During an interview on conservative host Hugh Hewitt’s talk radio program Thursday night, Sen. Marco Rubio (R-FL) joined fellow Tea Party favorites Sens. Ted Cruz (R-TX) and Mike Lee (R-UT) in demanding that a continuing resolution to fund the government for the rest of the fiscal year include provisions to defund Obamacare in its entirety.

Over the course of the program, Rubio parroted the usual litany of wild — and widely debunked — conservative hysteria about the dire consequences that Obamcare will have on American businesses and the U.S. health care industry, asserting that he would only vote to avert a government shutdown if Obamcare implementation is halted completely:

HEWITT: Senator Rubio, the continuing resolution is headed your way. How is this stacking up as Act III of the spending drama?

RUBIO: Well first of all, I don’t think anyone is in favor of shutting down the government, but I think that’s where we’re headed ultimately here, unfortunately, if we don’t fix our debt problem… But here’s what I’ve said about this continuing resolution. Senator Cruz from Texas is offering this amendment to defund Obamacare. If that gets onto the bill, in essence, if they get a continuing resolution and we can get a vote on that and pass that onto the bill, I’ll vote for a continuing resolution, even if it’s temporary, because it does something permanent, and that’s defund this health care bill, this Obamacare bill, that is going to be an absolute disaster for the American economy. You’re already starting to feel the outer edges of that… I already am running into businesses that are planning next year on not hiring people or laying some people off so they don’t have to meet these mandates. Others are going to push their employees off of their private plans that they offer and onto these exchanges, driving up the cost for the public. So this is going to be an implementation disaster. It’s going to hurt our economy severely. And we’re not spending enough time talking about that.

Later on, Hewitt asked if Rubio would settle for partially defunding Obamacare — specifically, by repealing a provision levying a 2.3 percent tax on medical devices — in exchange for funding the government. Rubio replied, “I don’t know if that alone would be enough” to secure his vote for the continuing resolution, but that he “certainly would support that amendment.”

Defunding the health reform law would devastate tens of millions of Americans who would no longer receive federal subsidies for purchasing health insurance or have expanded access to public insurance programs such as Medicaid. It would also fly in the face of public opinion, since the majority of Americans believe that implementing Obamacare should be a “top priority” in their state. And contrary to some Republicans’ claims, a government shutdown would be a decidedly bad development for essential government services and the American economy at large.

Earlier this month, Tea Party darling Sen. Ted Cruz (R-TX) admitted that his plan to introduce yet another Obamacare repeal bill would be unlikely to pass in the wake of President Obama’s decisive re-election. As it turns out, that was an understatement.

In a sign that the GOP’s anti-Obamacare fervor may finally be giving way to political reality, Rep. Michele Bachmann’s (R-MN) latest Obamacare repeal bill doesn’t have a single co-sponsor in the Republican-controlled House of Representatives. Bachmann made introducing the repeal bill her first order of business for the 113th Congress, even as millions of Americans waited for House Republicans to act on a disaster relief package in the wake of Hurricane Sandy.

And two other anti-Obamacare bills — one to repeal the law’s individual insurance mandate and another introduced by Rep. Steve King (R-IA) to repeal the whole law — also do not have any co-sponsors. By contrast, House Majority Leader Eric Cantor’s (R-VA) so-called “Repealing the Job-Killing Health Care Law Act” had a total of 182 cosponsors by the fourth day of the 112th Congress, and House Republicans successfully voted to repeal Obamacare a staggering 33 times during the last session — costing taxpayers an approximate $50 million. Public support for repealing the reform law has plunged to an all-time low as Americans begin experiencing its positive effects.

But the latest repeal efforts’ lack of co-sponsors should by no means be taken as a sign that Republicans will embrace health reform altogether. House Republicans can still try to obstruct Obamacare’s implementation by putting the law’s funding mechanisms on the chopping block and attempting to repeal measures such as the Independent Payment Advisory Board (IPAB). In fact, House Speaker John Boehner (R-OH) recently advocated for doing exactly that in an editorial for his hometown paper, and former Rep. Joe Walsh (R-IL) went as far as to suggest “civil disobedience” and breaking the law in order to stymie Obamacare.

Still, the full Obamacare repeal effort’s newfound loneliness in the House is a powerful demonstration of the difference an election can make.

The Wall Street Journal is reporting that 17 Democratic senators and senators-elect have joined Republicans in calling for a delay on Obamacare’s 2.3 percent surtax on most medical devices.

Device manufacturers have been trying to get the tax onto the chopping block as part of budget negotiations over the so-called “fiscal cliff,” setting up a showdown with the White House over an important Obamacare funding mechanism that proponents say will be balanced out by an influx of newly-insured, paying Americans into the health care market:

The Democrats’ support could give new momentum to the industry’s intense lobbying campaign to repeal or delay the 2.3% tax on device sales, which companies say will hurt profits and lead to U.S. job losses. However, they face a battle because other Democrats, as well as the White House, oppose any postponement.

“It’s already law; they’re not going to budge on that,” said Bart Stupak, the former Democratic congressman who is now an attorney at Washington law firm Venable LLP.

The tax, part of the health-care overhaul bill passed in 2010, is expected to generate $30 billion over the next 10 years to help pay for expanded health insurance. Along with the device industry, the law also placed new taxes and cost-cutting measures on the pharmaceutical, hospital and insurance industries under the premise that the newly insured will translate into new customers.

But as ThinkProgress has previously reported, repealing or delaying the device tax could prove to be a bad deal for Americans if Congress does not find an effective, alternative revenue source for funding Obamacare’s vast insurance expansion. While it is important for the tax to be applied in a way that doesn’t burden patients, hospitals, and smaller manufacturers, delaying the tax simply means putting off establishing reliable funding sources for Obamacare.

$30 billion over the next decade — which the health reform law will use to extend coverage to previously uninsured Americans through the state-level health exchanges and the Medicaid expansion — isn’t going to come out of thin air. And Congress’s mercurial approach to budgeting doesn’t exactly inspire confidence in lawmakers’ ability to make difficult fiscal decisions. Since the health reform law already imposes taxes on wealthier Americans and consumers who purchase top-of-the-line insurance plans, Congress will either have to get creative or get on board with raising more Obamacare revenue to avoid raising the cost of Americans’ health care.

The Republican-led House has already voted to repeal the device tax.

The IRS today released final rules on a 2.3 percent tax on medical devices passed as part of President Obama’s landmark health care reform law, Reuters reports. The tax, which will help fund Obamacare’s coverage expansion and insurance subsidies for Americans, is estimated to raise $29 billion over the next ten years according to Congressional Budget Office (CBO) estimates.

But despite the IRS rules, the tax’s future remains shaky, as manufacturing firms, Republicans, and some Democrats are considering delaying or even repealing the tax as part of negotiations regarding the so-called “fiscal cliff.” The trepidation over the revenue source stems from fears that the tax could be applied too broadly, potentially stifling manufacturers or driving up the cost of everyday medical tools.

But officials contend that there are enough exemptions to the tax for more common, over-the-counter devices, and that the flurry of new customers coming into the health care market after Obamacare’s insurance expansion will counteract any added costs to manufacturers:

“The excise tax is on the medical device manufacturers and importers (who) will now have access to 30 million new customers due to the health care law,” Treasury Department spokeswoman Sabrina Siddiqui said in a statement.

Many medical devices that are sold over-the-counter – such eyeglasses, contact lenses and hearing aids – are exempt from the tax, as are prosthetics, the IRS said. [...]

Some medical device companies are hoping to delay the tax’s start date as part of a resolution of the “fiscal cliff” deadline at the end of the year involving many tax and spending measures, said Steve Ferguson, chairman of Cook Group Inc.

“We would like to be part of the punt,” Ferguson said, referring to an extension of current tax policy into 2013.

ThinkProgress reported that repealing the tax would be a top priority for congressional Republicans in the wake of President Obama’s reelection. In June, House Republicans successfully repealed the tax, but the measure has not been taken up in the Senate. However, if a sufficient number of Democratic lawmakers feel pressured enough by industry interests to include a device tax repeal in “fiscal cliff” talks, that may change.

While it is certainly important for health care officials and lawmakers to make sure that the tax is applied in a way that doesn’t unnecessarily or negatively burden hospitals and device manufacturers, efforts to repeal or delay the tax risk leading down a slippery slope where Obamacare’s other funding mechanisms — such as the tax on premium health plans and wealthier Americans — are delayed, scaled back, or repealed in the face of persistent interest group lobbying.

As with any social program, Obamacare’s consumer protections, coverage expansions, and insurance subsidies can only be implemented effectively if they are responsibly paid for. The temptation to preserve popular consumer protections while shying away from the more painful costs of providing those protections might make for good politics, but it’s bad policy, and it could end up hurting more Americans in the long-term by making Obamacare unsustainable.

After President Obama’s decisive re-election, House Speaker John Boehner (R-OH) starkly admitted that “Obamacare is the law of the land.” Facing backlash from fellow Republicans and critics of the landmark health reform law, the Speaker’s office softened that stance, asserting that “full repeal” still remained the GOP objective. But with the Supreme Court’s decision to uphold the bulk of the law, Democratic control of the Senate, and President Obama’s victory, some have wondered what — if any — recourse Republicans have at the federal level to undo Obamacare.

On Tuesday, Boehner explained how, exactly, Republicans would go about dismantling the law in an op-ed on Cincinnati.com. In his piece, Boehner contends that House Republicans will conduct “vigorous oversight” of the law’s implementation in an effort to neuter its provisions:

The tactics of our repeal efforts will have to change. But the strategic imperative remains the same. If we’re serious about getting our economy moving again, solving our debt and restoring prosperity for American families, we need to repeal Obamacare and enact common-sense, step-by-step reforms that start with lowering the cost of health care. [...]

Congress has a constitutional responsibility to conduct thorough oversight of the executive branch, and congressional oversight will play a critical role in repealing Obamacare going forward.

Over the past couple of years, I have noted there are essentially three major routes to repeal of the president’s law: the courts, the presidential election process and the congressional oversight process. With two of those three routes having come up short, the third and final one becomes more important than ever.

Vigorous oversight of the health care law by the House can be expected and, in fact, is already under way. The House Ways & Means Committee recently issued a subpoena directing that the U.S. Department of Health and Human Services turn over any and all information regarding how taxpayer dollars have been used to promote Obamacare.

“Oversight,” as Boehner uses it, is basically a code word for obstruction. This isn’t exactly surprising — after the election, ThinkProgress reported that the GOP would still try to stall Obamacare implementation through a combination of holding up the law’s funding for Americans’ insurance subsidies and statewide insurance exchanges, Republican governors’ refusals to expand their states’ Medicaid pools, and GOP efforts to repeal Obamacare’s revenue sources and cost-containment measures, such as its taxes on large medical device manufacturers and the Medicare Independent Payment Advisory Board (IPAB).

Although Boehner does not mention any such specifics in his op-ed, in the absence of a way to fully repeal the law, these are the types of provisions that the GOP will most likely conduct their “oversight” on. But recent polls have shown that public support for repealing Obamacare is plummeting, making such GOP tactics a waste of time at best and bad policy for Americans’ health and financial security at worst.

After surviving a year-long battle in Congress, a Supreme Court challenge, and the presidential election, Obamacare is here to stay. Just yesterday, GOP House Speaker John Boehner admitted yesterday that Obamacare is, in fact, “the law of the land.”

But Boehner was quick to walk back his comments via Twitter, reasserting that the GOP’s wish is still to fully repeal or severely dismantle the law. Since the Senate and the presidency remains solidly in Democratic hands, the GOP has their work cut out for them. But that doesn’t mean they won’t try their best to beat back, sue, and defund Obamacare provisions in an effort to neuter the law at the cost of Americans’ health and financial security. Here are three ways that the GOP will likely attempt to attack and undermine Obamacare provisions:

1) Denying federal insurance subsidies to Americans under health exchanges. If states can’t make a decision by November 16th about whether to set up health insurance exchanges, the federal government will set up one for them. But House Republicans may try to throw a wrench into those plans. Republicans are claiming that a minor technicality in the health reform legislation restricts its health insurance subsidies to Americans living in states that set up their own exchanges, and doesn’t extend to the Americans in states where the federal government sets up an exchange. This is obviously not what the health reform law intends, and IRS Commissioner Doug Shumlin has already issued an IRS-rule setting aside subsidies for Americans in all states. But Republican leaders may pursue this line of obstruction for insurance subsidies, essentially leaving sick and needy Americans to fend for themselves by denying them the subsidies that would make it possible for them to afford health coverage.

2) Resisting the Medicaid expansion. ThinkProgress has consistently reported on how Obamacare’s Medicaid expansion will significantly lower state health care costs while extending insurance to as many as 30 million low-income Americans — but only if the states agree to take part in the expansion, which the Supreme Court ruled optional. Even after President Obama’s re-election, GOP governors in states such as Florida are digging in their heels against reform. Sadly, many of the expansion’s GOP detractors lead states with extremely large uninsured populations, and their refusals to implement Medicaid reform might leave millions of low-wage workers without the health coverage they depend on.

3) Undermining the medical device tax and Independent Payment Advisory Board (IPAB). The device tax and IPAB are ways that Obamacare raises revenue for its vast coverage expansion and controls the rate of Medicare spending. Republicans are already eyeing the 2.3 percent medical device tax, calling it a burden on American businesses. But repealing the device tax risks grossly under-funding Obamacare’s insurance subsidies to Americans, meaning that Republicans are seeking to lower big manufacturers’ costs by shifting the burden onto Americans’ subsidized insurance premiums in 2014. Similarly, the independent, 15-member IPAB looks to keep American health spending at sustainable levels by finding ways to control Medicare spending growth without compromising on quality or benefits. While some of these cuts may be painful at first for hospitals and some physicians, the savings accrued will act as a firewall against seniors’ rising premiums and assure that providers, rather than everyday Americans, are bearing the burden of lowering medical spending.

Americans can expect continued battles over the proper funding and implementation of Obamacare in the coming months — for example, employer groups are almost certain to challenge the law’s provisions requiring that all large employers offer their workers health benefits. But now that the uncertainty over Obamacare’s future no longer exists, it isn’t too difficult to see what attempts to weaken the law really are: giveaways to large corporations, providers, and partisan politicking at the expense of real Americans’ health care and financial security.

Tommy Thompson, the Republican senate candidate in Wisconsin, couldn’t decide if he supports maintaing provisions of the Affordable Care Act, during a debate against challenger Rep. Tammy Baldwin (D) on Friday. Responding to a question about health care reform, the former governor and Health and Human Services secretary insisted that the entire law should be gutted, but seconds later admitted that certain provisions “absolutely need to be maintained”:

QUESTION: Governor, just so we’re clear. There is nothing in the Affordable Care Act right now that’s worth maintaining?

THOMPSON: No, no. Right now, the Affordable Care Act has 20 taxes increases. We got to do away with the Affordable Care Act and then we can put in things like making sure that individuals could be covered … But there are things in there like wellness and prevention, Bob, that I drafted when I was Secretary that are in the Affordable Care Act that absolutely need to be maintained. Chronic illnesses is something I started when I was Secretary of Health. That’s got to be maintained and be able to continue.

Watch it:

Thompson’s contradictory views on reform have haunted his campaign. As a lobbyist for health care interests, Thompson “was very helpful in implementation,” to the Obama administration and even urged Republican governors to adopt the law’s health insurance exchanges.

Last April, he lauded Obamacare’s payment reform provisions, saying they give “great discretion” for exermination with “alternative payment systems.” He even tried to dissuade the GOP from repealing the measure, telling CNBC in November 2010, “When it’s all said and done, you’re not going to be able to repeal health care because President Obama is not going to sign it… And they don’t have enough votes to override a veto, so why push a cart uphill when you know it’s not going to be able to get to the top?”

Thompson’s senate campaign website now lists “repealing Obamacare and replacing it with market-based solutions” among his top legislative priorities.

Instead of fully repealing the Affordable Care Act, a narrow majority of voters would rather keep the law and change it as necessary, according to a new NPR poll:

When each of the pollsters was allowed to fashion and present an argument for and against the health care law, the choice was between repealing the law outright (the Republican Party position) and amending it to improve it and moving on (the Democratic case). In this formulation, a narrow majority (51 percent) said they favored amendment, improvement and moving on. That position was also favored by voters in the battleground states, 53 percent to 44 percent.

The poll indicates that voters disagree with GOP efforts to repeal the health care reform law outright. Last week, the GOP-led House voted to repeal Obamacare for the 31st time, and Republicans pushed for their leaders to hold more votes to repeal the health care reform law. In a letter signed by half of the House GOP, Reps. Michele Bachmann (MN) and Jim Jordan (OH) said efforts to subvert “ObamaCare” have to keep going “until we are successful.”

– Nina Liss-Schultz

A group of Aetna shareholders is challenging the health insurer for donating to the American Action Network and the U.S. Chamber of Commerce — two organizations dedicated to undermining Obamacare.

Aetna donated over $7 million to the two groups during the Democrats’ effort to enact health care reform, though the contributions did not become public until this year, when the company accidentally “made the disclosure in a year-end regulatory filing with the National Association of Insurance Commissioners.”

In a latter to Aetna on Monday, the shareholders claim that the company did not comply with disclosure policies or inform its investors about the donations:

“We believe Aetna is not in compliance with its corporate political and lobbying disclosure policy, a policy which we negotiated and expected would be met in spirit and in letter,” read the Monday letter to Aetna CEO and President Mark Bertolini from Mercy Investment Services Inc. and the Sisters of Charity of Saint Elizabeth, two Catholic groups with investments in Aetna. [...]

But in their recent complaint to Aetna, the Catholic investors point to a 2007 letter of agreement in which Aetna promised shareholders that it would disclose all expenditures for lobbying and political purposes, as well as trade association payments and grass-roots spending. The Aetna policy followed a 2006 shareholder resolution calling for the company to disclose its political spending.

“We, investors, withdrew the resolution in good faith expecting that the resolution establishing oversight and transparency would be followed, revised as best practices evolved and in place for reference by the members of the committee preparing the annual reports,” read the letter. In an interview, Sister Valerie Heinonen, one of the letter’s authors, said investors were “dismayed” that the agreed-on policy had not been followed.

Aetna maintains that it intended the funds to be use for educational purposes, yet both the American Action Network and the Chamber are still fighting reform. Just days after the Supreme Court’s decision upholding the constitutionality of the law, AAN announced a $1.2 million advertising campaign urging Republicans to repeal the Affordable Care Act.