Republicans grapple over how to deal with healthcare reform

“ObamaCare,” a rallying cry for Republicans for the last two elections, is now becoming a headache for the GOP.

The party’s principal fiscal road map, Rep. Paul Ryan’s (R-Wis.) budget blueprint, has left some Republican conservatives dissatisfied because it would not repeal the Obama administration’s healthcare reform law entirely. 

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“I think the Ryan budget is a strong positive step that doesn’t go nearly far enough,” said Sen. Ted Cruz (R-Texas), a leading conservative voice in the upper chamber. 

Cruz and other conservatives take issue with Ryan’s decision to keep $716 billion in Medicare cuts implemented by the Affordable Care Act and count them toward deficit reduction. 

The Texas Republican offered an amendment on the Senate floor Wednesday to prohibit funding for the healthcare law until the economy begins growing at a rate of between 3 and 4 percent. It predictably fell along party lines.

When he unveiled his budget on Tuesday, Ryan defended counting the tax revenue collected from the “fiscal cliff” deal reached in early January — which was opposed by most Republicans.

“We’re not going to refight the past,” said Ryan, who then had to fend off a reporter’s question on why he was still fighting the administration’s healthcare reform law after the president’s reelection triumph.

Most House Republicans will back Ryan’s measure, but conservative Sen. Mike Lee (R-Utah) on Wednesday endorsed Cruz’s complaint.

“My answer is the same as his,” Lee said. “I would have loved for it to have gone further.”

“I’d like to see it completely repealed,” said Sen. Marco Rubio (R-Fla.) when asked about the treatment of the healthcare law in the House GOP budget. Rubio’s position is consistent with the one adopted by presidential nominee Mitt Romney last year, which trumped Ryan’s on the GOP ticket.

In a statement that raised eyebrows on both sides of the aisle, Romney this month attributed his election loss to the president’s healthcare law. He told “Fox News Sunday,” “We did very well with the majority population, but not with minority populations ... I think ObamaCare attractiveness ... was something we underestimated, particularly among lower incomes.”

Romney had vowed to repeal ObamaCare on the first day of his presidency.

In the wake of GOP losses last November, Republicans have launched new initiatives aimed at courting minority voters — and trying in vain to repealing the Affordable Care Act could hurt those efforts.

Still, the GOP base is not relenting.

The Heritage Foundation, a conservative think tank, criticized Ryan Tuesday for keeping revenues raised by the landmark healthcare law.

“Perhaps the biggest shortcoming of this budget is that it keeps the tax increases associated with ObamaCare,” Heritage wrote on its blog, The Foundry. “These tax hikes are the oxygen that fuels the fire of ever bigger spending. But the entire fire needs to be put out — all of ObamaCare should be repealed, including its tax hikes.

The harder question for the Republican leadership and rank-and-file colleagues is how hard to push for a full repeal — especially now that some Republican governors are warming to it.

House Republican leaders opted not to attach language to defund the Affordable Care Act to last week’s stopgap spending measure that Congress must pass by March 27, prompting conservative defections. 

FreedomWorks, a Tea Party-affiliated advocacy group, sent an action alert urging members to demand Speaker John Boehner (R-Ohio) include a provision to defund the healthcare law, and several Republicans who defied their leadership cited the lack of such language as a reason for their opposition. 

Boehner has at times signaled his desire to move beyond the battles over healthcare reform that consumed the 111th and 112th Congresses. 

When asked by ABC’s Diane Sawyer after the election whether Republicans would make repealing the Affordable Care Act as high a priority in the past, Boehner said: “I think that the election changes that.” 

“It’s pretty clear that the president was reelected, ObamaCare is the law of the land,” he said. “There are certainly maybe parts of it that we believe need to be changed, we may do that.” But on Wednesday, Boehner said the House will again vote to repeal or defund the reform law. 

“Well I would expect that sometime in the coming months that we will once again move to get rid of ObamaCare,” Boehner said in an interview on Sean Hannity’s radio show. “We’ve had a number of votes in the House in the last two years to end Obama-Care or get rid of it.

House Majority Leader Eric Cantor (R-Va.) issued a memo after the election urging rank-and-file members suggesting a full repeal of the healthcare law was not realistic and that Republicans should pursue more modest proposals to address it. 

“While it is unrealistic for us to expect the President to embrace our vision of Medicare reform or ObamaCare repeal, it is equally unrealistic for the president to continue to insist that ObamaCare is off the table, or that Medicare and Medicaid require nothing more than some additional provider cuts,” Cantor wrote. 

Last year, Senate Republicans differed over how many votes to force on the law. Then-Sen. Jim DeMint (R-S.C.) pushed his colleagues to bring up the issue on the floor repeatedly, but Senate Republican Leader Mitch McConnell (Ky.) did not initially embrace that strategy. 

Republican efforts to force votes on amendments repealing healthcare reform stoke partisan tensions in the upper chamber and are often likely to bring retaliation from Senate Majority Leader Harry Reid (D-Nev.), who has the power to block Republicans from offering any amendments to pending bills.

Cruz and Lee declined to say whether they would follow in DeMint’s footsteps. “I certainly don’t want to foreclose the possibility of subsequent votes in the Congress,” said Lee. “It’s going to depend on a whole variety of circumstances.”

Senate Republican Conference Chairman John Thune (S.D.) suggested it’s time to move on to other issues. 

“I think it’s good to get the Senate on the record, and Republican senators want to be on the record expressing our support for total and complete repeal,” Thune said.  “Once we’ve had that vote, unless something changes, it may not be something we want to vote on all the time.”