Gearing Up for the Health Care Showdown

Sam Fulwood previews the upcoming partisan fight over repealing health care reform and why it’s likely to make progressives stronger.

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Rep. Robert Andrews (D-NJ) told <i>The New York Times</i> that he welcomes the debate on health care reform repeal. “We will respond by pointing out the impact of repeal on people’s lives,” he said. (AP/Mel Evans)
Rep. Robert Andrews (D-NJ) told The New York Times that he welcomes the debate on health care reform repeal. “We will respond by pointing out the impact of repeal on people’s lives,” he said. (AP/Mel Evans)

This new year brings a return to old-school political fights.

If leaders of the 112th Congress are to be believed, among the first orders of business will be a ceremonial vote to repeal the health care overhaul. That sweeping piece of legislation was President Barack Obama’s major achievement in the previous Democratic-led Congress. With Wednesday’s swearing in of the House of Representatives and a smaller Democratic majority in the Senate, more than a changed set of controlling leaders will quickly emerge—a doubling-down on partisan gamesmanship is just as likely to begin anew.

Sensitive to keeping the faith with the Tea Party legislators in their midst, the House leaders have promised to bring a vote on repealing the health care law, which provides the framework to provide health insurance for nearly every American for the first time in the country’s history. While the president—along with strong support from former House Speaker Nancy Pelosi (D-CA) and Senate Majority Leader Harry Reid (D-NV)—eventually prevailed and the legislation was signed into law over nearly unanimous GOP opposition, the legislation proved to be a lightning rod for the antigovernment Tea Partiers, who won seats in the new Congress.

So now, with a majority and Rep. John Boehner of Ohio poised to become speaker of the House, it’s time for House leaders to pay back the Tea Party rebels or risk calamity among the conservatives. Hence, the upcoming show vote on repealing the health reform law.

Of course, I don’t expect the repeal will succeed on an early, hasty vote in the opening weeks of the new year. Nor, in fact, do the conservatives pushing for it. Rather, a token vote will take place, one that may pass the House but surely will fail in the Senate. And even if miracle of miracles transpires and it clears both the House and Senate, a probable and insurmountable veto awaits in the Oval Office.

Rep. Fred Upton (R-MI), appearing over the weekend on “Fox News Sunday,” seemed to acknowledge as much, bouncing from bravado about the repeal’s chances for success to offering a back-up plan should it fail. “If we pass this bill with a sizable vote, and I think that we will, it will put enormous pressure on the Senate to do perhaps the same thing,” Upton said. He followed that sentence, which was filled with a mouthful of weasel words and conditional caveats, by offering a frank and more revealing conservative strategy. “But then, after that, we’re going to go after this bill piece by piece.”

So that’s the game plan. Still, key pieces remain bafflingly murky in the conservative’s line of attack. It all comes down to a series of questions that begin with: Why?

  • Why do conservative leaders feel compelled to waste time and energy in such a pointless pursuit?
  • Why are they allowing the Tea Party freshmen to push their leadership to the outer fringes of the political mainstream?
  • Why would the House want to start 2011 with a showdown with President Obama, who ended last year in greater standing than at any time since taking office?
  • Why make Democrats stronger by giving them a reason to rally their troops around a cause?

Why indeed pick a fight with your troops in the backward position, aiming at the support needed for bigger battles to come? To be specific, by challenging the health care reform law, conservatives run the risk of alienating racial and ethnic minorities who were among the most vulnerable in the old system.

My colleague Lesley Russell makes clear in a recent report released before the legislation was passed by Congress and signed into law by the president that chronically ill Americans from racial and ethnic minority communities are among the beneficiaries of the Affordable Care Act. The law promises them a measure of relief from the higher rates of chronic illnesses from which they suffer at a greater rate than the general public.

“The ultimate goal must be that all Americans, regardless of race or ethnicity, get the quality health care services they need when they need them,” she wrote. “We can ill afford to ignore the high cost in dollars and human life that the nation pays each year that is attributed to health care disparities, especially when much of the burden from chronic illnesses is preventable.”

This strategy also has other dangers for conservatives and Tea Partiers. To strip funding away from the health care law runs the risk of shutting down the entire federal government because of the way the law is written. The funding is tied to a range of other government projects beyond health care, so if conservatives kill funding for one piece of the law they essentially kill funding for something else. If they kill enough pieces of it the funding for the federal government collapses. Conservatives tried this strategy once before during the Clinton administration, and it didn’t work so well. Could they really consider doing that again? And wouldn’t that run the risk of turning the public against them?

House Democrats seemed almost gleeful at the coming partisan fight over health care reform, which has increasing support among the public. Rep. Robert Andrews (D-NJ) told The New York Times that he welcomes the debate. “We will respond by pointing out the impact of repeal on people’s lives,” he told the newspaper. “On women with cancer who could be denied insurance because of a pre-existing condition. On senior citizens who would lose the help they are receiving to pay for prescriptions.”

Even if we’re likely to see a year or two of political gridlock, the political confrontations should produce a doozy of a debate, one that will paint a bright line for the American people to see clear differences in political leadership and policies. I’m more optimistic now than I was at this point last year for public embrace of progressive programs such as full-throated support for the health care reform law given the conservatives’ track record and the overall looniness of the Tea Party.

Let the political games of 2011 begin, and may the public’s will be the ultimate verdict.

Sam Fulwood III is a Senior Fellow at the Center for American Progress. His work with the Center’s Progress 2050 examines the impact of policies on the nation when there will be no clear racial or ethnic majority by the year 2050.

The positions of American Progress, and our policy experts, are independent, and the findings and conclusions presented are those of American Progress alone. A full list of supporters is available here. American Progress would like to acknowledge the many generous supporters who make our work possible.


Sam Fulwood III

Senior Fellow

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President Barack Obama delivers his State of the Union address before a joint session of Congress on Capitol Hill in Washington, Tuesday, January 12, 2016. (AP/Evan Vucci)