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“Much has been written about the possibility that Republicans could win control of the Senate in the 2014 elections. In fact, some prognosticators have given Republicans a better-than-even-money shot at taking the Senate back. If Republicans keep the House and garner the net six seats necessary to win a Senate majority, what does that mean for health policy and politics in the next Congress? In particular, what does it mean for the continued implementation and expansion of the Patient Protection and Affordable Care Act, otherwise known as Obamacare?
I hear these questions a lot, having served as the Republican health policy director for one of the key Senate health policy committees in 2006, the last time Republicans held a majority in both houses of Congress. The one thing I know for sure is that Republicans simply can’t pick up where they left off in 2006, but that answer is far from satisfying.
This much, we know: if Republicans regain both houses in January 2015, health policy in the 114th Congress will be dominated by a showdown between a Republican Congress and a Democratic White House over the future of Obamacare. The challenge for Republicans will be how to balance the desire of the party faithful for repealing Obamacare with the reality that President Obama would never permit it under his watch.”

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