ObamaCare: What the GOP could (but probably won't) do now

Since ObamaCare’s passage on Sunday night, there has been much talk on the Right about repealing it and replacing it with better ideas. But everyone knows that is at best a medium-term project. John Hawkins floats the idea of starving the funding for ObamaCare’s infrastructure — a worthy idea, but one which again must wait until the Democrats are voted out of the majority in at least one house of Congress.

However, there are a few things the GOP could do even now to start unraveling the Democrats’ takeover of the US healthcare system. These suggestions are based on the fact that — now that it has been signed into law — even establishment media outlets like TIME and the Associated Press can implicitly admit that ObamaCare was a deal largely cobbled together by the very interest groups the Democrats demagogued to the public. The Democrats are now counting on these interest groups to help sell ObamaCare to the public. Republicans ought to teach these groups the risks of trusting your future to the government.

First, the Senate GOP ought to commit to filibustering the so-called “doc fix” that would repeal the current Medicare physician payment formula (which calls for a 20% cut in pay). House Speaker Pelosi and the White House reportedly plan to deliver this $252 billion payoff to the AMA in the next few months. The only compromise that the GOP should offer is support for a paid-for standalone bill that must bear the title, “The Democrats Shamelessly Lied About the Cost of Health Care Reform Act of 2010.” Presumably, the Democrats would reject this, which would leave them with having to pursue a temporary “doc fix” in a budget reconciliation act next year — at which point Democrats may not have the votes to pass it. (I would sympathize with doctors who disagree with the AMA, but if so few are willing to speak up when the president calls them greedy foot-rustlers and tonsil-grabbers, they should expect to become political targets.)

Second, the GOP should join in a bipartisan coalition with pols like Rep. Henry Waxman to stick it to Big Pharma. Waxman does not feel bound by the $80 billion deal the White House struck with PhRMA, so why should Republicans? Why should the GOP allow PhRMA to game the Medicare Part D benefit and avoid drug reimportation problems (as pointless as I might think the latter proposal)?

Third, both the House and Senate GOP will likely have opportunities to attack the individual mandate, and ought to exploit every one of them. The mandate is the straw that stirs the ObamaCare drink, and it is unpopular across the political spectrum. Indeed, the Left would likely join in efforts to weaken the mandate, not only because they see it as a windfall to Big Insurance, but also because they would like to choke off those profits in hopes of moving to a single-payer system. It is more likely that if Big Insurance is made to realize that a mandate-based system is not politically sustainable, these companies will stop backing government control.

Of course, with the possible exception of the mandate, the Beltway GOP probably won’t do these sorts of things. That’s the lesson to be drawn from the messaging idiocy of Sen. John Cornyn. He had a year-long course in what his supposed political opponents can and will do to achieve a key policy goal, and learned nothing from it. Pols like this will think more in terms of collecting donations from these groups later, after the Dems stab them in the back. By then, it may be far more difficult to roll back ObamaCare — but it should be clear now that the Cornyns of the world still have not adjusted to the Democrats’ new way of doing business.