Bottom-line issues stall GOP efforts to pull back health law

Senate Democrats turn from agenda

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Republicans scored historic gains in last year’s elections in part on their pledge to scrap the new health care law — but their passion for repeal has dimmed in the face of a split Congress and the difficulties of untangling the complex legislation.

Dozens of House-passed repeal bills and amendments have stalled in the Senate as Republican leaders have shied away from using them as bargaining chips in the broader spending debates that have dominated Washington this year.

Now, 18 months after President Obama signed the legislation, the only change to reach his desk has been a relatively minor repeal of the 1099 tax reporting requirement that drew near-universal condemnation from businesses.

“By the time we got to the debt-ceiling debate, you could tell the leadership, the [Republican Study Committee], the organizations that pushed the priority agenda through our conference had turned over to the money side of this equation rather than the principled side of Obamacare,” said Rep. Steve King, an Iowa Republican who has sponsored some of the repeal efforts.

Part of the problem is the bottom line.

The Affordable Care Act, as the law is known, intricately wove incentives, such as expanded coverage for young adults and pre-existing conditions, together with more contentious provisions such as Medicare payment cuts and the individual mandate that requires all Americans to find coverage.

Undoing the tax increases would require finding revenue elsewhere — a tough sell in the fiscal debate — and unraveling one unpopular part of the legislation could mean the ends of popular programs as well.

“I don’t think they’ve given up, but I think they see that more and more people are benefiting from it and therefore I think they’re trying to now talk about jobs without any real effort other than talking about it,” said Sander M. Levin, Michigan Democrat and ranking member of the House Ways and Means Committee.

Repeal was a major part of Republicans’ campaigns last year, and is featured prominently in the Pledge to America, the document that the House GOP issued in the run-up to the elections as their governing blueprint.

House Republicans consider this pledge to have been kept. They point to the passage of H.R. 2, a repeal bill that passed the House on Jan. 19.

But that legislation never advanced in the Senate, nor did repeated efforts to defund all or parts of the health care law’s implementation, which House Republicans tried to attach to stopgap spending bills throughout the early months of this year.

House Speaker John A. Boehner, Ohio Republican, ditched those amendments as he sought to find common ground with Mr. Obama on the final 2011 spending bills. The House hasn’t sought to revise the health care law since the end of May, when it voted to convert mandatory spending on graduate medical education to discretionary spending.

Republicans also are losing steam when it comes to public opinion. A Bloomberg poll in September indicated that 34 percent of the country supports repealing the health care law, down from 41 percent six months earlier.

Another repeal effort has gained ground since Health and Human Services Secretary Kathleen Sebelius said she couldn’t find a way make a long-term care program workable.

The announcement was a heavy blow to the Community Living Assistance Services and Supports (CLASS) program, a program for the elderly and infirm that was projected to raise $83 billion in the first decade.

Although months of analysis had shown CLASS to be unsustainable, Sen. John Thune of South Dakota lacked traction when he tried to repeal the program last spring. But the administration seemed to be taking his side earlier this month when Mrs. Sebelius proclaimed the program unsustainable.

Making up the lost CLASS revenue stood in the way.

Last week, however, Mr. Obama announced that he would not support repealing CLASS, raising the question of whether Republicans could summon the political will. The same day, the Congressional Budget Office (CBO) announced that it would treat CLASS as having no impact on the budget — effectively removing pressure to offset the $83 billion should Congress repeal the program.

The tale of CLASS illustrates the power of the balance sheet, which can help tip the political scales for or against laws depending on how they add up.

Mr. Thune is “actively looking” for ways to repeal the program, said spokeswoman AshLee Strong. He likely will be seeking the votes of the 12 Democrats and independents who supported an amendment to strip CLASS from the health care bill before it was ever passed.

One of those was Sen. Joe Lieberman, Connecticut independent, who told The Washington Times that he would vote to repeal CLASS, after Mrs. Sebelius‘ announcement.

“I think Secretary Sebelius has done the right thing,” said Mr. Lieberman, adding that he didn’t expect Mr. Obama to oppose repeal. “I was surprised at that since Secretary Sebelius said it wasn’t viable. I mean, maybe the president will come in with some ideas about how to fix it, but I just don’t think we can afford it.”

CLASS may fill in some slots on an otherwise vacant legislative calendar for health care repeal. Repeal remains an undercurrent in the presidential election, with all of the GOP candidates promising to overturn the law if elected. But for the most part, Republicans seem to be calling a truce as they peg their hopes on winning a majority in the Senate next year.

“We’re developing other bill packages, and timing is up to the leadership,” said Rep. Joseph R. Pitts of Pennsylvania, “but if we are successful in 2012, one of the first things we’ll do is act to repeal Obamacare.”

Paying for the health care law is a sensitive topic for Mr. Obama, who promised taxpayers that he would make sure it was funded. While he has trumpeted CBO projections that show the law decreasing the deficit, Republicans have charged that he relied on budget gimmicks.

Even without $83 billion from CLASS, the health care law would reduce the deficit by $127 billion over a decade, according to the CBO.

That is proof that Democrats didn’t continue supporting CLASS simply because it was lucrative, said Igor Volsky, with the Center for American Progress.

“The $83 billion is a nice bonus,” he said. “If you took it away and the law didn’t reduce the deficit, you would have a compelling argument. [But] I’m not sure it was all about the deficit.”

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