Democrats are preparing a spirited defense of the healthcare law in the face of Republican efforts to dismantle it.
Statements from lawmakers, advocates and the administration reveal a multi-pronged strategy as Democrats prepare to deal with a new Republican-controlled House that has made repealing the new law a top priority.
Ways and Means health subpanel Chairman Pete Stark (D-Calif.) unveiled a 14-page report last week to help Democrats hone their arguments against repeal. It’s a compilation of the law's benefits, such as subsidies for most people to buy insurance and the requirement that insurance plans cover even people with pre-existing conditions.
"The Affordable Care Act is already providing health coverage to people with pre-existing conditions and young adults, and lowering drug costs for seniors. In time, it will help millions more. Yet Republicans fought us every step of the way and used every tool — including outright lies — to try to kill health reform," Stark said in a statement announcing the report. "The Republicans failed, but they won't give up. Now, they want to refight the battles of the past. It is up to Democrats to make clear how dangerous their agenda really is."
It’s unclear whose side the public will be on. According to an October poll by The Hill, a majority of voters in key battleground districts favored repeal of the legislative overhaul. Nearly one in four Democrats also said they wanted the bill repealed.
Democrats from Obama on down have repeatedly said the reform is a good piece of legislation that was poorly explained to the public, and just like other laws — such as Republicans' Medicare prescription drug benefit — will become more popular as people see its benefits.
But it was the exception, rather than the rule, for Democrats to highlight the legislation on the campaign stump.
"I think [the repeal debate] will be a great opportunity for us to make the case to people about how beneficial this law will be to everybody," Rep. Henry Waxman (D-Calif.), the top Democrat on the panel, told The Hill.
The repeal effort will be on full display in the House, where Republicans will use their new majority to press for repeal, deny funding for the law's implementation and grill administration officials, including Health and Human Services Secretary Kathleen SebeliusKathleen SebeliusLeaked email: Podesta pushed Tom Steyer for Obama’s Cabinet Romney: Trump victory 'very possible' Fighting for assisted living facilities MORE and Medicare administrator Donald Berwick. Rep. Fred Upton (R-Mich.) will lead the effort next Congress as chairman of the Energy and Commerce Committee.
Democrats say Republicans who have been criticizing them for focusing on the healthcare reform law instead of jobs can expect to be paid back in kind. President Obama himself suggested as much the day after the midterm election.
“What the American people don’t want from us," the president said, "is to spend the next two years fighting the political battles of the last two years."
The administration is moving full speed ahead with implementation of the law, making it increasingly difficult — and expensive — to repeal it. HHS officials recently met with more than 150 officials from 44 states to discuss the next steps as states develop their health insurance exchanges over the next two years.
An administration official said that Republicans' repeal promise may have played well as a campaign pledge, but taking away benefits will be a much harder political sell. And from a legislative standpoint, Republicans will face an uphill battle coming up with acceptable pay-fors if they get rid of individual provisions that bring in a lot of money.
The "1099" tax reporting requirement is a case in point: Even though both parties in Congress — and Obama himself — have called for that measure's repeal, efforts to do so have repeatedly failed because of the difficulty in making up the $19 billion the provision brings in.
The influential conservative group FreedomWorks is urging Congress to hold votes in January to repeal healthcare reform in its entirety and replace it with a series of “patient-centered” bills.
Ron Pollack, the founding executive director of the healthcare advocacy group Families USA, warned that repeal efforts should be taken "very seriously" because they're "part of an ongoing attack to destabilize [the reforms] that will occur over a number of years."
Pollack said advocates have been discussing strategies with the White House and lawmakers and plan to "play offense" rather than just react to Republicans who have vowed to "hit the law 1,000 different ways."
For example, Pollack said, reform advocates plan to use certain milestones in 2011 — debate over the House Republicans' repeal bill, the start of new benefits, the law's one-year anniversary on March 23 — to rise to the law's defense.
At the same time, Pollack warned Democrats to be wary of Republicans' efforts to divide and conquer them by proposing to repeal individual provisions — the law's long-term disability insurance program, for example, or its Medicare payment board — that some Democrats dislike.
"It's very important that Democrats don't undermine what's eventually going to be a very important asset," Pollack said. Piecemeal repeal efforts "that are clearly designed to undermine the legislation and to score political points, those are things that should be vigorously opposed."
Pollack also said that reform advocates would continue to pound on Republican lawmakers who take advantage of federal health benefits themselves but "are taking away from us, the American people, what they intend to keep for themselves."
On the legal front, some liberal groups have attacked the motives of Republican judicial appointees who have allowed the process to go forward. They point out that 12 judges so far have dismissed challenges to the healthcare law, and two — both Clinton appointees — have found the individual mandate constitutional.
Democrats have long raised concerns about Virginia Judge Henry Hudson's passive investments in the Republican political consulting firm Campaign Solutions Inc. After Hudson, a George W. Bush appointee, ruled against the law's individual mandate on Monday, criticism redoubled, with Stark saying that "apparently Republicans are now for judicial activism after they were against it."
On Friday the liberal group Media Matters raised the rhetoric further with the release of a "report" deconstructing Hudson's 2007 memoir “Quest for Justice” for evidence the judge is politically motivated and "might have finally completed his lifelong quest for glory."
Meanwhile, Democrats suggest the governors and attorneys general, in 20 states, who are challenging the law in Florida chose the conservative judicial venue of Pensacola rather than the state capital, Tallahassee, for political reasons. The judge in that case, Roger Vinson, was appointed by Ronald Reagan.