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To repeal or dismantle? That is the internal debate roiling House Republicans as they plot their strategy on the landmark 2010 health care law, as its implementation accelerates.
Recognizing that neither President Barack Obama nor the Democratic Senate will entertain legislation that fully repeals the Affordable Care Act, House GOP leaders are pushing their conference to embrace a series of messaging bills altering or dismantling pieces of the law to publicize for voters what Republicans argue are the statute’s many failed and damaging policies. Their goal is to turn the law into an issue they can use against Democrats in the 2014 midterms.
But rank-and-file Republicans, particularly freshmen and sophomore members, worry that any legislation to repeal a portion of the law could be interpreted by their constituents as strengthening it. Or worse, many Republicans fear that repealing broadly unpopular parts of the Affordable Care Act, such as the medical-device tax, might strengthen voters’ opinion of the law, decreasing the possibility that political pressure for full repeal will mount as a predicted messy implementation progresses.
“It’s a pretty big debate and I don’t think there’s any consensus with our constituencies and therefore members don’t have an absolute [position],” Rep. Jack Kingston, R-Ga., said Thursday during a brief interview. “If you’re perceived as doing anything to facilitate implementation, you’re suspect.”
This simmering debate boiled over Wednesday, when House GOP leaders canceled a floor vote on legislation that would have diverted up to $3.7 billion from one component of the law Republicans deemed a failure, the Prevention and Public Health Fund, in order to bolster another part — the Pre-Existing Conditions Insurance Plan, which is facing implementation difficulties.
The bill was spearheaded by Majority Leader Eric Cantor, R-Va., and was intended to highlight a health care law failure while also showing voters that Republicans support the concept of helping Americans obtain insurance coverage for pre-existing medical conditions. But influential conservative advocacy groups opposing the bill labeled it a key vote, and the few dozen tea-party-affiliated members who tend to follow their lead revolted. A minimal number of Democratic votes existed for the bill, if any.
Republicans say their 2012 freshmen balked at supporting the bill because they have not yet had an opportunity to vote on full repeal — no such bill has been considered in the House during the 113th Congress. The freshmen and other conservative stalwarts are eager to prove their commitment to full repeal and skeptical that tinkering with the law or partially repealing it will accomplish their ultimate goal of completely abolishing the statute.