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GOP's Health Care Strategy: Fight Shadow War Rather Than Make Painful Cuts

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WASHINGTON -- Even though Republicans won a share of power because of voters' concerns about the economy, GOP leaders want to put something other than jobs, taxes or budget cuts per se at the center of their plan to retake the Senate and the White House.

It's repeal of the health-care law.

They made that choice even though they know -- but really because they know -- that they won't reach that goal in Congress, at least not this year or next.

"Health care is the catalyst," Gov. Haley Barbour of Mississippi told a small group of reporters at a dinner in Washington on Wednesday night. The law, he said, was emblematic of the kind of government overreach that voters rejected on Tuesday, and that a crusade to repeal it would be a two-year project that could inspire Tea Party activists and GOP traditionalists alike. Barbour's remarks were on background but his top aide, Nick Ayers, agreed today to put them on the record.

Senate Republican Leader Mitch McConnell of Kentucky today listed as the first of his "primary legislative goals" an effort to "repeal and replace the health spending bill." And note what he called it: a "spending bill."

"We see health care as a tax-and-spend issue," said Ayers.

House Speaker-to-be John Boehner and House Majority Leader-to-be Eric Cantor have used much the same language and laid out much the same strategic goal.

Which means that, having watched President Obama spend a year's worth of political capital on the measure -- a move that even many Democrats regarded as questionable -- the GOP seems eager to do the same.

But for a number of political, legislative and strategic reasons, the GOP thinks it can get more mileage out of the issue than almost anything else they can try.

Why? For one, it's easier to fight a shadow war against a program that has yet to be implemented than it is to make steep, painful cuts in existing and far more expensive programs -- say, Social Security and Medicare.

An across-the-board spending freeze, for example (a measure the GOP is advocating, too), would have more immediate and visible consequences for voters.

The health-care repeal crusade has the supreme benefit for the GOP of being impossible to achieve now. A straight repeal could probably pass quickly in the new House, but would face a filibuster in the Senate and a certain presidential veto if it ever came to that.

In the meantime, they can and will try to use every appropriation bill and other measure to deny the funding necessary to implement the law -- and do it in the name of deficit reduction. Cantor's new legislative plan counts "savings" of $15 billion on that alone.

If the president responds by trying to implement parts of the law by executive order, the GOP will respond by calling the moves unconstitutional -- always a fave charge to make in Tea Party circles.

The topic is also a "wedge" issue that can divide the Democratic Party, which voted for, but never really liked, the sweeping, complicated and ideologically impure measure. Liberals still think it weak; pro-business Democrats thought that passing it was a disaster.

And it contains some provisions -- especially one requiring the IRS to be notified of minor business transactions -- that even the administration concedes may need to be fixed. Officials say they will consider "tweaks;" the GOP will push the envelope of defining them.

The bill's requirement that all Americans obtain health insurance is the kind of federal mandate that drove Tea Partiers to the polls, and that has generated 10th Amendment legal challenges from the states that the Tea Party types admire. "Mississippi is litigating it," said Barbour, a former party chairman who now heads the GOP Governors Association. So are numerous other states, whose GOP governors and attorneys general win points for doing so.

Recent insurance rate hikes are another factor in the decision to put the law at the center of next year's conversation. Insurance companies are raising rates at a furious clip, a trend they blame on rising costs (hospitals, doctors, Big Pharma) but that administration critics are trying to pin on the new law.

And now that they run the House, the GOP can collect campaign contributions and "independent" spending from the same industries that tried to kill the law last year.

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