Fresh from election victories, Republicans are charting a new legislative agenda that likely includes both philosophical and practical strategies to roll back the Affordable Care Act, President Obama's signature healthcare reform law.  

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Changing the Affordable Care Act: 2015 Legislative Outlook Part 1

Mon Nov 17, 2014

Congressional Republicans, fresh from Election Day victories and poised to assume leadership in the U.S. Senate and House of Representatives, are charting a legislative agenda for 2015.

High on their list of priorities will be rolling back the Affordable Care Act, President Obama’s signature healthcare reform law. Armed with polls showing that more Americans oppose the law than favor it, Republicans are expected to pursue both philosophical and practical strategies next year.

Philosophical Strategy: Repeal the Affordable Care Act lock, stock and barrel. All 2,500 pages.

In a Nov 6 editorial in the Wall Street Journal House Speaker John Boehner (R-OH) and presumptive Senate Majority Leader Mitch McConnell (R-KY) pledged “renewing our commitment to repeal Obamacare, which is hurting the job market along with Americans’ health care.”

As an expression of core philosophy few actions would be more powerful than voting to scrap the controversial health reform law. Election Day exit polls revealed that almost half of voters thought the healthcare law “went too far.” And there would be a clear line differentiating ACA opponents and supporters, with the latter again having to vote for an unpopular law.

The problem with the repeal ACA strategy is that it can’t succeed, at least not in the next two years. True, Republicans could have a solid 54-46 majority in the U.S. Senate next year. However, Senate rules allow the minority to “filibuster” measures, so Republicans would need 60 votes to send a repeal bill to President Obama to be signed into law.

And therein lies a second procedural obstacle. Even in the unlikely event 6 Democratic senators join 54 Republicans to vote for complete repeal President Obama would veto the legislation—meaning the repealers would need two-thirds or 67 Senate votes to override the veto.

Practical Strategy: It’s worth noting that Republicans and some Democrats agree the Affordable Care Act needs fixing. Notwithstanding all the partisan bickering, compromises to repair the 2010 law are achievable.

This reality offers important insight into how the Affordable Care Act legislative battle may play out next year. Rather than voting on a new 2,500 page reform of the original reform, look for the House and Senate to vote on separate bills to change the ACA, some of which Democrats may support.

On the other hand, some proposed changes will be hotly debated, involving presidential vetoes and veto override votes in both House and Senate. There seems little doubt that the landmark healthcare reform law, reaching its five-year milestone in March 2015, will see legislative trench warfare for most of the year.

Part 2 of this blog will look at ACA amendments Congress might consider in 2015.