The great healthcare showdown: Round One

The debate over healthcare reform will be a fascinating one, and already its unexpected twists and turns illustrate that no one can tell exactly where this showdown is ultimately headed.

As Republicans prepare to vote next week (Jan. 12) on a full repeal of the entire law enacted last March, Democrats are gearing up for a public-relations blitz, hoping to defend the program and reframe it in time for the next election. No matter that it was radioactive during the recent election just two months ago and Democrats chose not to campaign on its virtues. The now largely liberal and quite diminished Democratic Caucus is ready to sing its praises in the face of a sustained GOP effort to undermine what's left of healthcare's appeal. Polling shows the bill's disapproval at between 50 and 60 percent.

The Democrats are hoping that the brand-new healthcare benefits that kick in now will be appealing enough to persuade voters to give reform a second look. These include: a 50 percent discount on brand-name prescription drugs for seniors who fall into the Medicare doughnut hole, free cancer screenings and the ability for parents to keep their children covered on their insurance plan until they reach the age of 26. Democrats will showcase these provisions as Republicans work toward partial repeal.

Though full repeal is highly unlikely, both parties predict that an effort by Republicans to defund parts of the law and to undermine it through the hearing process will result in partial repeal. President Obama has already admitted that the 1099 reporting requirement is burdensome enough on small businesses that it should be repealed. Hearings shining the light on rate increases like the 59 percent increase Blue Cross policyholders will soon see in California are also likely to keep the Obama administration on the defensive. Health and Human Services Secretary Kathleen Sebelius recently told ABC News that those policyholders — many of whom are likely to drop their insurance — ought to contact their state legislators and governor demanding that "those laws be changed." It turns out the new healthcare law allows the government to expose such drastic rate hikes but not to prevent or stop them.

But just as Democrats will face obstacles defending the law, deficit questions now challenge the GOP campaign against repeal. This week the nonpartisan Congressional Budget Office warned the new Republican majority that its repeal bill (which has already broken not only the promise to put all bills through the hearing process, as well as to pass under open rules on the floor, but for them to be deficit-neutral) would increase the deficit first by $145 billion by 2019 and up to $230 billion by 2021. House Speaker John Boehner (R-Ohio) dismissed the claim yesterday, taking issue with the CBO's scoring practices and saying the office is entitled to its opinion.

Round One. This promises to be quite a show. 


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