Earlier this week, former Bush speechwriter David Frum posted a note on his website warning Conservatives against trying to repeal health care reform legislation. “No illusions please. This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs?” Frum asked. “[T]oday’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished.”

Indeed, as the President prepared to sign the the most sweeping domestic legislation since Medicare, Fox News Channel ran numerous segments about the repeal effort, inviting the Texas Attorney General and the Governor of Idaho to plead their cases, without offering anti-repeal advocates the opportunity for rebuttal or seeking comment from any constitutional experts. While both Sen. John Thune (R-SD) and Rep. Steven King (R-IA) appeared on the network to discuss the party’s efforts to introduce repeal legislation in Congress, only one a columnist for the Examiner appeared to question the validity of these efforts:

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Indeed, immediately after the President signed the Senate health care bill into law, “13 Republican state attorneys general filed a federal lawsuit against the overhaul” and Sens. Jim DeMint (R-SC) and Rep. Steve King (R-IA) “introduced legislation that would repeal the legislation.”

Despite Fox’s breathless coverage, however, neither effort has any serious chance of succeeding. Since the 1930’s, the Supreme Court has ruled that Congress can regulate almost any kind of economic activity, while the supremacy clause of the constitution says that federal laws are supreme to the laws of the states. The legislative effort is even more far-fetched. As King explained in the clip, opponents of reform would have to win over 218 votes to repeal the legislation and override a presidential veto with a two-thirds majority. And that’s not something even Glenn Beck can achieve.

Moments ago, President Obama signed into law the most sweeping health care reform legislation in the nation’s history. As Obama and Vice President Biden approached the podium, the group of Democratic lawmakers and health care advocates gathered in the East Room of the White House, began chanting, “fired up, ready to go,” echoing the president’s campaign slogan. The audience, clearing relishing in the greatness of their accomplishment, interrupted with frequent applause and standing ovations, giving the ceremony a distinctive campaign-like atmosphere. Not a single Republican voted for the health care reform legislation and none attended today’s event.

During his speech, the president noted the reform efforts of all those leaders who had come before him and recognized the challenges lawmakers faced in passing the health care bill. “I’m signing this bill for all the leaders who took up this cause through the generations, from Teddy Roosevelt to Franklin Roosevelt, from Harry Truman to Lyndon Johnson, from Bill and Hillary Clinton to one of the deans who’s been fighting this so long, John Dingell to Senator Ted Kennedy, ” Obama said, fully embracing the historic nature of the occasion:

OBAMA: Our presence here today is remarkable and improbable. With all the punditry, all of the lobbying, all the game playing that passes for governing in Washington, it’s been easy at times to doubt our ability to do such a big thing, such a complicated thing, to wonder if there are limits to what we as a people can still achieve. It’s easy to succumb to the sense of cynicism about what’s possible in this country. But today we are affirming that essential truth, a truth every generation is called to rediscover for itself: that we are not a nation that scales back its aspirations, we are not a nation that falls prey to doubt or mistrust.

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“In a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform,” Obama said, suggesting that now that the bill is law, the way we talk about it will change. No longer will we be arguing over conflicting interpretations of the same provision or debunking claims of death panels and taxes on small businesses. No, despite the best efforts of Republicans to transfer the pre-reform debate into the post-reform world, the conversations about health care reform will now focus on how reform affects every day people. Rather than arguing about the burden reform will place on small businesses, we’ll discuss the adequacy of the tax credits they receive. The sensationalistic claims about government takeover of health care will cede to an evaluation of the effectiveness of the exchanges in holding insurers accountable. The bill, in other words will, for the first time in this debate, be judged squarely on its merits. And Democrats shall rise and fall by its failure or success. Here is what Americans can expect and when:

The health care reform debate is by no means over, however. While the repeal rhetoric will likely abate, Republicans will seize on every system failure and imperfection, on every flaw and every kink to argue that reform has failed to live up to its expectations. Progressives will have to remain vigilant both in the way they implement reform and in the way that they defend it.

CIGNA CEO David Cordani appeared on Your World with Neil Cavuto yesterday to argue that health care premiums will continue to increase, despite the passage of health care reform. Acting as if insurers had no say in the matter Cordani blamed providers for any anticipated rate hikes. “Over the near term, the legislation did nothing to reduce the cost equation. In fact, aspects of the legislation actually increase the cost equation so the positive is, it expanded access, the negative is, it did nothing to reduce costs and will actually drive costs higher for insured lives of the next four to five years.”

Cordani also conceded that the industry will likely increase premiums to WellPoint-like levels in the near future:

CAVUTO: Could we have a WellPoint hike? Do you remember that a few months back where out of hte blue they proposed, I think a 38 percent rate increase. Could we see something like that after the fact, after the health care issue becomes law?

CORDANI: Neil, I think what you’ll continue to see — without any change in the system — health care costs will go up, so premiums will go up. Insurance commissioners in every state will continue to be very diligent…the underlining premium costs are driven by underlining health care costs and in an environment where emergency room utilization and costs have quadruped in five years, use of MRIs have doubled in the last five years, biomedical utilization is growing rapidly. The costs will continue to grow and that’s the opportunity that wasn’t addressed.

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Overutilization of health care services and the leverage of dominant providers in certain health care markets do contribute to rising health care costs, but insurers shouldn’t pretend that they’re not contributing to this trend. The reality is, large insurance companies rarely use their bargaining power to negotiate with providers and often pass on higher costs to the beneficiary, raising premiums beyond health inflation to guarantee a profit. And as Cordani admits here, insurers will continue to increase premiums, particularly in the period between now and when the new insurance regulations kick in.

The Senate health care bill tries to address this problem by requiring insurers to spend a certain percentage of premiums on health care benefits (it establishes medical loss ratio targets) and stipulating that the Secretary of Health and Human Services, in consultation with the states, must develop a plan to look for “unreasonable increases.” Insurers are required to submit “a justification for an unreasonable premium increase” to the state insurance commission authority, who then makes the appropriate recommendations “to the State Exchange about whether particular health insurance issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.”

Since the interim period between now and when the exchanges become operational is critical for winning over public support for the legislation and capitalizing on its success, Democrats might want to introduce some additional cost control mechanisms as stand alone measures. Legislation establishing a new federal rate review authority would allow the federal government to review and deny excessive, unreasonable or discriminatory health insurance premium increases and could help keep insurers in line. The federal authority could also help tow a tougher line on excluding insures who levy egregious premium increases from the exchanges. The President included the reconciliation in his own health care plan, but it was stripped from the House package because it did not comply with the rules of reconciliation.

Lawmakers will have to tweak the legislation over time, but insulating voters from steep premium hikes in the interim period is both good policy and good politics.