Health care reform: House marches toward repeal vote

Health care reform law is top target of the new GOP House majority. But critics say GOP leaders set aside their pledges of fiscal restraint and openness in pushing forward on vote to repeal it.

After promising a new era of openness and fiscal restraint, House Republicans veered from that standard on the first big vote of the new Congress: the repeal of health-care reform.

The powerful Rules Committee on Thursday vetted dozens of amendments, mainly from Democrats, but rejected all but one on party-line votes, eliminating the possibility of changes to legislation on the floor and leaving Democrats crying foul. [Editor's note: This paragraph has been changed from the original to account for an accepted amendment.]

GOP leaders also rejected calls to offset the cost of repeal, estimated by the Congressional Budget Office to be $230 billion over the next 10 years – more than double the spending cuts that the new GOP majority aims to pare from spending bills for fiscal year 2011. The CBO’s preliminary estimate of the cost of repeal, released Thursday, also projects that repeal would leave 32 million more Americans uninsured.

The full House on Friday accepted that rule, setting the terms for next week's floor debate and ensuring the final vote will be a straight up or down one. The Friday vote in favor of those terms was 236 to 181, falling mainly along partisan lines.

Responding to criticism that this rule violates a key GOP pledge, Rep. David Drier (R) of California, who chairs the Rules Committee, said: "There is nothing to amend to the repeal bill. Either we’re going to wipe the slate clean and start fresh or we’re not."

"Once that slate is completely wiped clean, we will be ready for this open and collaborative process to develop the real solutions we promised," he added in Friday's floor debate on the rule.

In a break with past practice, the entire meeting was televised – fulfilling a GOP pledge to make all committee proceedings more accessible to the public.

“I promised a more open process. I didn't promise that every single bill was going to be an open bill,” said Speaker John Boehner in his first press briefing on Thursday. “We went through a whole Congress, two years without one – without one open rule. As I said yesterday, there will be many open rules in this Congress, and just watch.”

Democrats had hoped to force repeal proponents to take recorded votes on the most popular aspects of the new law, thus providing grist for campaign ads in the 2012 elections. These include ending the new ban on insurance companies discriminating on the basis of preexisting conditions, taking away the option for young adults up to the age of 26 to be covered by their parents’ health insurance, and free annual wellness visits, tax breaks to help employers pay for coverage for employees, and a ban on lifetime caps on coverage.

Democrats also protested the rush to a vote next week, without holding committee hearings and debate as promised by Speaker Boehner.

“Not a single hearing has been held on this reform package,” said Rep. James McGovern (D) of Massachusetts, a member of the Rules Committee. “Why don’t we hold hearings on the impact [of repeal]? We’re rushing something to the floor.”

GOP lawmakers' dismissal of the CBO estimates on the budget impacts – typically considered the gold standard for assessing the cost of all legislation – especially riled Democrats, who charge that it takes the referee off the field. “[You’re saying]: We don’t care what the nonpartisan referee says, and I would encourage you not to go down that road,” said Rep. Chris Van Hollen of Maryland, the top Democrat on the Budget Committee.

"Now we know the secret weapon for reducing the deficit – a blindfold," said Rep. Louise Slaughter of New York, the top Democrat on the Rules committee in Friday's debate.

Republicans argue that Democrats in the last Congress rigged the CBO estimates with flawed assumptions and double counts. These include ignoring the $115 billion needed to implement the law; double-counting $521 billion in gains from Social Security payroll taxes, premiums, and Medicare cuts; and counting 10 years of revenues to offset six years of new spending, they say.

Pressed on this point in Thursday’s briefing, Boehner said: “CBO is entitled to their opinion."

“CBO can only provide a score based on the assumptions that are given to them," added Boehner spokesman Michael Steel, in an e-mail. "And if you go back and look at the health care bill and the assumptions that were given to them, you see all of the double-counting that went on, you see the fact that the doc fix [a subsequent series of House changes to the original legislation] wasn't even part of the bill.”

Even if the House votes to repeal health-care reform next week, as expected, the Democratic-controlled Senate is unlikely to take up the issue – and, even if it did, President Obama would be sure to veto a repeal. But the House vote restarts a national debate on health-care reform – a key pledge for the 87 freshman who gave Republicans their majority. In a second vote Friday, House committees are instructed to report legislation to “replace the job-killing health care law.”

“ObamaCare spends a trillion dollars that we don’t have and kills jobs at a time when our top priority must be getting people back to work,” said House majority leader Eric Cantor (R) of Virginia, in a statement. “This job-killing health care law has caused great uncertainty for employers small and large and has put our country on a path to fiscal insolvency.”