Hoyer believes that's easier said than done. If Republicans win, "I think they would have second thoughts about repealing health care," the Democratic leader predicted.
Republicans would face tricky political and policy challenges, he explained, listing a few:
— Would they allow insurance companies to again deny coverage to children with medical problems? The new law prohibits that.
— How would the GOP make up billions in lost federal revenue, since the Congressional Budget Office has ruled that the law reduces the deficit?
— Would Republicans bring back the coverage gap in the Medicare prescription drug benefit? The law gradually closes it.
"The pain that a family feels when their sick child is denied health care is real," said Nadeam Elshami, a spokesman for Speaker Nancy Pelosi, D-Calif. "The threat by Republicans to take away patients' rights and put insurance companies back in control just demonstrates the GOP's commitment to the special interests."
If Republicans win back the House, expect a House floor vote on repeal in short order, whether or not the GOP also controls the Senate. That's the opening move, to send a message. What happens next is anybody's guess.
Senate Republican Leader Mitch McConnell of Kentucky sought to lower expectations.
"I would like to repeal it and replace it," McConnell told home state reporters recently. "What can we do? We can make narrow targeted efforts to go after the cost problems. Without the president, we can't repeal it. But we can go after portions of it aggressively."
One provision of the law is already on its way to being rescinded — a requirement that nearly 40 million businesses file tax forms for every vendor that sells them more than $600 in goods. Other targets include the fines for people who refuse to get coverage and a new long term care insurance program.
If Republicans get back in power, Coburn doesn't think they can back off on repeal.
"If the Republicans are in control and they fund it — they're history," he warned.
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