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Health Reform Repeal: Round 1

January 23, 2011 by Somebody Else

On January 19, 2011, the House of Representatives voted 245-189 to repeal the new health reform law. Republicans unanimously voted for the repeal. All Democrats but three voted against it. The repeal bill is now headed for the Democratic-controlled Senate, where it faces certain defeat -- it may not even come up for a vote there. And assuming that, against all odds, the bill was somehow passed by the Senate, it would wind up on the president's desk, where it would most definitely be vetoed.

The Republicans in the House of Representatives know that their repeal bill doesn't stand a chance, at least for the time being. The vote amounts to a symbolic gesture of sorts. Here is the message, in a nutshell:

"If only the Senate had a Republican majority and the White House had a Republican in the Oval Office, we could repeal health reform. We can make this happen in 2012."

Can Republicans make it happen in 2012? In theory, yes, they might.

Here is a possible scenario:

Obama gets the Democratic Party's nomination, of course. The Republicans nominate Mitt Romney, Mike Huckabee or Sarah Palin. For the sake of argument, let's say Mitt Romney. Popular opposition to the Democratic Party continues to grow during 2011 and 2012, so that when November 2012 rolls around, voters are ready to give the Republican Party decisive majorities in both houses of Congress. Mitt Romney wins the election and is sworn in as president January 2013. The new Congress wastes no time in voting on health reform repeal, which sails through both houses and makes a beeline to Romney's desk, where it is immediately signed into law. The status quo for health care is preserved. Republican legislators propose no health care reform to replace the one they have just euthanized. They turn their attention to what they consider more pressing matters, such as privatizing Social Security.

How likely is such a scenario? If you are in favor of health reform, here is some bad news: It is likely enough. If Republicans can win control of the House, they can win control of the Senate and the presidency. If Obama and his colleagues in Congress provoke the collective ire of the voting population, they will get spanked in 2012. And if they get spanked hard enough, health care reform will get shot down in flames just as some of its most important provisions are due to go into effect.

I do not share the rosy optimism of many people who think that the newest health reform law is similar to Medicare and Medicaid, which faced heated opposition in their day and concerted efforts at repeal, yet nonetheless managed to weather the storm and become mainstays of American society. The fate of the new law is much more precarious and uncertain.

In our present age of hyper-partisan politics, this law is only as secure as the Democratic Party's ability to maintain a majority in at least one house of Congress or to hold the presidency. So, you may ask, how often have Republicans had control of both houses of Congress and the presidency at the same time? Since 1945, they have only managed to do this from 2003 to 2007. In the long term, this is not much, but in recent memory, it is plenty.

Another possible scenario is for Obama to win a second presidential term but for the Democratic Party to lose both houses of Congress in 2012. In my view, this is the more likely scenario. In that case, the repeal bill would make it to the president's desk, and it would of course be vetoed. By 2014, all the provisions in the health reform law would go into full effect. From 2014 to 2016, the American people would find out how they feel about the new legislation and how it affects their lives, both for good and for ill.

Then, assuming that Republicans get the presidency in addition to both houses of Congress in 2016, we would see how well a full repeal of the health reform law would go over after Americans have lived under its full provisions for about two years. And I suppose that Republicans would probably feel a bit squeamish about voting for a full repeal in 2016. At that point, they might try for a piecemeal repeal of certain less popular provisions of the law, such as the individual mandate, which would be difficult considering that the health insurance industry as a whole is -- no surprise here -- strongly in favor of it. Even John Boehner, vociferous opponent of health reform that he is, might find that he is rather reluctant to vote for a specific repeal of the individual mandate, considering that he himself is such a staunch and stalwart supporter of the private health care industry.

So, all of that considered, Republicans really need to win both houses of Congress and the White House in 2012 to have a shot at fully repealing health reform. If they win complete control of Washington in 2016, it would probably be too late.

I think that Republicans do hold out some real hope for a full repeal of health reform, but they must also be pragmatic about it. If the time comes when they see the writing on the wall and they realize that repeal is a lost cause, they will move on to something else. As I have already explained, their window of opportunity is closing quickly.

And for the sake of all us with relatively limited incomes, who always potentially face the prospect of personal financial ruin under the current health insurance system, let's hope that efforts to repeal health reform continue to fail.

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