The new Republican Congress may not be able to repeal and replace Obamacare entirely, but it could make substantial progress by targeting the health law’s key structural components.

This November’s electoral wave reopened and widened the strategic playing field for critics of the Affordable Care Act (ACA). Republican control of both houses of Congress, plus larger majorities of state governors and state legislatures present both opportunities and challenges to move beyond rhetorical opposition and advance changes in national health policy. Initial speculation tends to focus more on tactical considerations on Capitol Hill: which items are easiest to pass in the Senate, how to use budget reconciliation, and which votes will “look good” politically even if vetoed by President Obama.

With the Supreme Court due to rule on a major ObamaCare legal challenge by next summer, thoughts in Washington are turning to the practical and political response. If the Court does strike down insurance subsidies, the question for Republicans running Congress is whether they will try to fix the problems Democrats created, or merely allow ObamaCare’s damage to grow.

On Dec. 24, 2009, the Democratic-controlled Senate passed President Obama’s healthcare law with a filibuster-proof 60-vote majority, triggering a massive backlash that propelled Republicans to control of the House the following year. On the Senate side, going into this year’s midterm elections, 25 senators who voted for Obamacare were already out or not going be part of the new Senate being sworn in next month. After Democratic losses on Nov. 4 and Saturday’s defeat of Sen. Mary Landrieu, D-La., the number has risen to 30. In other words, half of the Senators who voted for Obamacare will not be part of the new Senate.

Why the hell did Jonathan Gruber say that? And that? And that? And (sigh) the other thing? Those are the questions on the minds of virtually everyone in the health care world—especially the people who worked the hardest on Obamacare. Ever since the videos started popping up, one after another, America has come to know Gruber—the MIT economist who worked closely on both Obamacare and Romneycare—as the guy who thinks voters are “stupid.” And the guy who thinks Obamacare was passed because of trickery. And who says, ha-ha, voters don’t understand economics. For a while, Fox News didn’t have to bother running anything else.

The Supreme Court is more likely to act if Republicans have an alternative bill ready.

Thanks to four justices of the Supreme Court, there is now a clear path to repealing and replacing the Affordable Care Act next year, finally bringing Obamacare to an end.

But Republicans won’t accomplish this by waiting for the court or just voting to repeal the law one more time. The only way they can succeed is by crafting their own replacement — and they need to start right away.

By Jonathan Ingram, Nic Horton and Josh Archambault— Mr. Ingram is Research Director, Mr. Horton Policy Impact Specialist, and Mr. Archambault a Senior Fellow at the Foundation for Government Accountability.

After months of secretly negotiating a backroom deal with the Obama administration, Governor Gary Herbert (R-UT) has finally released (some of) the details of his Obamacare expansion plan. We’ve not hesitated to share our disappointment over Herbert’s recent actions to bring Obamacare to Utah (which has always seemed out of character for him), but we’ve also met with the governor and his chief of staff privately to share our concerns about this welfare program. Sadly, Gov. Herbert continues to move forward with an Obamacare expansion plan that is bad for taxpayers and the truly needy.

By Tom Coburn And Phil Roe
In the four years since the Affordable Care Act was passed, health care in our country has become more complicated and expensive. The law has many troubling aspects, but the Independent Payment Advisory Board is among the worst and most dangerous. This is why, on Thursday, several members of the House will file an amicus brief asking the U.S. Supreme Court to take up Coons v. Lew. This lawsuit, filed by the Goldwater Institute on behalf of Dr. Eric Novack, an orthopedic surgeon, and Nick Coons, an Arizona businessman, challenges the constitutionality of IPAB.

“As I wrote at Forbes yesterday, New York Senator Charles Schumer has placed the blame for the Democrat’s disastrous defeat in this fall’s election squarely at the feet of the Affordable Care Act (Obamacare).
Speaking at the National Press Club the other day, the third-ranking Democrat in the US Senate said that whatever the merits or demerits of health reform, it was bad politics.”

“The Obama administration is seeking to clarify rules for the coverage of elective abortion in health insurance exchanges. That is the issue that almost scuttled the Affordable Care Act before it became law.
A complicated compromise that got the final few anti-abortion Democrats to agree to vote for the measure in 2010 required every exchange to include health plans that do not cover abortions except in the cases of rape, incest or a threat to the life of the pregnant woman. Plans that do offer abortion other than in those cases are required to segregate funds and bill for that abortion coverage separately.”

“A rising number of Americans are claiming that Obamacare has negatively impacted their health insurance policies.
Only 14 percent claim they have been helped by Obamacare, while more than twice as many (35 percent) say they have been hurt by it, according to a Rasmussen Reports poll release Monday.”