Friday, May 22, 2015

Will the Republicans Kill Obamacare?

Fresh off of their election victories, Republicans promise death to Obamacare. Their top priority in the new Congress is to follow through on a vow they made repeatedly during the campaign - to repeal the President's signature domestic initiative. Incoming House speaker John Boehner has pledged that no part of the health reform law will be spared. But, can they follow through? Most analysts think not.

Will the Republicans Kill Obamacare?

By guest blogger Robert Field:

Fresh off of their election victories, Republicans promise death to Obamacare. Their top priority in the new Congress is to follow through on a vow they made repeatedly during the campaign - to repeal the President’s signature domestic initiative. Incoming House speaker John Boehner has pledged that no part of the health reform law will be spared.

But, can they follow through? Most analysts think not (see New York Times ). With Democrats still in control of the Senate and the White House, repeal is not politically realistic. (Pending lawsuits could lead to judicial repeal, but it will take time before there is a final resolution by the Supreme Court.)

Republicans can still go after the law on a piecemeal basis. They can challenge individual provisions or try to block funding for implementation. They can also use newfound clout in many states to impede rollout of central features, like the new insurance exchanges.                                                                                                                      

However, Republicans may find that opposition to repeal is not limited to the Democrats. Numerous business interests have stakes in maintaining key parts of the law, and they may prove difficult to ignore (see the Wall Street Journal). Insurance companies, pharmaceutical firms, and hospitals, for example, all stand to gain from reforms that will bring them tens of millions of new customers. They have already begun priming their lobbyists to push for changes that leave the broad outlines of the law intact. 

These realities may force Congressional Republicans into using a scalpel instead of a sledgehammer. Their best shot at challenging Obamacare may be to negotiate revisions rather than outright repeal. Ironically, bipartisan negotiations over the law’s details are what President Obama had sought during the maneuvering that led to its passage. 

If they follow this route, Republicans might benefit by earning credit in the minds of voters for improving a law that many Americans find flawed. They might also please important business constituencies. However, they could also find themselves with a new dilemma. Responsibility for a revised Obamacare could be seen as theirs as well as the Democrats’. In that case, they might end up being on the hook with voters for its success, at least in part. This awkward political result is not something they would readily accept. 

 

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About this blog

Check Up covers regional health news and a wide array of healthcare topics from pharmaceutical happenings to patient safety. Read about some of our bloggers here.

Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
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