Following Tuesday’s midterm elections, both parties have indicated that they wanted to re-visit the Affordable Care Act, but the skeptic in me doesn’t think that they’ll agree on anything beyond the 1099-reporting requirement and even that holds its own difficulties. Assuming of course, that repeal is a non-starter — The Hill’s Mike Lillis reported earlier today that Sen. Tom Harkin (D-IA) reiterated that the effort would go nowhere in the Senate — what other health initiatives will the new Congress consider?

Health care industry and employer lobbyists who, in anticipation of the midterm wave, have shifted their campaign contributions to Republicans this election cycle, may provide some clues to what lawmakers are hearing about the affects of reform and other health priorities. And so what follows is only a partial list of their concerns and demands:

PHARMACEUTICAL INDUSTRY: The industry doesn’t expect Republicans to reopen the doughnut hole, but it does want Congress to “reauthorize the Prescription Drug User Fee Act, or PDUFA, which allows companies to pay fees to the Food and Drug Administration to accelerate product reviews.”

LARGE EMPLOYERS: “They don’t want to repeal it,” said Geoff Manville, principal in Mercer’s Washington Resource Group. “But large employers for their part want to amend the law and make changes, largely around provider payments and delivery-system reform.” Big employers “would like to see more aggressive pay-for-performance measures that aim to improve patients’ health results while reducing costs in the Medicare program, he said. “That’s the 800-pound gorilla that drives the entire health-care system.”

INSURERS: “The insurance industry is working to persuade the next Congress to roll back a roughly $70 billion tax on insurance companies that takes effect in 2014, saying it will disproportionately hit small businesses that insure their workers. It also wants lawmakers to allow insurers to widen the rating bands that dictate how much more insurers can charge older customers. Insurers also want to tackle the growth of health costs by enacting a new measure to give robust protections against medical malpractice lawsuits to doctors who follow certain “best practice” guidelines.”

HOSPITALS: The American Hospital Association formally came out “in support of Sen. Cornyn’s bill to repeal reform’s Independent Payment Advisory Board (IPAB).” “America’s hospitals support the repeal of IPAB because its existence permanently removes Congress from the decision-making process and threatens the long-time, open and important dialogue between hospitals and their elected officials about the needs of local hospitals and how to provide the highest quality care to their patients and communities,” they wrote in a letter.

DOCTORS: “The American Medical Association (AMA) is warning of ‘a catastrophe’ if lawmakers don’t step in to block the 23 percent cut, which is scheduled to take effect Dec. 1, and another 6.5 percent cut that’s due a month later.”

I’ve chronicled the GOP’s early hints of dismantling the Affordable Care Act by challenging the law’s regulations, but Senate Minority Leader Mitch McConnell’s reference to the tactic in today’s address solidifies this as a serious GOP repeal strategy, and as such it deserves some additional consideration.

As far as I can tell, Congressional oversight of rule-making began with the Congressional Review Act of 1996, which allows Congress to review and reject both past and present federal regulations. Before a rule can take effect as a final rule, the law stipulates that the Federal agency issuing the regulation must submit to each House of Congress and the Comptroller General a report containing a copy of the rule and a proposed effective date. The specific details of this strategy are below (courtesy of the Congressional Research Service) but the gist is that if both houses pass the disapproval resolution and the President does not veto it, the resolution becomes law, and the rule becomes “of no force and effect”:

For initial floor consideration, the Act provides an expedited procedure only in the Senate. (The House would likely consider the measure pursuant to a special rule.) The Senate may use the procedure for 60 days of session after the agency transmits the rule to Congress. In both houses, however, to qualify for expedited consideration, a disapproval resolution must be submitted within 60 days after Congress receives the rule, exclusive of recess periods. Pending action on a disapproval resolution, the rule may go into effect, unless it is a “major rule” on which the President or issuing agency does not waive a delay period of 60 calendar days.

If a disapproval resolution is enacted, the rule may not take effect and the agency may issue no substantially similar rule without subsequent statutory authorization. If a rule is disapproved after going into effect, it is “treated as though [it] had never taken effect.” If either house rejects a disapproval resolution, the rule may take effect at once. If the President vetoes the resolution, the rule may not take effect for 30 days of session thereafter, unless the House or Senate votes to sustain the veto. If a session of Congress adjourns sine die less than 60 days of session after receiving a rule, the full 60-day periods for action begin anew on the 15th day of session after the next session convenes.

Congress has only invoked this prerogative only once, in 2001 when President Bush signed into law “a repeal of Clinton administration regulations that set new workplace ergonomic rules to combat repetitive stress injuries.” Democrats considered using the technique to reverse President Bush’s environmental regulations once Obama came to power, but never did.

For Republicans, this too will be an uphill climb, but many Tea Party conservatives seem energized at the possibility of taking down unpopular regulations. As incoming Senator Rand Paul (R-KY) told CNN several days ago, “I think we should sunset all regulations unless they’re approved by Congress. That doesn’t mean we won’t have regulations, it just means that Congress should be approving the regulations and you shouldn’t have unelected bureaucrats making regulations.”