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51 Votes to Obamacare Repeal?



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That’s the case Karl Rove makes after talking to some folks who ought to know:

Keith Hennessey, a former White House colleague of mine, says Democrats are wrong. He argues that Republicans can repeal health-care reform with a simple Senate majority.

Director of the National Economic Council under President George W. Bush, Mr. Hennessey now teaches at Stanford Business School and is a research fellow at the Hoover Institution. Last week on his website, KeithHennessey.com, he made the case that congressional Republicans could use the reconciliation process to kill ObamaCare with 51 votes in the Senate and a majority in the House of Representatives.

The Budget Act of 1974 established the reconciliation process. The House and Senate Budget Committees can direct other committees to make changes in mandatory spending (like ObamaCare’s Medicaid expansion and insurance subsidies) and the tax code (such as ObamaCare’s levies on insurance policies, hospitals and drug companies) to make spending and revenue conform with the goals set by the annual budget resolution.

For example, under reconciliation the Senate Budget Committee could instruct the Senate Finance Committee to reduce mandatory spending on insurance subsidies and Medicaid expansion. These two items make up more than 90% of spending in ObamaCare. All the changes from all the committees are then bundled into one measure and voted upon. Because reconciliation is protected by the rules of the budget process, it doesn’t take 60 votes to bring it up and it requires only a simple majority to pass.

Will this 51-vote strategy work? One long-time GOP budget whiz, embarrassed he hadn’t thought of this, told me it would. Another Republican veteran of the budget wars agreed, though she had some concerns that certain elements of ObamaCare, such as some insurance provisions, might be beyond the reach of reconciliation. For example, would reconciliation allow Republicans to kill the requirement that younger, healthier workers pay higher premiums than they rightly should to keep premiums for older workers lower?

Mr. Hennessey believes that these are “strategically unimportant” items. He says the goal should be to repeal ObamaCare’s big-cost drivers, and reconciliation provides the tool to do it.

As we learned last March, the reconciliation rules are to a certain extent open for interpretation. Even if Republicans were in a position to try this come 2013 (and had a friendly pen in the White House), they’d have to draw the lines around the reconcilable bits very carefully.

Food for thought, though.



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