House Republicans are soon expected to pass their bill repealing the national health care law, but the bill won’t go any further than that given Democratic control of the Senate.
To do a clean repeal of the entire bill, Republicans would have to maintain control of the House in 2012 while gaining the White House and a 60-vote majority in the Senate. That’s unlikely to happen, which means that it’s more likely Republicans will have to pursue a more piecemeal approach. In the short term, there will be some efforts to defund ObamaCare — but that will only get them so far. If Republicans are willing to use reconciliation, however, they could make a major dent in ObamaCare with a simple majority in the Senate. Though this method would still require them to take back the White House, they wouldn’t need 60 votes in the Senate.
Last year, I spoke with former Senate parlimentarian Robert Dove about the prospect of repealing ObamaCare through reconciliation, and he gave me this simple formula: “Anything that reduces the deficit is okay…and nothing that increases the deficit is okay.” The key thing to keep in mind is that this is judged on a provision by provision basis, not taking into account the legislation as a whole.
What this means is that it will require a lot of political fortitude by Republicans, because to meet the requirements of reconciliation, the bill would have to focus on rescinding benefits, which account for the bulk of the cost of ObamaCare. Chief among them are the expansion of Medicaid and the subsidies to purchase insurance on government run exchanges. The Republicans would not be able to use reconciliation to repeal regulations, tax increases, or Medicare cuts.
However, were they to show the courage to repeal the government benefits, it would make it easier to go after other aspects of the bill. Without the subsidies to purchase insurance, the new exchanges that provide the infastructure for ObamaCare would be effectively gutted and the mandate forcing people to purchase insurance becomes even harder to defend. At the same time, it would be difficult to justify the tax increases — totaling $770 billion through 2021.
Today’s vote on repeal, as I noted before, is a no-brainer — it’s the bare minimum Republicans should do. But it is only the first step in a long and arduous process that will require an increasing amount of resolve by Republicans.