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As they exult in their smashing victory in last week's midterm elections, conservatives must resist the temptation of assuming that President Obama's health-care reform law is on the road to repeal. Nothing could be further from the truth.
Although Republicans took the House of Representatives handily, Democrats still control the Senate, and the president will veto any bill that does more than tinker with his signature legislative achievement. At the same time, the president controls the media bully pulpit; his liberal allies, from labor groups to Moveon.org, will flood the airwaves to stave off any GOP push for repeal.
Instead of making a dramatic but doomed effort to overturn the health-care law with one stroke, critics of Obamacare should take a more measured, strategic approach--one that forces the president to defend the massively expensive and bureaucratic bill that he's inflicted on the country. At the same time, Republicans must present a coherent, bipartisan alternative that offers a menu of patient-friendly health-care reforms that expands coverage gradually without busting the federal budget.
Opponents of Obamacare should stay focused on two tracks: first, show why Obamacare fails to address the fundamental health-care problems afflicting the nation while spending trillions on a new health-care entitlement; second, make moderate voters comfortable with their own health-care reform agenda. Here's how they can do it.
Earlier this year, Speaker of the House Nancy Pelosi, D-Calif., committed an infamous gaffe when she said: "We have to pass the bill so that you can find out what is in it." House Republicans should help this process along and hold hearings to examine all the unintended consequences that have resulted (and will result) from Obamacare: Companies like McDonald's and other employers threatening to drop coverage; rate increases for private insurers due to new insurance regulations; and hundreds of billions of dollars in uncounted implementation costs for the legislation. Worst of all, 16 million Americans will be forced into the broken Medicaid program - and then struggle to find doctors and specialists who accept the program's low payments and cumbersome bureaucracy.
Republicans should also highlight how Obamacare is unaffordable. The president promised that health-care reform would "bend the curve" of health-care costs, but independent observers, from the Medicare Actuary to the Lewin Group, estimate that it will increase U.S. health-care spending by hundreds of billions of dollars over the next decade.
Rather than reducing federal health-care spending, Obamacare will create new entitlements that we can't afford while sapping hundreds of billions of dollars in taxes and fees from the private sector to pay for it.
Republicans should bring a parade of governors to testify to Congress. States led successful welfare-reform efforts in the 1990s, and states should take the lead in health-care reform now.
Instead, Obamacare dictates health-care reform from the top down and inflicts new costs on state governments--from expanding Medicaid eligibility to the start-up costs associated with running new state insurance exchanges. Republicans should give governors a platform to voice their concerns and highlight the efforts of state leaders like Gov. Mitch Daniels, R-Ind., to create more affordable health-care options for low-income Americans.
Finally, Republicans should push legislation that will attract bipartisan support and dare the president to veto it. Proposals could include using targeted defunding efforts to kill unpopular parts of the legislation--like the Independent Payment Advisory Board for Medicare; creating a national, interstate market for health insurance; enacting tort reform to rein in junk lawsuits against doctors; and killing the 1099 IRS reporting requirement for suppliers that will drown small businesses in paperwork.
By fighting smarter now, Obamacare's critics can improve the situation in the short term--and perhaps even lay the groundwork for repeal in 2012, when the president will have to defend his choices directly to the American people.
This article first appeared in the Washington Examiner.
Paul Howard is a senior fellow at the Manhattan Institute and the director of its Center for Medical Progress.