Repeal Can’t Happen, Rollback Can

Dave Weigel has a good report on the repeal health reform movement:

But as Republicans gravitate towards a repeal message for the 2010 elections, they’re running up against the reality that health care reform would be prohibitively hard to roll back. According to conservative health care analysts, legal analysts, and political strategists, if President Obama signs health care reform into law, Republicans will have extremely limited opportunities to repeal any part of it.

Anyone who thinks they’ll be able to repeal ObamaCare is kidding themselves,” said Michael Cannon, director of health policy studies at the libertarian Cato Institute. “If they want to stop it, they need to stop it now.”

Michael Cannon is a smart guy. This law, if signed, will change the game. People will still debate what to do about health care, but it will be in a new framework. As Austin Frakt says, a more plausible scenario would be to just hurt low-income people:

What I think is more likely than repeal, though by no means certain or even highly probable, is an erosion of the low-income subsidies in real terms, perhaps tied to a change in the minimum level of coverage required. A Republican congress and president might pass such changes along with a tax cut. It is very likely that Republican candidates will campaign on it.

Maybe. It should be said, though, that there’s really no precedent for a GOP president taking the ax to a major program. Small, highly targeted programs like Section 8 housing vouchers or legal services for the indigent get the axe when Republicans run things. But cutting spending has not normally been an important priority. Cutting taxes, busting unions, gutting enforcement of various regulations, hiking spending on baroque missile defense schemes, that’s what conservative governance is all about.

The only reason you would try to seriously pare back subsidies is if you felt that increasing budget deficits were a bad thing. But conservatives don’t think deficits are a problem so there’s really nothing here.