Health Care Law Could Fall, and With It Obama's Legacy

By David Paul Kuhn - June 17, 2011

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The nonpartisan Congressional Budget Office determined that rescinding the health care law increases the federal deficit by about $230 billion over the next decade. Any potential reconciliation bill must compensate for that gap, and then some. But with the power, Republicans will likely have the political will to find a way.

These legislative war games could prove moot. The Supreme Court might hold the law, or critical portions, unconstitutional. In the past, court mavens said that outcome was unlikely. It's now unclear how the court might rule, as Slate's Dahlia Lithwick has smartly explained. It could consider the law next year.

But it's really an electoral matter outside the court. Democrats have 23 Senate seats up for re-election in 2012. Republicans have 10. Republicans could plausibly hold the House and win a Senate majority in 2012.

Thus, the GOP's best chance to overhaul the overhaul is likely to be in 2013. Why? Recall all those foolish predictions that health care would become suddenly popular after passage. They ignored the timeline. People don't appreciate what they do not yet have. The converse should, however, inform GOP strategy. People do not miss what they never had. In 2014, those 32 million Americans who lack coverage will begin to gain it. Politicians cannot easily cut entitlements once, well, people feel entitled to them. They are called third rails for a reason.

Congress has never repealed landmark social welfare legislation within years of passage. But previous major social legislation also enjoyed some significant measure of bipartisan support. The hyper-partisan nature of health care's passage explains its vulnerability.

This vulnerability only matters if the GOP has a historic victory in 2012. That potential victory also means that Democrats must consider all that could still be lost. In this age of austerity, their vision of health care reform is on the line. And so is the Democratic vision itself.

Democrats had hoped to take their medicine up front, in the midterms. The worst was surely behind them -- they paid a great electoral cost in 2010. The benefits were surely ahead of them. Or so they thought.

Last year, as the president signed the bill into law, you could almost feel the collective Democratic relief. Obama lifted the last pen off the desk. And simply said, "We are done."

We'll see.

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David Paul Kuhn is a writer who lives in New York City. His novel, “What Makes It Worthy,” will be published in February 2015.

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