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 First they have to pick up the six seats they need for a U.S.
Senate majority in Tuesday's midterm elections, which would give the
party control of both congressional chambers for the first time
since 2006.
With opinion polls showing the odds for Senate control increasingly
in their favor, Republicans are exploring a series of efforts to
repeal some of Obamacare's taxes and penalties on businesses.
The Affordable Care Act, Obama's signature domestic policy
achievement, aims to reduce the number of uninsured Americans by
offering subsidized private coverage to lower income Americans and
by extending Medicaid program for the poor.
But the law has been a target for constant Republican attack since
Congress enacted it in 2010, when both chambers were controlled by
Democrats. Republicans view it as an unworkable expansion of big
government that will only raise healthcare costs while hurting
businesses, job growth and the economy.
A Republican-controlled Congress would still be expected to kick off
in January with separate bills to repeal the entire law, as well as
the penalty for individual Americans who fail to obtain health
coverage and the federal subsidies for low-income people enrolled in
private Obamacare health policies.
Senate Republican Leader Mitch McConnell came under fire from
conservatives critics last week after saying the party was unlikely
to have the 60 Senate votes, out of 100, needed to repeal the law
with standard legislation. A McConnell spokesman said his position
had not changed: a Republican-controlled Senate would still see a
full repeal vote and McConnell remained committed to undoing the
law's funding provisions through a special parliamentary process
requiring only a simple 51-vote majority.
But with a White House veto of such measures all but certain,
Republicans hope to move on quickly to legislation capable of
drawing enough Democrats to surmount the Senate's legislative
hurdles and put pressure on Obama to acquiesce, lawmakers and aides
said.
Chief among Republican targets is the ACA's employer mandate, which
requires businesses with at least 50 full-time workers to offer
health coverage to their employees or pay a penalty. Also on the hit
list are the law's definition of "full time" as any employee who
works 30 hours a week or more, provisions that compensate health
insurers for market losses and an excise tax on medical devices,
including the machines that produce CAT scans and magnetic resonance
images.
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"There's consensus that we need to tear down the most destructive
parts of the law that are hurting people and are hurting our
economy. And there's proven bipartisan support for some of our
ideas," said Senator John Barrasso of Wyoming, an orthopedic surgeon
and a leading Republican voice on healthcare.
Employer requirements and taxes have also been the subject of
intense lobbying by the business community, including medical device
manufacturers, while risk provisions that seek to reduce insurer
losses have become a favorite target for Tea Party-backed
conservatives who warn of a looming government "bailout" for the
insurance industry.
Some measures have won support from senators in both parties,
including Republican Orrin Hatch's budget resolution amendment last
year to repeal the excise tax on medical devices. That measure was
blocked from a later floor vote by Democratic leaders.
There also could be room for negotiations between parties once the
repeal efforts run their course. Democratic Senate aides say they
have talked to Republican aides about compromises including
streamlining reporting requirements for employers and replacing the
tax penalty with an incentive for firms to offer health coverage to
workers.
Both parties could add proposals to tweak Obamacare to broader
pieces of legislation, such as a budget or appropriations bill.
"That is the old fashioned way of passing legislation. You pull
together a bunch of things that could have gone separately, you find
a way to pay for them and you get enough people to hold their noses
and vote for it,” said Joe Antos of the conservative American
Enterprise Institute.
(Reporting by David Morgan; Editing by John Whitesides and Frances
Kerry)
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