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Will midterms really change healthcare reform?

Tim Gould
by Tim Gould
November 5, 2010
2 minute read
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Can Republicans — emboldened by their strong showing in the mid-term elections — scuttle President Obama’s healthcare reform program?
The short answer is: Probably not. But the new GOP members of Congress and, perhaps more importantly, the new Republican governors, will probably be able to achieve a substantial slowdown of the process.
Outright repeal unlikely
First things first: Repealing the law just isn’t likely to happen, no matter how loudly presumptive House Speaker John Boehner crows about it. The GOP controls the House, but it’s still the minority party in the Senate.
So any legislation to wipe the law off the books isn’t likely to get passed. And even if it did, President Obama would veto it — and Republicans don’t have the votes to override that veto.
What’s more likely is that Republicans will try to “gum up the works,” in the words of one Congressional scholar. According to Bloomberg news, at least 30 bills to roll back specific provisions of the law are on hold in both houses of Congress.
And since Republicans now hold the chairmanships of House committees, they can drag administration officials like Health and Human Services Secretary Kathleen Sibelius into drawn-out public hearings on various aspects of the reform program.
Republicans could also attempt to block funding for parts of the plan.
‘Sand in the gears’
Individual states now have more muscle to fight reform — at least 10 states ousted Democrats in favor of GOP candidates for governor in the midterms.
According to Julie Appleby and Mary Agnes Carey, writing for Kaiser Health News, the new governors can draw from a number of approaches to at least delay the full implementation of the reform law:

  • They can lobby state congressional delegations to change the law
  • They can make formal application for waivers to some of the law’s provisions, and
  • They can drag their heels on setting up the “insurance exchanges” the states are required to have in place  by 2014.

In other words, as Appleby and Carey quote Rutgers University professor Ross Baker, “The governors could, without defying federal law, simply implement it inefficiently — throw sand in the gears.”
The overall goal: Slow things down until the 2012 presidential election. That’s likely to be when the real showdown on health care takes place.

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