5 Reasons Republicans Should Let Go of Health Care

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Reporters leaving Capitol Hill in the wee hours of Monday morning were, for the most part, heaving sighs of relief: health care reform had – finally! — passed, a vote for the history books. However imperfect, the deed was done, the fat lady had sung. A day later and Republicans seem not to have gotten the memo: they are attacking the bill as ferociously as they did before it passed. Repeal it, they’re saying; strike it down in the courts; and in the Senate, the reconciliation fixes may die a death of a thousand amendments.

Health care reform has been a rich vein for the GOP. Think back to the August town hall meetings and Sarah Palin’s death panels. Indeed, polls show the bill is incredibly unpopular – which is why Dems are more than happy to move on to jobs, the economy, and more jobs. But, keeping the bill in the forefront of news doesn’t come without risk to the GOP. Here are five reasons this could be a losing argument for Republicans:

1.    What happens when, as President Obama put it to the Democratic House Caucus on Saturday, “lo and behold nobody is pulling the plug on granny”?

The way many protestors (and some Republicans) were talking over the weekend you’d think passage of the bill represented an end of days: better stock up on canned goods because communism is a hair’s breadth away. “If we pass this bill, there will be no turning back,” Minority Leader John Boehner thundered on the House floor just before the vote. “It will be the last straw for the American people.”

When Obama signs the bill into law, as he’s expected to later this morning, the system will actually see very little immediate upheaval. The bulk of the bill won’t come into effect until 2014 and the changes right off the bat are politically targeted to, well, essentially make people feel good: children with preexisting conditions will not longer be denied health insurance, the so-called Medicare Part D donut hole will be fixed meaning lowers drug prices for seniors, a ban on lifetime insurance caps. If the sky does fall, it won’t until three elections cycles from now — pretty anti-climatic for those bracing for the worst.

2.   Repeal the bill?

Many Republicans this morning are calling for the bill to be repealed — a politically popular statement with the base, to be sure. But to repeal such a massive piece of legislation they would need a 60-vote majority in the Senate as well as control of the House. The odds of this happening before 2014 are slim. Not impossible, mind you, but I wouldn’t put money on it. And after 2014, are you really going to strip 32 million Americans of their health care insurance in order to start over? That seems politically tough.

3.   In opposing reconciliation the GOP would, in some cases, be opposing things that they, um, actually like.

Yes, there are plenty of things in the reconciliation amendments that Republicans hate: there’s an addition $50 billion in tax hikes, some new sweetheart deals such as the Bismarck Bank Job* and it’s more expensive than the Senate bill.

But, there’s also a lot the Republicans like in the amendments: they strip out of the Cornhusker Kickback and the Florida Flim Flam deals, tighten overpayments to private insurance companies, increase fees on drug companies and they have more stringent provisions on waste, fraud and abuse in Medicare and Medicaid. Plus, according to the Congressional Budget Office, they go farther than the Senate bill in reducing the deficit: $143 billion in the first 10 years and $1.3 trillion in the second decade.

*Apologies, the Bismarck deal was stripped by the House Rules Committee.

4.   The courts have a long history of federal law taking precedent over state laws: ahem, Medicare and Medicaid.

Google “Medicare Medicaid challenged in courts” and you get more than a million hits. Both programs have been sued so much by states on down that there are whole practices that specialize in such cases. And yet both programs are still functioning in all 50 states. Most constitutional lawyers expect legal challenges of this bill will end up much the same way as most previous 9th and 10th amendment cases have: that the federal law would stand.

5.    The ‘Party of No’ label.

As Adam Nagourney notes in today’s New York Times, this is the most immediate risk for Republicans ahead of the 2010 elections. Dragging out reconciliation for weeks or months has the potential to reinforce that stereotype. “Republicans appear to believe that obstructing any aspect of the President’s health reform agenda will pay electoral dividends,” says Thomas Mann, a congressional scholar at the left-leaning Brookings Institution. “They may well be deluding themselves. If they choose to follow a course of filibuster by amendment, I suspect the presiding officer will put them out of their misery after a few days.” Indeed, Senate Majority Leader Harry Reid’s office has said they expect the amendments to pass by the time the chamber breaks for Easter recess on Friday (and, just in case, Reid can force an end to proceedings). But, on the heels of Senator Jim Bunning’s disastrous one-man filibuster, some Dems I spoke with wouldn’t mind seeing the Republicans filibuster by amendment for a good long while. And in the meantime, Reid’s office tells me they plan on putting lots of human faces on health care this week and what this means to so-and-so’s sick granny or child.
In some ways this debate is now more about spin than substance: racing to define the bill in the public’s mind before it fades from view. And, truth be told, no one will know for sure how the bill will play at the polls until voters actually go to the polls.