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Many of the Republicans in the next Congress were elected or re-elected on a promise to repeal the health care law. The issue is popular with Republican voters. But some traditional Republican allies are pushing back.

NPR's Julie Rovner explains why.

JULIE ROVNER: Incoming House Speaker John Boehner told Fox News earlier this month he'll do whatever it takes to eliminate the new health law.

Representative JOHN BOEHNER (Republican, Ohio): This health care bill will ruin the best health care system in the world and it will bankrupt our country.

Unidentified Man: So you'll take a vote on repealing?

Rep. BOEHNER: We are going to repeal ObamaCare and replace it with common sense reforms that'll bring down the cost of health insurance.

ROVNER: Now, 88 percent of Republican voters polled on Election Day agree with that goal. But a lot of key players in the health care industry don't. Rich Umbdenstock, for example, is president and CEO of the American Hospital Association.

Mr. RICH UMBDENSTOCK (President and CEO, American Hospital Association): Doing away with this would certainly be the wrong thing. People have been gearing up for some time, well before this actual bill got passed, to make these changes locally, and have invested a lot.

ROVNER: And it's not just hospitals. Employers, particularly large employers, have already put a lot of time, effort and money into implementing the parts of the law that have already taken effect.

Helen Darling heads the National Business Group on Health, which represents many of the Fortune 100 corporations. She says just the possibility that the law will be repealed or substantially changed is a serious problem.

Ms. HELEN DARLING (National Business Group on Health): It takes a long lead time to execute any policy, so at this point having a lot of uncertainty and policy volatility really work against helping us to move toward solving the problems of the country.

ROVNER: Which is not to say that the health care industry loves the law. No segment of the industry got everything it wanted, and everyone is busy lobbying for something to be changed, she says.

Ms. DARLING: There are plenty of opportunities for improvement, fine-tuning and actually adding some significant enhancements, especially in controlling costs.

ROVNER: The health insurance industry wants to make more than just fine-tuning changes - it's been among the most outspoken critics of the measure. But even insurers haven't come out in favor of scrapping the whole law and starting over, particularly not when it stands to get millions of new customers.

Robert Zirkelbach is a spokesman for America's Health Insurance Plans.

Mr. ROBERT ZIRKELBACH (Spokesman, America's Health Insurance Plans): We looking forward to working with both parties to minimize coverage disruptions caused by the new law and to make health care coverage more affordable for working families and small businesses.

ROVNER: So what's going on? Are Republicans being abandoned by their usual allies in the business community? Not exactly, says Jonathan Oberlander, a political scientist at the University of North Carolina at Chapel Hill.

Professor JONATHAN OBERLANDER (University of North Carolina, Chapel Hill): Usually we think of the health care industry as being in alliance with the Republicans and opposing more government intervention in the health system. But you have to ask, why did the health care industry support the reform law in the first place?

ROVNER: The reason, he says, is because the more people there were without health insurance - that number is now more than 50 million - the more threatened the industry got financially. In other words, its entire business model was threatening to fall apart.

Prof. OBERLANDER: The health care industry needs paying customers and insured customers to make their business model work. To the extent that Republicans push repeal, they are threatening the bottom line in some sense of the health care industry.

ROVNER: And to the extent the health industry perceives the new law as better than the world as it was before, he says, expect industry players to oppose repeal - strenuously.

Prof. OBERLANDER: 'Cause they're putting so many resources into it, a repeal in that sense represents a threat to them because they're already spending lots of money getting ready for the law. If you're talking about rolling the law back, that's a blow to their future, but it also represents a loss of all the resources they've pumped into it right now in getting ready for it.

ROVNER: Which leaves Republicans with a dilemma of their own: Please their voters or please some of their biggest donors. When it comes to health care, they may not be able to do both.

Julie Rovner, NPR News, Washington.

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