I agree with many political observers that it wouldn't have made much immediate difference had Republicans won nominal control of the Senate last night, since they have enough seats to comfortably block anything President Obama proposes anyway and they won't be able to pass anything substantial as long as he's president.
That said, there are longer term implications to the GOP coming up short in West Virginia, Colorado, Washington and Nevada. A full repeal of ObamaCare, as with anything else important in the Senate, would require 60 votes.* Had Republicans won all of those close Senate races, they would have been 9 pickups short of attaining a filibuster-proof majority. But having lost those races, they now have to pick up 13 seats in 2012, a much steeper climb. And that following year may be their last chance to repeal the law, because it goes into full effect in 2014, after which point it will be that much more difficult to dismantle given that politicians aren't typically keen on taking benefits away from people.
* There is a way to repeal major parts of the health care law with 51 votes through reconciliation, but it would be very messy and still wouldn't achieve a full repeal.
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