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Repeal it or not

Presumptive Republican presidential nominee Mitt Romney wasted no time in delivering his verdict on the U.S. Supreme Court’s historic ruling on the Patient Protection and Affordable Care Act.
"What the court did not do on its last day in session, I will do on my first day if elected president of the United States," he said. "And that is I will act to repeal Obamacare."
Mr. Romney was echoed by a chorus of Republican lawmakers and party officials, who no doubt were as stunned as most observers that Chief Justice John Roberts had joined with the court’s four liberals to uphold the controversial 2010 health care law. They need only recapture the White House and the Senate, the Republicans said, and Obamacare would be history.
It sounds simple, but a couple of not-so-minor obstacles lie in their path. First, Mr. Romney needs to beat the incumbent president and the GOP must win enough Senate seats to regain control while also retaining its House majority. And second, the Republicans likely need a 60-vote majority in the Senate to repeal the entire health care law.
The process known as "reconciliation" could allow a simple Republican majority in the Senate to kill budget-related ACA provisions such as taxes, fees and subsidies. The individual mandate also might be within reach, because the Supreme Court characterized it as a tax, though Mr. Romney’s view (shared by President Barack Obama) that it’s not a tax could prove problematic. But many provisions such as allowing young adults to be covered on their parents’ plans until age 26 would be very difficult to repeal.
That assumes, of course, that a President Romney would even want to get rid of the numerous provisions that most Americans seem to favor.
Then there’s the political equation. In a Kaiser Family Foundation poll conducted shortly after the Supreme Court opinion was handed down, 56 percent of respondents wanted the law’s opponents to "move on to other national issues."

So the choice for Mr. Romney, his fellow Republicans and other Affordable Care Act foes is this: Make full repeal the goal, no matter how unlikely that might be, or focus instead on changes that would greatly improve the law-especially ones targeting the cost side.

7/6/12 (c) 2012 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email rbj@rbj.net.


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