Even if Republicans could wave a magic wand and persuade enough Democrats to change the big federal health law in the next two years, the effort might hurt chances of eventually repealing it, some conservatives say.
"There’s a danger to getting rid of the most egregious provisions," said Tevi Troy, a senior fellow at the Hudson Institute and a former top health official in the Bush administration. "It carries a huge political risk" because it would eliminate political momentum to repeal the full law, he said.
So just 48 hours after a major Republican victory, conservatives were debating whether it's better for them to chip away at part of the law in the next Congress or just lay the groundwork for 2012 when they could pursue a takeover of the Senate and White House.
Republican leaders said after winning back the House Tuesday that they plan a vote early next year to repeal the health law. But it would only be a symbolic gesture since substantive changes to the legislation likely would be opposed by the Democratic-controlled Senate and President Barack Obama.
In addition to the political challenges, Republicans would also have a difficult time altering the law because removing many provisions could increase the deficit and possibly derail political momentum for a full repeal after 2012, conservative policy experts said Thursday at a forum sponsored by the Hudson Institute, a conservative think tank.
"There are formidable barriers to changing the law," said Doug Badger, a lobbyist and former health adviser to President George W. Bush. But he said Republicans have a chance to try to change the bill — such as eliminating the requirement that everyone buys insurance — if they can recruit moderate Democrats up for reelection in 2012 and build support from Republican-dominated state Houses and employers worried about increased costs they might face under the law.
But Nina Owcharenko, director of health policy studies at the conservative Heritage Foundation, said Republicans will need to keep the attention on the health law the next two years by trying to block implementation and funding for the law. "There is no need to use tweaks and fixes when the foundation of the law is unstable," she said.