RENEE MONTAGNE, host:

Now that they control the House, one issue Republicans say they'll deal with is health care. They vowed to repeal and replace the new health care law. But as NPR's Julie Rovner reports, that won't be easy.

JULIE ROVNER: Indiana Republican Congressman Mike Pence spoke for a lot of his colleagues yesterday morning, when he told CNN exactly what Tuesday's elections meant for the health law.

Representative MIKE PENCE (Republican, Indiana): Obamacare was roundly rejected, last night, by the American people. We need to rip it up, root and branch, and House Republicans are determined to do that.

ROVNER: But House Minority Leader John Boehner, who's in line to become Speaker in January, was a little more circumspect about how fast that might happen.

Representative JOHN BOEHNER (Republican, Ohio): The American people are concerned about the government takeover of health care. I think it's important for us to lay the groundwork before we begin to repeal this monstrosity and replace it with commonsense reforms that will begin to bring down the cost of health insurance in America.

ROVNER: One reason for Boehner's caution, is that despite all the rhetoric, the Republican House by itself can't make the new health law go away.

Mr. MICHAEL CANNON (Director of health policy studies, Cato Institute): Republicans cannot repeal Obamacare with President Obama wielding the veto pen - I mean, thats not within the set of possible outcomes.

ROVNER: Michael Cannon is director of health policy studies for the libertarian Cato Institute and no fan of the new law. With the Senate still run by Democrats, a full-scale repeal is simply out of the question. But that's not to suggest that House Republicans are without tools to cause pain to supporters of the health law.

Mr. CANNON: Theyre going to do everything they can to try to cripple the law, throw sand in the gears and make it even more unpopular than it has been for the past 18 months.

ROVNER: One major way they can do that is by holding oversight hearings, using subpoena power if necessary, that could end up forcing Obama administration health officials to spend nearly as much time on Capitol Hill as they do in their offices. Cannon says relentless hearings by Republicans could help solidify public opinion against the measure.

Mr. CANNON: The more they keep the law in the news and the more of a steady drumbeat of bad news they create about this law, the more likely it is that, eventually, someone with the power to overturn or repeal this law will do so.

ROVNER: But all those hearings could also have the opposite effect, says Martin Corry. He's a healthcare lobbyist and former official at the Department of Health and Human Services during the Bush administration. He says the hearings will also give the administration a chance to make its case about the law - a case that often got drowned out during the election campaign.

Mr. MARTIN CORRY (Healthcare lobbyist): The next round of this, while there will certainly continue to be the, you know, the broad sloganeering on both sides, presumably will get a little bit more into the detail. And so if you're a family with a 22 year old still in college, you may not want to see that provision repealed.

ROVNER: Corry says other threats - such as trying to starve the new law by holding back its funding - or by preventing agencies from writing regulations needed to implement it - could also backfire.

Mr. CORRY: Many of the provisions in the law take effect, regulations or not, implementation dollars or not.

ROVNER: Things like requiring insurance companies to spend a specific amount of each premium dollar on medical services. Former Republican Senator Dave Durenberger says he thinks the Democratic Senate might well try to dampen the House repeal efforts by holding a series of hearings of its own. Among other things, they could give health care groups a chance to tell Congress what things in the law they want to see fixed.

Mr. DAVE DURENBERGER (Former Republican Senator): And so just putting some of that - here are some things that could be improved - on the table, takes some of the wind out of the sail for repeal.

ROVNER: At his news conference yesterday, President Obama signaled he was open to some changes to the health law. He even suggested one of his own, repealing an unpopular provision - increasing the number of forms small businesses must file with the IRS.

Julie Rovner, NPR News, Washington.

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