Forget the GOP’s longstanding pledge to repeal the entire healthcare law in one fell swoop.
A Republican-led Congress would attempt to dismantle Obamacare one provision at a time and would try to replace the law the same piecemeal way, using a collection of proposals for improving the nation’s health insurance system that have garnered at least some bipartisan support during the past four years.
“It’s not a 2,700-page bill we’d wheel down to the Senate floor,” a GOP leadership aide told the Washington Examiner, referencing the massive legislative document that became the Affordable Care Act.
Ideas for replacing Obamacare have long been discussed in both chambers, outlined in legislation, and passed in the GOP-led House during the past two years.
The proposals consist of allowing people to purchase insurance across state lines, reining in medical malpractice awards, expanding health savings accounts, and allowing small businesses to pool resources to lower insurance costs for employees. Medicaid reform is another element of the GOP’s healthcare overhaul plan.
“We are open to having a lot of good ideas, and there are a lot of ideas out there,” said Don Stewart, a spokesman for Senate Minority Leader Mitch McConnell.
This week’s election could finally afford the GOP the opportunity to take on Obamacare, a move it has been promising since President Obama signed the bill into law on March 23, 2010.
But first Republicans would have to dismantle much of the program, which may be impossible to do.
The law is largely unpopular, in part because it has cost more than anticipated and caused many people to lose the doctors and health insurance they had.
A mid-October Pew poll found the public disapproved of the law, 51 percent to 43 percent.
But Obamacare has expanded coverage, particularly for the poor, and the law’s healthcare exchanges are functioning well in some states.
The mixed public response to Obamacare has left Republicans in a quandary. They can’t simply gut the law, particularly if parts of it are popular. Besides, their majority won’t be big enough to override a guaranteed veto from Obama.
Even if they could repeal the law, they can’t replace it with another colossal piece of legislation.
Senate Minority Leader Mitch McConnell, R-Ky., who is running in a competitive race to hold onto his Senate seat, got caught in this conundrum earlier this month during a debate with his opponent, Democrat Alison Lundergan Grimes.
While promising that the state’s popular healthcare exchange, Kentucky Kynect, “can continue,” McConnell pledged to dismantle Obamacare “root and branch.”
The comment caused confusion and forced McConnell to attempt to explain his position in a Fox News interview the next day, but he may have further muddled the issue.
McConnell pointed out that a GOP majority in the Senate is unlikely to reach the 60 votes needed to repeal the law entirely, and he added that a full repeal would actually require a veto-proof majority of 67 votes to stop the president from blocking it.
Nonetheless, McConnell said, “it’s on the top of my list.”
While McConnell did not outline the specific steps, other GOP Senate leaders were willing to disclose the plan, among them Sen. John Barrasso, a Wyoming physician who heads the Senate Republican Policy Committee, which would play a leading role in formulating a GOP majority’s legislative plan of action.
Barrasso said the GOP would start with legislation to repeal parts of the law that are unpopular with both Republicans and Democrats, such as the mandate requiring large employers to provide insurance, or the law’s medical device tax.
“I think we can get 60 votes to repeal the employer mandate,” Barrasso told the Examiner.
Other provisions a GOP-led Senate would take up include a change to the definition of full-time employment under the healthcare law from 30 hours to 40 hours per week, which proponents say would stop job loss associated with the law.
Barrasso said the GOP would also take up legislation to block the Obama administration from reimbursing insurers who lose money in the healthcare exchanges.
He said several of the proposals could garner the 60 votes needed to send bills to the president’s desk, leaving Obama under political pressure to sign them.
Barrasso said he also plans to push for a vote to repeal the entire law, even though it has virtually no chance of passing, because it would signify the party’s longstanding opposition to Obamacare.
“I think it’s important we make that statement,” Barrasso said.
