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A congressional vote to repeal the Affordable Care Act marked the end of one skirmish over the future of health reform and the beginning of a long-term battle.
The headlines sure looked triumphant for the Republicans. The House of Representatives voted 245-189 for the repeal. The same week, six states with new Republican governors or attorneys general petitioned to join the multistate lawsuit against the individual mandate, bringing the total to 26.
But just what the GOP accomplished is unclear. If the new states are added to the lawsuit, it may help when it comes to splitting the check, but doesn't change the merits of the lawsuit. Yes, the House has repealed "Obamacare." Well, not really. Republicans sent the repeal bill to the Senate, but they may have just as well sent it to the morgue. Even in the unlikely event it sees a vote in the Democrat-dominated upper chamber, it cannot pass.
This doesn't sit well with Majority Leader Eric Cantor, who decried, "The Senate ought not be a place where legislation goes to a dead end." Memories can be short. Cantor's party notched a record number of filibusters in the last Congress.
But Republicans did accomplish something few thought possible: they unified the Democratic party on health care reform. Just three Democrats voted for the repeal -- 35 fewer than voted against the Patient Protection and Affordable Care Act last year. The day after the vote, a coalition of Democratic and progressive groups launched a campaign going after Republicans who voted for repeal while accepting taxpayer-funded health insurance.
The vote also came as new polling shows Americans with a more favorable view of the reform act than ever. An Associated Press-GfK poll showed an even split between those who support and oppose it, but just one in four favor a full repeal. (Other polling showed the pro-repeal view as high as 45%.)
As President Barack Obama and the Democrats learned two years ago, voters can be fickle. The GOP succeeded in making the reform law sound scary for the November elections. But as actual specifics of the act began to sink in, they started sounding pretty good to a lot of people. It's one thing to campaign saying a giant federal insertion into health care is bad. It's another to tell people they should be denied coverage for pre-existing conditions, or that their kids shouldn't be covered under their insurance plan or that their small business shouldn't get tax breaks to insure their employees.
But Democrats would be wise to hold their celebrations. House Republicans will be able to influence implementation of the law through the budget process. They are capable of making the next two years very tough indeed on those who want to see more of the Affordable Care Act actually enacted. Agents and brokers are already working with Republicans to alleviate what they see as onerous medical-loss-ratio rules.
There is even hope for some common ground on small changes to the bill. A number of Democrats are inclined to join Republicans in overturning a much-disliked tax reporting requirement. That could be just the first of many tweaks.
(By Sean P. Carr, Washington Bureau Manager: mailto:email@example.com)