House GOP sending Obama a message on health repeal

WASHINGTON (AP) -- Eager to show who's now in charge, the House's new Republican majority plans to vote to repeal President Barack Obama's landmark health care overhaul before he even shows up in their chamber to give his State of the Union address.

Though full repeal is a longshot - the House vote would be just the first, easiest step - they'll follow up with dozens of attempts to hack away at what they derisively call "Obamacare."

The strategy is not risk-free for the Republicans, who won't have a replacement plan of their own ready by the time of the repeal vote. But they say there's no time to lose.

Senate Democratic leaders are sending their own "you-don't-scare-me" message. In a letter Monday to House Speaker-to-be John Boehner, they served notice that they'll block any repeal, arguing it would kill popular provisions such as improved prescription coverage for Medicare.

All the while, the Obama administration intends to keep putting into place the law's framework for covering more than 30 million uninsured people. Ultimately, Obama still has his veto pen, and Republicans aren't anywhere close to the two-thirds majorities they would need to override.

Most likely, both parties will carry the main issues of the health care debate into the 2012 presidential election, when Obama is expected to seek a second term and House and Senate control will be up for grabs again.

"It's not going to be easy; it's going to be a long, hard slog," said Rep. Steve King, R-Iowa, an early leader in the repeal drive. The quick thumbs-down vote by the House will have "tremendous utility and value," King said, but it may take electing a Republican president in Obama's place to accomplish the overall goal.

"Repeal and replace" worked as a campaign slogan to motivate voters concerned about the growing reach of government under Obama. But a single-minded focus on repeal could backfire as a Republican governing strategy. Polls show that some parts of the law are popular, and many Americans would have wanted even bigger changes.

Look for Republicans to try to deny money for the government to carry out the law. They'll also attempt to strip out sections of it, such as a new long-term care program. And they'll move to strengthen restrictions on funding for abortions.

It's far from clear that they'll be able to prevail in those efforts either. There's talk that an effort to deny funding could even escalate to the point of a possible government shutdown, and no one seems eager for that.

"I don't think the health issues will cause anything dire in the way of a government shutdown," said economist Robert Reischauer, president of the Urban Institute think tank. "There are other things on the agenda besides health care, namely broader budget issues that have to be dealt with."

The two parties may be able to get a deal on some limited fixes, like repealing an income tax reporting requirement that small business is calling a paperwork nightmare.

At the White House, spokesman Reid Cherlin said Obama would have no qualms about delivering his State of the Union speech to lawmakers who've just repudiated his signature accomplishment, one that Democrats compare with the establishment of Social Security and Medicare. The president "feels pretty confident about defending the health care law," Cherlin said.

Senate Democrats agree. In Monday's letter to Boehner, Majority Leader Reid and top lieutenants said repeal would undermine improvements already on the books, such as deep discounts on brand-name drugs for Medicare recipients who have fallen into a coverage gap called the "doughnut hole."

"This proposal deserves a chance to work," the Democratic leaders said. "It is too important to be treated as collateral damage in a partisan mission to repeal health care." The law would gradually close the coverage gap.

Democrats also are preparing counterattacks.

Supporters of the health care law have launched a "drop it or stop it" campaign, challenging Republicans who vote to repeal the overhaul to also give up the government-funded health insurance provided to members of Congress.

"These Republican members need to understand that they are going to pay a risk for taking away people's health care," said Ethan Rome, executive director of Health Care for America NOW, a coalition of the law's supporters. "It's hypocrisy, their willingness to take health care from the U.S. Congress, while they're denying it to their constituents."

Republicans say that's nonsense: Lawmakers are only accepting the same employer-sponsored health care coverage available to other federal workers.

They may be more vulnerable on another score. The House vote will be to simply repeal the health care law. The "replace" part of the GOP slogan will be delegated to several committees, charged with developing an alternative as the year goes on. That can be a laborious process, one that produced plenty of disagreements and embarrassments for Democrats when they were in control.

It's a risk worth taking, says Rep. King. "I do not believe that you can leave any of Obamacare in the law," he said. "To pick and choose would start endless squabbles. If there are components of Obamacare that have merit, they can be reintroduced as part of a replacement process."

Finally, there's a wild card: the courts. Challenges to the constitutionality of the health care law are working their way toward the Supreme Court. Opponents say Congress overstepped its authority by requiring most Americans to carry health insurance, effective in 2014. The case may take a couple of years, and it could change everything.