Will The GOP Take An Axe To The ACA?

While total repeal of healthcare reform isn’t in the cards as long as there’s a Democrat in the White House, Brett LoGiurato predicts that “the overall GOP strategy will likely be to chip away at parts of the law in bills that could make it to the president’s desk”:

A full-repeal bill would certainly prompt a presidential veto. One item Republican House and Senate aides think is likely to make it to Obama’s desk, and potentially get his signature, is a bill to repeal Obamacare’s tax on medical devices. A similar amendment, championed by Sen. Orrin Hatch (R-Utah), who is in line to become the next chair of the Senate Finance Committee, passed by a 79-20 vote in 2013. “I think the med-device tax and some other little areas would be the best place to start, because that is the ‘possible,'” a senior GOP aide on the Senate Finance Committee told Business Insider of Republicans’ pursuit of Obamacare-related legislation in the next session of Congress. Republicans could also take aim at so-called risk corridors in the health law, a potential fight that some Republican senators have already begun discussing as part of a shutdown battle.

Cohn wonders whether the new Senate will try to kill the individual mandate:

Of all the proposals Republicans might pass, this is the one that would probably threaten to wreak the most havoc.

Economists say that the requirement to get health insurance (or pay a fine) entices lots of people, particularly young and healthy ones, to buy insuranceand, in so doing, keeps premiums for everybody else lower. If their projections are right, then taking away the mandate would mean more people without insurance, and higher premiums for those who hold onto it. Obama, a skeptic of the individual mandate during his presidential campaign, eventually decided the economists were right. He’s fought to keep the mandate ever since and there’s no reason to think he’d back off that position now. But the provision is unpopular with the public and Republicans might be able to pick up enough Democratic votes to pass a bill, just to force a very public veto.

The GOP’s statehouse victories are also bad news for Obamacare, as the newly elected or re-elected Republican governors aren’t likely to move forward on expanding Medicaid and might well tinker with or scale back existing expansions:

In Arkansas, where Democratic Governor Mike Beebe pioneered a way to use Medicaid expansion funds to subsidize private coverage, the future of that program is in doubt under the incoming Republican governor, Asa Hutchinson. Republican leaders in moderate states have expanded Medicaid, including Rick Snyder in Michigan (who won last night) and Tom Corbett in Pennsylvania (who lost). Republicans taking over in blue states, including Illinois, Maryland, and Massachusetts, may seek permission from Washington to revamp those Medicaid programs to make them look more like the privatized versions in Arkansas, Indiana, and a handful of other places.

Overall, Gerard Magliocca concludes that the ACA “is still not settled law”:

While Congress cannot repeal the Act over the President’s veto, the issue will remain a live one through 2016.  More important, the election results may influence the Court’s thinking on whether to take the cert. petition in King.  Court watchers noted the other day that the petition was relisted, which is often (though not always) a prelude to a grant.  The timing of the relist to correspond with the midterm election may be a coincidence, but in any event the election result may embolden the Justices who dissented in NFIB to take a statutory crack at the Act.

Meanwhile, Igor Volsky glosses over the GOP’s other likely legislative targets:

Republicans promised to force approval of the Keystone XL pipeline — a project 16 senate Democrats endorsed when the body voted on a non-biding resolution in March of 2013 — and have pledged to pass a budget in both chambers. Rep. Paul Ryan (R-WI) — the likely chairman of the House Ways and Means Committee — has promised to tackle tax reform (a project he told Bloomberg on Tuesday night would ideally attract 60 votes in the Senate) and insisted that Republicans still plan to advance immigration reform — on a step-by-step basis that begins with border security. Obama endorsed such a process last year. Other issues with bipartisan support include an insistence that the administration submit any deal to stop Iran from developing a nuclear program to Congress and approving fast-track authority for trade deals with the European Union and nations in Asia.

Correction from a reader:

One of the quotes on your recent post on the ACA at the state level said the following: “Republican leaders in moderate states have expanded Medicaid, including Rick Snyder in Michigan (who won last night) and Tom Corbett in Pennsylvania (who lost).” Former Governor Corbett did not actually expand Medicaid. He submitted his own privatization plan to the federal government, but it was never approved or enacted.