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Go Home Could Republicans Repeal Health Care Reform?

JONATHAN CHAIT MARCH 19, 2010

Could Republicans Repeal Health Care Reform?

BY JONATHAN CHAIT

Mitt Romney lays out his plan to repeal Romneycare... I mean, Obamacare:

The key, he said, is having Republicans reclaim the White House and take majorities in the Senate and the House.

Then, "we can clamp down on this bill ... by not funding it," Romney said during a speech Thursday

I think Romney is just trying to cover his tracks and protect himself from the inevitable, true Republican primary attacks that he enacted a health care plan similar to Obama's, except more left-wing in the sense that it lacked the long-term cost controls. But he's still laying out the closest thing to a plausible Republican legislative plan to repeal health care reform should it be enacted into law. The problem with repealing health care reform is the filibuster -- Republicans would need 60 votes to undo the exchanges, regulations on things like preexisting conditions, and the individual mandate. But they could use budget reconciliation, which just needs a majority, to undo the tax credits and Medicaid expansion that make coverage affordable. (Even though using reconciliation to undo a major reform would be unprecedented!)

The question is, could they really pull that off? First, you're doing a lot of pretty unpopular things -- yanking coverage away from people, raising taxes on the middle class. You'll have news stories about people whose lives are about to be ruined by the GOP. Second, if you do pass that, then you've started to unravel the system. You'll have a Republican administration and Congress presiding over a policy meltdown that, among other things, will raise enormous ire among insurers, doctors, hospitals, and others who will take a huge hit because they'll be flooded with patients who they have to treat or but can't pay the cost. So you're just setting things up for the Democrats to reinstate the subsidies when they take back power, which would become more likely if the GOP has deliberately caused a health care disaster.

I think the most plausible strategy for the Republicans is to challenge the law in the Supreme Court. You only need a simple majority of 5 votes, the branch has no democratic accountability, and it's shown a willingness to ignore precedent exercise extreme judicial activism on behalf of high-stakes Republican priorities.

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- Keep going...The "Happily Ever After" part? The end of this is all good for the GOP and President Obama will sign the Republican bill. Yeah... But if not, Plan B is for Republicans to override his veto. [Discuss] I think the GOP needs another bookie, Dick Morris has had a bad couple of years placing bets with other people's money.

- michael

March 19, 2010 at 9:49am

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I'm still not sure that Chait really understands the conservative mind. The very difficulty of repeal actually increases its saliency as a conservative issue. Conservatives prefer policy goals they cannot achieve. I mean, take abortion: rather than doing any of the dozens of things the government can easily do to reduce the actual number of abortions, Republicans run on outlawing abortion via a constitutional amendment so implausible that they don't even bother proposing it when they control both houses of Congress. So if there were an easy path to repealing healthcare reform, then conservatives would not promise to do it. The problem is that repeal is a hell of a lot easier then Chait (or even Romney) seems to appreciate. He assumes that conservatives feel themselves bound by rules of procedure and the niceties of institutional precedent. They do not. So something close to a full-scale repeal depends on only two conditions: Republican control of both houses of Congress, and a Republican president and vice president. Having promised repeal and made major gains in 2010, Republicans will assume that healthcare repeal is their #1 winning issue against Obama in 2012. So repeal will top their agenda in the next presidential campaign. And so if 2013 dawns on a Republican Congress and a new Republican president, Republicans will find that they actually have to follow through on repeal. Which they will do, and in so doing they will destroy the entire system of employer-provided insurance, which the conservative press will blame on Obamacare, and Republicans will propose tax cuts and health savings accounts. It may seem an overly dire prediction, but that's how the dominoes are placed. Knock over the first, and the last will surely fall. The Republican campaign for repeal is no laughing matter. Believing it an empty promise, they will run on it, and if they win, finding that it's actually quite easy, they will have to do it.

- rhubarbs

March 19, 2010 at 10:05am

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rhub, while your scenario is theoretically possible, it relies on 3 extraordinary unlikelihoods, Republicans taking both houses of Congress and the Presidency. The Senate is a good maybe, the House is more doubtful (mostly because they are set to purge all moderates and so will never win swing districts, much less left leaning ones) and who is the next President you envision? Not even Romney can contort himself so much to run against this: it was great for my state but bad for the country because...states should take the lead...and I want to become President to do nothing and let states take the lead...??? Beyond Romney, who else is there? Who can pull in the crowds outside of the nutjob Palin?

- blackton

March 19, 2010 at 11:19am

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blackton, I would quibble slightly with your odds. Republicans are much more likely to take the House than the Senate this year, and if they pick up even 5 seats in the Senate in 2010, only a miracle will prevent them winning control of the Senate in 2012. This is due to the imbalanced partisan makeup of the three "classes" of senators who run every second year. So the GOP controlling both houses of Congress after 2012 is better than even odds at this point. (Barring major unpredictable events, which are bound to occur, but which are as likely to favor Republicans as to favor Democrats.) And since we've never had a black president run for reelection before, and in particular we've never had a black Democrat run for reelection when at least a third of the electorate regards a moderate pragmatist who governs mainly with conservative policies to be a "socialist," we have to regard 2012 as a crapshoot. The bottom line is that if Republicans control Washington in 2013, which is not less likely than a one-in-four chance, probably more like one-in-three, they will almost certainly pass some form of repeal that guts healthcare reform. Political and procedural calculations will not prevent Republicans from repealing healthcare reform. Only the lack of the power to do so will stop them. This is Chait's error. The political argument he makes is sound, but he fails to recognize that because conservatives are going to run on repeal in 2010, and because they are going to make major gains in Congress whatever they run on, therefore they will conclude that repeal is a lasting, winning issue for them. Since there will be no opportunity for that belief to be tested prior to 2012, repeal will most likely be the top conservative domestic issue in the 2012 race. And so if Republicans win the White House, they will conclude that healthcare repeal was their winning issue. And once they realize how easy repeal is, they will have no choice but to deliver on what will appear, to them, to be their most winning domestic issue since the Red Scare.

- rhubarbs

March 19, 2010 at 11:59am

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rhub, I agree with your criticism of Chait, just not on the House and Presidency. Right now, I think the Republicans will go to the bottom of the barrel in 2012, giving Obama an even bigger landslide in 12 so for me it is far from a crapshoot. Millions of people have left the Republican party to become independents and in many states can't vote in Primaries. The only interesting thing will be states with open primaries, will Democrats (who have the vote to waste) be naughty and vote for the radical or go towards the most moderate Republican (if there will be such a thing). It is precisely the existence of the large number of whack jobs that will lead independents and even some Republicans to re-elect Obama. I am fairly Conservative, I am pro-life, pro-Iraq war, thinks Education is a local issue, etc. but 5 minutes of Fox news has me willing to even vote for a Bernie Sanders, better a sane person I disagree with than an insane person I agree with. As to the House this year, barring disaster (like a no vote) I see the Dems losing only 23 seats, and in 2012 Obama having big enough coattails to assure Democratic control of the House. That is my prediction and I am sticking with it.

- blackton

March 19, 2010 at 12:37pm

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- Consider this exchange. (Ed Schultz and David Frum) "David, how critical is this political moment for President Obama, in your opinion?" DAVID FRUM: "It‘s critical for everybody, and not just the president. It‘s critical for us on the Republican side, too. If this thing passes, there is going to be an accountability moment on the Republican side. We had a choice, do we negotiate and try to get some of our values in the bill? Or do we go for total defeat of the president and bet everything on that? I was one of those who said negotiate. That advice was rejected. We went for total defeat of the president. If he prevails, it is going to be a shutout of Republican views in one of the most important pieces of legislation ever passed in the United States." He added, "We‘re going to have a Democratic plan, when we could have had a balanced plan. It will be a big defeat for those who said go for all the marbles on the Republican side."

- michael

March 19, 2010 at 1:01pm

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David Frum: "We're going to have a Democratic plan, when we could have had a balanced plan. It will be a big defeat for those who said go for all the marbles on the Republican side." There are marbles left on the Republican side?

- rhubarbs

March 19, 2010 at 2:48pm

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ARG!! First: The bill IS a mostly Republican plan--- Nixon warmed over. That doesn't mean it shouldn't be passed, but it also means that the BS about this being a liberal, socialist takeover is just that-- BS. Second: If Republicans control the House, Senate, AND Executive Branch AND wish to repeal Obamacare, they will do so via the nuclear option or other parliamentary means that the Dems could use right now, but lack the cojones to do so. You need stop smoking whatever it is your smokin' , if you think otherwise.

- drofnats1

March 19, 2010 at 5:36pm

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Michael: Thanks for that Frum quote -- nice to see a Republican admitting that Republicans had a chance to contribute, as opposed to the usual "Democrats are pushing a purely partisan bill" bs.

- frippo

March 20, 2010 at 12:54am

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I think Chait is just gearing up for the inevitable so he can say, "Oh, those nutty Justices. They're so predictable."

- Nusholtz

March 20, 2010 at 11:57am

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