If elected, Republican presidential nominee Mitt Romney would face a number of challenges to fulfilling his pledge to fully repeal the Affordable Care Act, but he still would have ways to obstruct the law, the Washington Times reports.
Observers note that there is little chance that Republicans will gain enough seats in the Senate to have the 60-vote, filibuster-proof majority needed to completely repeal the law. Analysts have said that Romney also would have difficulty blocking parts of the law by issuing executive orders, because the ACA does not contain any waivers that could be halted through such orders.
Possible Tactics To Obstruct ACA
However, there still are several tactics that would be available to Romney to combat the law. If Republicans gain a simple majority in the Senate, the GOP would be able to block most of the law through the budget-reconciliation process. In addition, Romney could rewrite some of the ACA rules already in place, such as changing the list of preventive services insurance plans must cover at no cost, which currently includes contraception.
According to the Times, Romney also could delay implementing provisions that have not yet taken effect, such as the Independent Payment Advisory Board.
Sylvia Law, a health law professor at New York University said Romney "could just decline to implement [IPAB]" because the board members have not yet been appointed. Still, some analysts have said delaying implementation of the law is an unlikely strategy, because the Supreme Court already has upheld it (Cunningham, Washington Times, 10/24).
ACA Supporters Concerned About Law's Future
Despite the barriers to Romney issuing a full repeal, some supporters of the ACA are concerned about the future of the law, as recent polls show Romney even with President Obama or taking the lead in several key swing states, The Hill's "Healthwatch" reports.
According to "Healthwatch," supporters of the ACA have said that using the budget-reconciliation process to repeal the law is complicated and could cause chaos and rising insurance premiums.
Further, ACA supporters have said Romney could eliminate insurance subsidies in the federally run insurance exchanges, which would cause problems in the insurance market. In addition, since the federal exchanges do not have any explicit funding, Romney could enact policies that would effectively starve the federal exchanges, according to "Healthwatch."
Tim Jost, a Washington and Lee University law professor who supports the ACA, said he is "nervous" because a Romney administration probably would at least slow down the law's implementation (Baker, "Healthwatch," The Hill, 10/25).