The procedural motions that Republicans filed during the healthcare reform debate offer the best insights into which provisions of the law the party wants to repeal first, a top staffer for a senior House Republican told The Hill.
Publicly, the GOP has made wholesale repeal of the unpopular law a key plank for the 2010 elections. House Minority Leader John Boehner (R-Ohio) has said it's his party's "No. 1 priority," and the GOP’s "Pledge to America," unveiled last month, promises to "repeal and replace the government takeover of healthcare with common-sense solutions."
Details about how to do that have been scant, however, and Republicans acknowledge that President Obama will certainly veto any legislation repealing his administration's signature domestic achievement. Sen. Tom Coburn (R-Okla.), who supports full repeal, has nonetheless called that approach "an exercise in futility" and has joined calls for starving the law of the federal appropriations it needs to function smoothly.
Defunding the law, however, might not placate healthcare reform opponents who want to see real results if Republicans take control of the House and/or Senate after the midterm elections. One option for Republicans would be to chip away at unpopular provisions of the bill that some Democrats dislike as well.
If Republicans can get enough Democrats to support repealing specific provisions, that could make it politically difficult for Obama to exercise his veto power. And Democrats who have publicly spoken out against specific provisions, such as Medicare cost-cutting and long-term disability insurance, could be tarred as flip-floppers if they refuse to go along.
Republicans offered several motions to recommit during the debate on the healthcare legislation that would have repealed specific aspects of the law. A review of those motions by The Hill indicates that Republicans have already proposed repealing the following provisions:
• Special rules for abortion coverage. Republicans tried to derail passage of the bill in March by proposing to repeal the section on abortion restrictions and replacing it with stricter language. At least two anti-abortion Democrats — Reps. Marion Berry (Ark.) and Daniel Lipinski (Ill.) — voted against the Senate bill in March after supporting the original House bill because they weren't mollified by Obama's executive order on abortion coverage.
• The Independent Payment Advisory Board. Republicans have proposed striking the provision that would require Congress to keep Medicare costs under control. Critics say it would lead to government rationing, and liberal Rep. Pete Stark (D-Calif.) — the chairman of the Ways and Means Health subcommittee — has called it a "dangerous provision" that "sets [Medicare] up for unsustainable cuts" and endangers patients' health. "I intend to work tirelessly to mitigate the damage that will be caused by IPAB," Stark said in a statement right after he voted for the health overhaul.
• Comparative Effectiveness Research. The healthcare reform law calls for the creation of a public-private partnership aimed at boosting research into what treatment options offer the best value. Republicans say this could open the door to government health programs eventually refusing to cover more expensive treatments that may be better suited for a specific patient.
• The Prevention and Public Health Fund. Republicans have denounced a fund to promote prevention and wellness activities as a $2 billion-per-year slush fund for local governments to build "jungle gyms."
Separately, Republicans have also offered repeal legislation. Last month, Coburn and four other Republican senators marked the six-month anniversary of the law by introducing a bill repealing its long-term disability insurance program. Several centrist Democratic senators spoke out against the CLASS Act during the healthcare reform debate, raising concerns that it would not sustain itself and would eventually add to the deficit.
Six Democrats — Sens. Kent Conrad (N.D.), Blanche Lincoln (Ark.), Mary Landrieu (La.), Evan Bayh (Ind.), Mark Warner (Va.) and Ben Nelson (Neb.) — and independent Sen. Joe Lieberman (Conn.) wrote to Majority Leader Harry Reid (D-Nev.) urging him not to include the provision in the Senate bill. And Senate Finance Committee Chairman Max Baucus (D-Mont.) said he was "no fan of the CLASS Act" either.
"Many members who voted for the health bill did so knowing that the CLASS Act provision was a budget gimmick," Coburn spokesman John Hart said. "Dr. Coburn does hope members will reconsider their support for a plan that is full of budget gimmicks, empty promises, hidden costs and unintended consequences."