GOP’s Gambit To Alienate Dems On Medicare Savings Board

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Republicans have lost some, if not all, of the bipartisan cover they once had for their effort to repeal a key piece of President Obama’s health care law. Could they have done so on purpose?

One health policy insider thinks that’s possible — and sees a political upside to putting all Democrats on the wrong side of powerful interest groups.

“It’s an election year,” the industry lobbyist and former GOP aide told TPM in an email. “One doesn’t need legislative victories … just tough votes for the other team!”

At issue is the House’s Thursday vote to repeal a powerful Medicare cost-cutting panel created by the Affordable Care Act. Many Democrats also dislike the so-called Independent Payment Advisory Board (IPAB), and were set to join the GOP repeal effort. But that was before the GOP proposed paying for the cost of repealing it with a medical malpractice reform bill.

That will cost Republicans the support of dozens of Democrats who were otherwise on board to eliminate IPAB, House Minority Whip Steny Hoyer told reporters. Repeal is also nonstarter in the Senate and faces a veto threat from the White House.But counter-intuitive as it may seem, the GOP may benefit from alienating those Dems. The malpractice pay-for all but forces them to vote in favor of a controversial piece of the health care law, which Republicans intend to run against in the 2012 election. It also cast Democrats, in this instance, as largely united against the influential American Medical Association and other health industry groups, who vehemently hate IPAB and largely support tort reform.

A party-line vote in favor of two high AMA priorities would help the GOP repair fissures that developed when the doctors group backed the Affordable Care Act. AMA gives millions of dollars in campaign contributions annually, divided about evenly between the two parties in recent years.

Rep. Tom Price, the No. 4 House Republican, downplayed the political implications, telling TPM that the reason for the bill is “because the policy in place by this administration, by the Democrats in Congress, is the wrong policy for America.”

But in a sign that the GOP sees their Dem allies’ flight as a winning strategy, House Republicans’ electoral arm this week blasted out statements to dozens of districts held by Democrats warning of the vote ahead, with scare stories about the dangers of IPAB and the usual slate of messaging points against the health care reform law.

Republicans have, however, taken fire from their right flank over the strategy. Sen. Jim DeMint (R-SC) and Rep. Steve King (R-IA), along with prominent right-wing advocates, repudiated House leaders for targeting one portion of the Affordable Care Act instead of continuing the fight against the entire law. The malpractice reform pay-for has also drawn fire from conservative 10th Amendment advocates who view federal caps on liability damage awards to be a violation of the Constitution.

The friendly fire apparently caught the attention of Speaker John Boehner, who Wednesday morning released a video statement defending the IPAB repeal vote, while also vowing to continue the party’s “full court press” to scrap the Affordable Care Act in its entirety.

A separate longer-term downside for Republicans here is that by scaring away dozens of Democrats who want to repeal IPAB, they will lose a major opportunity to portray opposition to President Obama’s vision for Medicare as bipartisan. And that, in turn, is key to their argument that the shift to a privatized Medicare voucher or “premium support” system is inevitable.

As it turns out, that seems to be a trade they were willing to make in this election year.

ABOUT THE AUTHOR

Sahil Kapur is TPM's senior congressional reporter and Supreme Court correspondent. His articles have been published in the Huffington Post, The Guardian and The New Republic. Email him at sahil@talkingpointsmemo.com and follow him on Twitter at @sahilkapur.
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