GOP Leaders Take Conservative Fire For Health Care Repeal Strategy

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When top House Republicans advanced a bill this month aimed at repealing one of the most contentious parts of President Obama’s health care law, they didn’t see much downside. More bad press for health care reform, a splintered Democratic House minority and a consolidated Republican Party. They didn’t look hard enough.

Not only have they managed to alienate some Democratic allies on the bill, slated for a floor vote this week, they’re also facing heat from the right for targeting just the one provision of “Obamacare,” instead of the law in its entirety.

The provision is the Independent Payment Advisory Board (IPAB), a panel of 15 experts that will be charged with holding down Medicare per-beneficiary costs years from now by restricting provider payments. The repeal bill easily cleared House committees, with some help from key Democrats, a number of whom are uncomfortable with the idea.

On Friday, two prominent conservative members of Congress, Sen. Jim DeMint (R-SC) and Rep. Steve King (R-IA), publicly accused the House GOP of muddying the party’s message on the Affordable Care Act. In a Washington Times op-ed titled “End Obamacare, don’t mend it,” the two lawmakers declare that scrapping the law in its entirety is a defining plank of the Republican platform.

“Unfortunately, the clarity of that choice may soon be muddied, not by Democrats desperate to hide from their record, but inexplicably, by Republicans pushing a vote on a bill to undo one part of Obamacare: the Independent Payment Advisory Board (IPAB),” DeMint and King write. While denouncing IPAB as “one of the most obnoxious parts” of the law, they declare that “we are as adamantly opposed to IPAB as we are to the rest of Obamacare — from the individual mandate to the abortion-pill requirement to the multitrillion-dollar price tag.”

“The Democratic Party is the party of Obamacare,” they continue. “If Republicans, through their toying with Obamacare, present themselves to voters as the party of some of Obamacare, we will lose.”

The op-ed dovetails a same-day letter from more than a dozen prominent conservative advocates to House Speaker John Boehner and Majority Leader Eric Cantor, pleading with them not to “muddy the water” of conservatives’ hatred for health care law by singling out IPAB. They write: “We cannot allow the idea to take root that the worst parts of Obamacare can somehow be ‘removed’ when in fact the entire law must be rescinded.”

Messaging merits aside, the argument by the conservatives is something of a false choice: House Republican leaders have made clear their preference to repeal the entire law, as their chamber voted to do last year. Part of the goal here is to enlist Democrats to rebuke Obama’s long-term vision for Medicare — 20 House Dems cosigned the bill by Rep. Phil Roe (R-TN) to scrap IPAB. But as it turns out, that strategy is not going too well, either.

The votes of those Democrats are now in question after House GOP leadership opted to pay for the $3.1 billion cost of repealing IPAB with medical malpractice reform, an unrelated issue that has long been a poison pill for Dems. Two prominent Dem signatories to the IPAB repeal bill — Reps. Barney Frank (MA) and Allyson Schwartz (PA) — rebuked GOP leadership for attaching the partisan pay-for.

On the other side of the Capitol, Senate Minority Leader Mitch McConnell is also under fire from the right, after a report in The Hill said he told his GOP members he would prefer not to hold another vote on health care repeal until after the election.

After the Mike Huckabee-affiliated conservative group Restore America’s Voice Foundation threatened to turn its more than 2-million members against him, demanding a repeal vote, McConnell vowed through a spokesman to speak to his members about how best to attack the Affordable Care Act this month.

More than halfway through the month, however, no repeal vote is yet in the pipeline.

The schisms reflect the different goals of GOP leaders and rank-and-file members. Leaders, having already enlisted every Republican in both chambers to vote to repeal the law last year, know it’s a lost cause for now and want to try to beat Obama where they can. But red-meat conservatives are more concerned about the clarity of their anti-“Obamacare” message as they seek to energize their base ahead of the 2012 election.

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