I or Bush II) can they “cut” (even in the sense of prevent future increase) entitlement programs. This is why real conservatives are driven to conclude “We Are Doomed.” (Even neo-con squish David Brooks today has a piece up acknowledging how the modern entitlement state undermines all fiscal discipline.)

  8. Paul A. Rahe
    C

    If Romney and the Republicans do not repeal Obamacare, there will be hell to pay.

  9. James Of England

    Robert, Bush 41 repealed CatCare, Reagan’s massive medicare expansion, and his welfare reforms allowed Wisconsin and other states to experiment, ultimately cutting welfare for us all. His cuts and his tax cut, combined with his tax hike, produced smaller government as a portion of GDP and balanced budgets. I agree that Reagan and Bush 43 both failed on these grounds, but not every Republican President fails the fiscal conservative test.

  10. James Of England

    Fortunately, the process of reconciliation favors cutting the expensive stuff, and fortunately Mitt’s greatest political achievements have been in forcing unhappy legislatures to cut government and cut spending. Of course he’ll have some problems with the House, but we should have a margin there. In the Senate, I don’t believe there’s a Republican who would vote down a straight repeal by reconciliation. It’d be the end of their careers. With Maine on our side, who could be against us?

  11. Nick Stuart

    The GOP can (and please God will) capture the White House, the House of Representatives, and have a filibuster-proof majority in the Senate, and they won’t actually repeal Obamacare. They haven’t the cojones to face the media and inevitable protesters.

  12. Misthiocracy
    Ben Domenech: I wish stopping funding would stop it all, but it would leave many aspects intact, unfortunately, resting dormant until a future Democratic administration could revive them.

    Sounds like Cthulhu.

  13. Duane Oyen

    If all that was needed to accomplish something was determination, even with a filibuster-proof Senate, we would now have had privatge accounts in SS, Medicare reform to a premium support approach, and a single payer health care system.  Like it or not, to get things passed, you almost always have to give something up in order to get something. 

    The only people who seriously believe that we can do what we really want when  in power, and wave wands to eliminate every program that we want to get rid of, and that failure to do so is traitorous and Stockholm Syndrome Beltway Selling-Out are people who believe that Harry Potter really exists and can do magic.

    Ben is describing what is probably possible in the real world.  And, by the way, that is the reason for moist of GWB’s spending as well- he had to make trades to get GWOT support.

  14. James Of England
    Paul DeRocco: The thing that scares me the most is how many Republicans are eager to keep the requirement of covering pre-existing conditions. I can understand liberals not caring if every insurance company in the country is driven to bankruptcy–then they get their vaunted single-payer system by default–but are Republicans really that stupid to think that the end result wouldn’t be precisely that? · 5 hours ago

    Republicans have passed pre-existing condition coverage before (HIPAA). Fortunately, most of them, including Romney, are against it now. It’s important to note for this that pre-existing condition coverage was not introduced by Romneycare, which did little to alter the state’s pre-existing laws on the subject; Romney would be distinct from the other Republicans in not flip flopping on this. There are individuals who will fight on the other side of this, more in the House than in the Senate, but not, I believe, enough to get an amendment passed. Having the leadership on our side is helpful for this.

  15. James Of England

    Incidentally, Ben, do you believe that Romney has not said, loudly and repeatedly, that he’s in favor of a clean sweep reform of Obamacare?  Do you think it’s accurate, then, to describe those House Republicans who disagree with him as “join[ing]” him?

  16. Paul DeRocco

    The solution is to repeal it in its entirety, while reassuring the country that the intent is to immediately begin to put together something to replace it. That short-circuits any immediate squawks about repealing this or that aspect that some people might like–they’ll need to stifle their upset and wait to see what materializes gradually over the following months. But it also eliminates any bias in favor of what’s already in the law, over what should be in it. Eventually, when something popular doesn’t seem to re-materialize, any resentment will be diffused over a longer period of time, instead of rising all at once.

  17. Paul DeRocco

    The thing that scares me the most is how many Republicans are eager to keep the requirement of covering pre-existing conditions. I can understand liberals not caring if every insurance company in the country is driven to bankruptcy–then they get their vaunted single-payer system by default–but are Republicans really that stupid to think that the end result wouldn’t be precisely that?

  18. KaneCountyFarmboy
    Paul A. Rahe: If Romney and the Republicans do not repeal Obamacare, there will be hell to pay. · May 18 at 10:04am

    Paul, unfortunately, as Ben points out, doing so is nearly impossible in the next Congress.  The key is to start building a policy consensus now on the smart things that can be added to the PPACA (like extending programs similar to what Mitch Daniels has done in IN), and on making the insurance markets more competitive (like repealing McCarran-Ferguson), not tilting at windmills.

  19. James Of England
    KaneCountyFarmboy

    Paul A. Rahe: If Romney and the Republicans do not repeal Obamacare, there will be hell to pay. · May 18 at 10:04am

    Paul, unfortunately, as Ben points out, doing so is nearly impossible in the next Congress.  The key is to start building a policy consensus now on the smart things that can be added to the PPACA (like extending programs similar to what Mitch Daniels has done in IN), and on making the insurance markets more competitive (like repealing McCarran-Ferguson), not tilting at windmills. · 16 hours ago

    Ben does not say it’s nearly impossible in the next Congress. He says it can’t be done before the first May of the next Congress, and will be hard work. I think he’s wrong about May (if Romney is true to form, the budget should be passed more quickly than usual, having been written up and whipped even before the new Congress sits), but right about it requiring a good deal of effort. Thankfully, I think most people agree that it’s worth some effort.

  20. KaneCountyFarmboy

    James, I don’t think you read it correctly.  Quoted from his original post:  That’s a very heavy lift, and it’s why those of you who think anything less than full repeal is unacceptable are very likely to be disappointed.  (emphasis added).  Full repeal is not possible without getting to 60 votes in the Senate providing a filibuster proof majority.  Partial repeal will be possible in a very piecemeal function, and would leave such a mishmash that the unintended consequences would destroy the insurance market.  That may be the right technique to get the Democrats to negotiate, but it will certainly be a mess and could sway people to providemoregovernment intervention, not less.  I’d rather be the grown-up party and figure out how to add true market reforms, than get blamed (as we certainly would) for the mess.  Call me a Rob Long RINO squish, but a “d*** the torpedoes approach” is what got us into this mess in the first place (GOP primary voters in NV and DE, I’m looking at you).

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