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Another Way the GOP Could Go About Repealing Health Care Reform

I’ve been saying that the ACA repeal vote now scheduled in the House for next week is basically a symbolic payoff to Tea Partiers and other core Republicans, who the leadership hopes can be bought off with symbols since their real goal—full repeal of ACA—is unrealistic in the current Congress.

Note that there was another track Republicans could have taken. Rather than go for a full repeal that will be dead on arrival in the Senate, Republicans could have targeted the least popular provisions of the ACA and attempted to force them through by attaching them to must-pass bills, thus forcing Democrats in the Senate to either sign off on them or face a damaging fight. 

Now, Republicans could still do that. It’s actually not a bad way to unravel ACA; most of the unpopular parts are needed to pay for direct benefits, or to make an overall popular scheme (such as helping those with pre-existing conditions get insurance) work.

But as Aaron Carroll notes today, there’s a very good reason for Republicans to avoid that path: GOP-aligned interest groups, and independent groups that support many Republicans, like things the way they are. Read the post for details.

What interests me here is that this is sort of the flip side of the much-noted passage of ACA with only Democratic votes. Many, at the time, claimed that strict partisanship in passing major legislation is highly unusual, and speculated that the result would be that the bill would be more vulnerable in the future. This story suggests that not only was it important in an age of partisan polarization to buy off various important groups in order to get the bill passed, but that very same process may also protect the bill after passage. 

We shall see, of course, how it works out in practice. Republicans certainly didn’t hesitate to oppose the bill in 2009-2010 despite the support from several groups who are normally GOP-aligned or at least GOP-friendly. Will they fight against the interests of those groups now? Will they, if they win full control of Congress and perhaps the White House in the near future? I don’t know. What I do know, or at least suspect, is that industry lobbyists aren’t really going to care one way or another about purely symbolic votes on the floor of the House. If that’s all it takes to satisfy GOP activists, well, that’s a deal that the lobbyists will be very happy to make.