By Sarah Ferris - 05/11/15 06:00 AM EDT
Democrats are chiding Republican leaders in Congress as standing in the way of improvements to ObamaCare that enjoy bipartisan support.
More than a half-dozen proposed changes to the law have approval from at least some Democrats, including legislation to repeal a controversial cost-cutting board for Medicare that gained its 218th co-sponsor this week.
“Absolutely, I think there are some things [we’d be willing to change],” said Sen. Chris Murphy (D-Conn.), the leader of the Senate’s "Affordable Care Act Works" campaign. “I am just not confident that Republicans in this Congress are focused on anything other than repeal.”
“I think there’s general willingness to sit down and talk. I just don’t think we feel like we have a partner on the other side,” he added.
Democrats are looking to take advantage of a deepening divide within the Republican Party about what to do with President Obama’s healthcare law during his final two years in office, particularly as they await a pivotal ObamaCare decision from the Supreme Court that could strike down insurance subsidies for millions of people.
Some voices in the party, including Louisiana Gov. Bobby Jindal (R), say the Republican Congress must keep its promise to put a repeal bill on the president’s desk.
“The best thing that Republicans can do is repeal the entire bill and replace it, and I think they need to do it now,” Jindal, a possible presidential candidate, told reporters last week. “Let’s challenge the president to do the right thing.”
But some establishment members of the party, including GOP strategist Karl Rove, are urging a shift away from full repeal while Obama remains in office. Focusing solely on repeal would “chew up valuable time and give the president a veto opportunity he relishes,” Rove wrote in a Wall Street Journal op-ed this week.
GOP leaders in the House and Senate have said they plan to pursue a full repeal as well as targeted changes to the law.
“We can/will do both. The Leader supports full repeal, as well as targeted measures that provide Americans relief from the worst provisions of ObamaCare,” Don Stewart, the spokesman for Senate Majority Leader Mitch McConnell (R-Ky.), wrote in an email.
Some of the bills — including one that would repeal the law's definition of workweek as 30 hours — have passed the House but have not been taken up by the Senate. Others, like an effort to repeal the medical device tax, have been introduced in the Senate and stayed there.
While there is Democratic support for both of those bills, the White House has expressed opposition to similar bills in the past, and it’s unclear whether either measure could avoid a veto.
Other ObamaCare legislation is moving through committees in both chambers, though any bills are likely to be overshadowed in the next several weeks by trade, highway funding and surveillance reform.
While the GOP debates its ObamaCare strategy, a growing number of Democrats are calling for the repeal of unpopular provisions of the law, particularly excise taxes designed to help cover its cost.
Prominent Democrats such as Sens. Elizabeth Warren (Mass.) and Al Franken (Minn.) back an attempt to eliminate the medical device tax. And Rep. Joe Courtney (D-Conn.) recently renewed a bipartisan push to stop a tax on high-dollar healthcare plans.
The GOP’s inaction has given Democrats a chance to highlight their willingness to make changes to the law — as long as it doesn’t affect coverage or affordability.
"The onus here is on the Republicans,” said Doug Thornell, a Democratic strategist and managing director at SKDKnickerbocker.
"I think they are scared of the blowback from the Tea Party if they were to do something that could be perceived as making improvements to the law."
The GOP’s challenge has been compounded by the Supreme Court case over ObamaCare subsidies. Republicans are debating whether to temporarily restore those subsidies if the court strikes them down and have yet to coalesce around a solution.
Lobbyists say they think that case, King v. Burwell, has stalled much of the progress on healthcare that they’d seen at the beginning of the GOP's majority in Congress.
“We are continuing to work the issue on Capitol Hill, but with the Supreme Court case King v. Burwell, that has really sucked a lot of the oxygen out of the air,” said Neil Trautwein from the National Retail Federation, who has lobbied against the 30-hour workweek requirement for insurance.
Another healthcare lobbyist said the Supreme Court case “has confused the playing field for the time being, with everybody being pretty focused on what the court’s going to do.”
“It does seem to have caused enough angst that it’s frozen the field.”
There have been some signs of progress, advocates of the bills on both sides have said, pointing to recent events like the Senate Finance Committee’s hearing on the medical device tax.
“As some Republicans move away from laser focus on repeal and are more interested in working on productive improvements that help expand coverage, affordability and quality, they’re going to see a lot of interest," a Democratic aide said.
"That shift is obviously slow-moving," the aide added.
Parts of ObamaCare targeted by both parties:
• Independent Payment Advisory Board: An independent agency appointed by the president is given oversight power over Medicare costs, which lawmakers warn will threaten seniors’ care.
• Medical device tax: Manufacturers and importers must pay a 2.3 percent excise tax on medical devices. Lawmakers say the tax drives up prices for patients.
• 30-hour workweek requirement: Under a complicated formula, companies are required to offer healthcare for qualified employees who work 30 hours per week.
• Health insurance tax: Insurers pay an annual fee to help pay for the law, generating $145 billion in revenue over a decade.
• "Cadillac" tax: People with the highest-cost insurance programs will pay a 40 percent excise tax on benefits they receive from their companies above a certain threshold.
• Reinsurance fee or "belly button" tax: Employers are forced to pay a $63-per-person fee for each person — including spouses or children — insured to help pay for ObamaCare’s reinsurance program.
