There’s no real precedent for such a major piece of social policy legislation as this health care bill being enacted into law on a party-line vote. That naturally raises the issue of the sustainability of this legislation. What happens when the Republicans run things?
One thing to note is that it’s hard to imagine the GOP getting to 60 Senators any time soon. The more-disciplined Republican Party has more trouble putting together supermajorities. Indeed, there have never been sixty Republican Senators at any time in American history. The last time the GOP controlled over 60 percent of the Senate (59 out of 96, specifically) was the 67th Congress of 1921-22.
But the larger reason I don’t think this will get repealed is that a staggering quantity of opposition to this bill is fake. It’s fake in two ways. In part, people have been pretending to believe things they don’t believe. For example, lately Chuck Grassley has been pretending to oppose an individual mandate to buy health insurance. In the past, however, he’s supported such a mandate. And insurance companies will want the mandate to be made stronger, not weaker. Then there are people opposing the legislation over provisions that they’re pretending exist. Grassley, for example, is very worried about death panels but since there are no death panels he can’t actually repeal them.
Related to the opposition based on fake things, there’s a lot of opposition based on hypotheticals and vague slippery slope claims. People think this will lead to price controls or to mandate creep or that IMAC spending guidelines won’t be enacted. Once the bill is signed, however, none of that points in the direction of repeal—it points in the direction of opposing price controls, of opposing mandate expansions, and of favoring stringent cost-controls.
Last, for the past fifteen years Republican domestic policy has, in practice, consisted pretty overwhelmingly of seeking lower taxes on rich people without any offsetting spending cuts. I see no sign of that changing. I think the safe prediction is that when Republicans have more political power in the future, they’ll try to make taxes on rich people lower. Linking that agenda to lower subsidies for people to buy insurance would be politically disastrous, so they won’t do it.