Q&A: What is the future of healthcare law?
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The future of President Barack Obama’s healthcare reform will be at stake after Republicans take charge of the House of Representatives on Wednesday following their gains at midterm elections last year.
Here are some questions and answers about the political and legal challenge to healthcare reform.
WILL CONGRESS REPEAL THE WHOLE LAW?
Republicans will be in control of the House but not the Senate, limiting their power to overturn the healthcare law. House Republicans will hold a vote on repeal on Jan 12, before Obama’s State of the Union address, and are set to win it.
This is likely to be little more than a symbolic vote given Democrats could block repeal in the Senate, and Obama could veto it if he needed to.
It will be easier for Republicans to chip away at parts of the law such as the individual mandate, given the opposition they will face in the Senate. Obama has said he would veto any bill repealing parts of the healthcare law.
Republicans also can try to withhold money needed to administer and enforce the law, and likely will work to at least delay the funding.
Reid Cherlin, a White House spokesman, has said: “The President is confident about defending the healthcare bill.”
WHAT HAPPENS NEXT IN THE COURTS?
A U.S. judge in Virginia last month declared a key part of the healthcare law unconstitutional, in the first major setback to the reform. U.S. District Judge Henry Hudson backed the state of Virginia’s argument that Congress exceeded its authority by requiring Americans to start buying health insurance in 2014 or face a fine.
A federal court in Florida is also hearing a multi-state lawsuit opposing the plan on much the same grounds as Virginia’s and the judge has said a decision will come soon. Wisconsin recently joined the challenge, bringing the total number of states in the lawsuit to 21.
Constitutional scholars expect one of the two dozen lawsuits filed since the law was enacted to reach the U.S. Supreme Court, most likely the multi-state lawsuit or Virginia’s.
WILL OBAMA PUT THE PLAN ON HOLD DURING COURT PROCESS?
Senior White House officials said after the Virginia ruling that Obama will continue implementing the healthcare reform while the court challenges play out.
The administration has the latitude to do so because the part of the law ruled unconstitutional, known as the individual mandate, will not come into force until 2014. Already, provisions allowing states to review increases in health insurance premiums and sending money to community health centers have moved forward.
HOW ELSE CAN STATES AFFECT HEALTHCARE’S FUTURE?
Many of the provisions in the healthcare law were given to the states to implement, which has set them scrambling to start programs or expand existing ones at a time when revenues are low and some are unable to meet basic spending pressures.
Only a few provisions gave them funds to hire additional staff or change computer systems. Adding to the confusion is the process under which the law made it out of Congress, known as reconciliation, which required lawmakers to use an early draft of the bill. By the time the law was signed, many of the legislated deadlines states had to meet had already passed.
Some states have already decided not to establish or run health insurance exchanges, an open market where individuals can buy insurance. Others are putting off expanding Medicaid, the healthcare program for the poor run by the states with federal reimbursements.
Minnesota Governor Tim Pawlenty, a leader in the Republican Party, and others have issued statewide orders to only implement parts of the plan that are mandatory and not to participate in the optional programs.
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WASHINGTON
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