By Daniel Weintraub
Newly ascended Republicans in Congress say one of their first goals will be to repeal the health care reform law Democrats in Congress and President Barack Obama enacted in March.
But that task is likely to prove more difficult than they believe, or at least harder than Republican politicians are letting on to their supporters.
Republican leaders on Wednesday were citing a CBS News exit poll that found nearly half of voters saying they wanted the law repealed. But as Obama pointed out in a post-election press conference, that also means that half of the voters want the law preserved.
Besides, those impressions, especially the negative ones, are based largely on opponents’ characterization of the reform as a federalization of health care, a big-government over-reach that will fundamentally change the way most people get their insurance and their care. Rep. Eric Cantor of Virginia, expected to be the majority leader once Republicans take control of the House, called the law an “abomination” and said he expected to have a bill to repeal it on the floor of the House “right away.”
But Republicans know they have no chance to repeal the entire bill with the Senate still in Democratic hands and Obama in the White House. So they instead will try to chip away at it, piecemeal. But the American public might not be as supportive of that approach, because many of the individual pieces of the plan are far more popular than the concept of a big, comprehensive, government-led overhaul. The parts of this many-faceted law are more popular than the whole.
Republicans, for instance, are unlikely to try to repeal provisions that will prohibit insurance companies from denying coverage to people based on pre-existing conditions, or allow families to keep adult children on their policy until age 26. Both ideas are very popular with the public. Other pieces will make preventive care available without out-of-pocket charges and prevent insurers from using errors in consumers’ applications to justify rescinding coverage to people after they get sick.
GOP lawmakers could try to roll back the bill’s requirement that every individual have insurance, either through an employer or on their own, probably the least popular provision in the bill. But many Americans who have coverage now might see that mandate as a way to get “free riders” to take responsibility for their own care. Also, Republicans know that if they repeal the mandate, they would wreak havoc on the insurance market if they left in place the more popular requirement that insurers sell to all comers, because without the mandate, people would have a big incentive to simply wait until they were sick to buy insurance.
Republicans are also not likely to try to repeal subsidies for small employers to help them buy coverage. They might try to repeal the bill’s subsidies for low-income people, but that’s hardly a huge rallying point for their supporters. In other words, if they can’t repeal the entire program in one swoop, and they can’t, at least until 2012, they will find it very difficult to build broad public support for incremental roll backs.
Obama mentioned some of the more popular parts of the bill in his press conference Wednesday and, while saying he would work with Republicans to tweak it, he all but dared them to try to repeal it.
“I don’t think that you’d have a strong vote for people saying, you know, “Those are provisions I want to eliminate,” the president said.
He added: “Now if the Republicans have ideas for how to improve our health care system, if they want to suggest modifications that would deliver faster and more effective reform to a health care system that, you know, has been wildly expensive for too many families and businesses, and certainly for our federal government, I’m happy to consider some of those ideas.”