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Ill-Fated Health Care Repeal Effort Kicks Off in House Today

Debate begins today on a health care repeal bill in the House, which retains the civil title “Repealing the Job-Killing Health Care Law Act.” In a corollary bill, Republicans will direct to the relevant committees instructions for changing the health care bill and coming up with some other solution to what remains a crisis in America. The LA Times reports on that alternative:

When they take up the much-anticipated repeal resolution Tuesday and Wednesday, GOP lawmakers also will begin crafting an alternative with the goal of reducing insurance premiums, expanding coverage, preserving Medicare and holding down taxes […]

“It’s more than just repeal,” said Rep. Fred Upton (R-Mich.), the new chairman of the House Energy and Commerce Committee. “We recognize that there are reforms that are needed. We’re not going to just sit on our hands and do nothing.”

The GOP will face a challenge as daunting as Obama did: reconciling the difficult — and politically sensitive — trade-offs that come with trying to provide more and better healthcare while also controlling costs. That balancing act is one of the reasons Obama’s healthcare law is so complicated. And it explains in large part why GOP leaders never produced a comprehensive alternative during the debate over the Democratic legislation or the 2010 congressional elections.

Take that a step further: they never produced a comprehensive alternative in the eight years they held the White House under George W. Bush, or the previous 12 under George H. W. Bush or Ronald Reagan. No Republican in the White House has taken health care seriously since Richard Nixon, and no Republican majority in the Congress has taken it seriously perhaps ever.

They’ll probably come up with some “plan” to completely deregulate the health insurance industry, but that has as much chance of being considered as repeal does.

Meanwhile, McClatchy notes that the health care law may be a lot of things, but it’s not actually a “job killer.” In fact, the fastest-growing job sector in America is health care, and that shows no sign of slowing down regardless of the law. As for the effect on employers, small businesses are actually signing up for health benefits for their workers in reaction to the law, not firing workers.

The White House tried to pre-empt the debate today by releasing a report showing that 129 million Americans have what could be considered a “pre-existing condition” by the health insurance industry:

As many as 129 million Americans under age 65 have medical problems that are red flags for health insurers, according to an analysis that marks the government’s first attempt to quantify the number of people at risk of being rejected by insurance companies or paying more for coverage.

The secretary of health and human services released the study on Tuesday, hours before the House plans to begin considering a Republican bill that would repeal the new law to overhaul the health-care system […]

The new report is part of the Obama administration’s salesmanship to convince the public of the advantages of the law, which contains insurance protections for people with preexisting medical conditions.

Since we have an employer-based health care system that allows coverage for those with pre-existing conditions, as well as Medicaid and TRICARE, these numbers are entirely possible, though it doesn’t mean all of them would be denied coverage.

These first salvos won’t result in any actual legislative change, in all likelihood. But it will set the ground rules for changes to the law that could follow. I don’t see a lot of common ground there, however. So this battle just prefigures a more consequential battle over funding the law, which requires an affirmative action of Congress.

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David Dayen

David Dayen