What's next for health law? Repeal efforts, 'compromise,' congressional conflict

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Nov 8 2010

Kaiser Health News' "Health on the Hill" features Mary Agnes Carey and Marilyn Werber Serafini talking about the GOP gains, what they mean for state implementation to health reform and what possibilities there are for major changes being made to the health law. The video and transcript include remarks from Rep. John Boehner and President Obama (Carey, Serafini and Judd, 11/3).

The Washington Post: Republican leaders Wednesday set their sights on repeal of the law. "'It's pretty clear that the Obama-Pelosi agenda is being rejected by the American people,' [John] Boehner, the speaker-in-waiting, told reporters." Republicans' ultimate target is "Obama's health-care overhaul, which many new members ran on a promise to repeal. Boehner said he would move slowly, adding that it is important to 'lay the groundwork before we begin to repeal this monstrosity.' … Exit polls showed that roughly half the public wants to repeal the bill but that the other half wants to keep or expand it, setting the stage for a potential showdown" (Kornblut, Kane and Murray, 11/4).

The Christian Science Monitor: "In their 'governing agenda,' House Republican leaders have already committed to repealing the 'job killing' health-care law. 'Because the new health care law kills jobs, raises taxes, and increases the cost of health care, we will immediately take action to repeal this law,' Republicans promised in their 'Pledge to America,' which they released in September. But they are also proposing that Congress enact elements left out of the Obama health-care law, such as medical liability reforms, the option of purchasing health-care insurance across state lines, and the expansion of health savings accounts" (Russell Chaddock, 11/3).

The Associated Press: Republicans may in fact prefer to "tinker and tweak" the law to keep the debate fresh in the minds of voters in hopes of unseating Obama in 2012. "Republicans could use the oversight authority of Congress to slow down or block regulations, essentially tying up the instruction manual for the overhaul. Expect flyspeck scrutiny of agencies implementing the law. GOP lawmakers may be able to pick off unpopular provisions. … Another target is a yet-to-be-named board with the power to make Medicare cuts. And look for a move to tighten restrictions on abortion coverage" (Alonso-Zaldivar, 11/4).

NPR: One major way Republicans can hold up the law is by "holding oversight hearings. Using subpoena power if necessary, Republicans could end up forcing Obama administration health officials to spend nearly as much time on Capitol Hill as they do in their offices actually trying to implement the law. … But all those hearings could also have the opposite effect — giving the administration a chance to make its case in favor of the law, a case that often got drowned out during the election campaign" (Rovner, 11/4).

Related, earlier KHN story: House Takeover Will Give GOP Ways To Attack Health Law (Werber Serafini, 11/2)

Politico: Democrats are offering compromise. "Senate Majority Leader Harry Reid said Wednesday that he's willing to 'tweak' the legislation and Obama told reporters that he'd 'be happy to consider' Republican ideas on how to modify the law, particularly rolling back a new tax reporting requirements" (Haberkorn, 11/3).

Reuters: "'To the degree that having Republicans control the House forces the administration and the Democrats to try to think through certain parts of the bill in a more measured, rational way, that's a positive for the insurers,' said Dave Shove an analyst for BMO Capital Markets, a financial services provider" (Heavey, 11/3).

National Journal: But Reid also said, "'But I'm not going to — in any way — denigrate the great work we did as a country in saving America from bankruptcy because of [the] insurance industry bankrupting us.' … He lauded measures in the legislation that would reduce the debt by $1.3 trillion, extend the life of the Medicare program by 12 years, and help seniors pay for prescription drugs" (DoBias, 11/3).

The New York Times: There will be a significant fight at the state level as well "where many changes are scheduled to take effect in coming years. … The results will also probably complicate efforts to carry out the complex measure, which is expected to provide coverage to more than 30 million people by 2019. At a news conference on Wednesday, Mr. Obama delivered a stout defense of the health care law, saying, 'This was the right thing to do.'" Other changes could include rolling back new taxes on high-cost health insurance plans and medical device manufacturers (Pear and Abelson, 11/3).

Related, earlier KHN story: With Newly-Elected Governors, GOP Gains Clout To Fight Health Reform Law (Appleby and Carey, 11/3)

ABC News: "Gail Wilensky, an economist and senior fellow at Project HOPE, an international health foundation, said, 'The real question is whether the Republican House and the more closely divided by Democratic Senate work to fix aspects that are regarded as particularly troublesome or leave it as is, so that the more egregious parts are more obvious.' Either way, she added, Congress must address at least one [separate] issue immediately. 'They need to fix the Medicare physician fee schedule right away,' she said. 'Starting on Dec. 1, Medicare payments to physicians will drop 23 percent.' … With a repeal unlikely, Congress could debate whether to pay for certain provisions in the bill, although analysts disagreed on how much power it has over the payment system" (Carollo, 11/3).

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.