Thursday, March 25, 2010

Republican Health Care Reaction

At the risk of stating the obvious, Republican talk of repealing health care reform is unrealistic political posturing.  Firstly, Republicans would need either both chambers of Congress and the Presidency, or massive veto-override majorities, which will never happen.  Besides that, repealing the law would now increase the deficit, forcing fiscal hawks to either raise new revenue or bypass PAYGO rules.  Some parts of the bill are widely popular, like eliminating pre-existing conditions, and it's simply politically impossible for Republicans to kill them.  Most recently, talk of a Republican Congress not funding HCR seems insane, especially considering who's trumpeting this course of action.

Another bizarre response to health care reform is the legal push-back by many states.  The bill is clearly constitutional, and opposing HCR on the basis of states' rights is futile; the courts have long upheld the primacy of the federal government.  This is not principled opposition to federal power, but pure political theater.  'States' rights' has become a method to achieve political and policy objectives, nothing more.  George W. Bush's big expansions of federal power (NCLB, prescription drug act, federal abortion restrictions) didn't spark much action among conservatives, and liberals (medical marijuana, gay marriage, environmental regulation) aren't complaining now.

Republicans have failed (or will fail) to block HCR at virtually every level of the policy process: agenda-setting, congressional committees, drafting legislation, passing legislation, funding legislation, and constitutionality and states' rights legal challenges.  According to public policy 101 Republicans have only one avenue left: stop HCR in its implementation phase.  Given its high-profile and national scale, that seems unlikely.  While there is uncertainty about how the law will evolve, one thing seems obvious: Democrats won, health care reform is here to stay.

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