3 ways Republicans can still dismantle ObamaCare

The law has survived the Supreme Court and a presidential election, but it has a few more hoops to jump through

House Speaker John Boehner
(Image credit: Olivier Douliery-Pool/Getty Images)

Republicans have had President Obama's health care law in their sights for years. At first, they hoped the conservative-leaning Supreme Court would slay the beast, but Chief Justice John Roberts joined the court's four liberals in upholding the individual mandate. Then GOPers spent hundreds of millions of dollars to elect Mitt Romney president, but Romney — who vowed to kill the law even though he's arguably its intellectual father — fell short at the polls. Democrats hoped that ObamaCare, having survived these brushes with death, could finally stop looking over its shoulder, but Republicans remain committed to hacking away at it. They have until 2014, when most of ObamaCare's provisions will take effect. Here, 3 ways Republicans could still dismantle it:

1. Through Congress

When Obama won re-election, Speaker John Boehner (R-Ohio) proclaimed that voters had affirmed that ObamaCare is the "law of the land." But a few days later Boehner was once again trying to repeal it, saying that any budget deal to avoid the fiscal cliff should include changes to ObamaCare. Republicans acknowledge that they have little chance of overturning the whole law, says Jennifer Haberkorn at Politico, but they are hell-bent on weakening it. Their three-point opposition plan: "Focus on piecemeal repeal where it might be possible to pick up a few Democratic votes; use the House majority to conduct investigations into the implementation of the law; and be ready to act when the law crumbles, as [Republicans] argue that it will."

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2. Through the courts

ObamaCare emerged victorious from its battle with the Supreme Court, but that may have only been Round One of the fight. In what is being described as an unusual move, the court this week ordered a lower court to decide whether the law's employer mandate is constitutional. While most employers already provide workers with insurance, religiously affiliated institutions — in this case, Liberty University — have argued that the law's contraception coverage requirements infringe on their religious rights. The Supreme Court's move means ObamaCare is on "a potential path back to the highest court by late 2013," says Sarah Kliff at The Washington Post.

3. Through the states

A central element of ObamaCare is the creation of state-based health-insurance exchanges, which "are intended to make buying health insurance comparable to booking a flight or finding a compatible partner on Match.com," says Elise Viebeck at The Hill. The problem is that 16 states, most of them led by Republican governors, have refused to set up the exchanges, despite the offer of billions of dollars in federal grants. That means the federal government has to step in and manage a hydra-headed project that could prove disastrous. Each state has its own complex web of health care requirements, which means the government "can't simply take a system off the shelf as a one-size-fits-all fail-safe," says Viebeck. Furthermore, the Department of Health and Human Services has only a year left to set up these exchanges, increasing the likelihood of screw-ups.

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