Virtually from the opening gavel of the new 112^th Congress, health reform has been a front burner issue. As predicted at the December Board of Trustees meeting, the House of Representatives moved quickly to pass legislation (H.R. 2) repealing last year’s reform law (“PPACA” for short). On February 2, on a party line 47-51 vote, the Senate refused to waive a budget point of order against an amendment to repeal PPACA offered by Senator Mitch McConnell (R-KY) to an unrelated Federal Aviation Administration bill. Sixty votes are required to proceed when there is a point of order.

While the fact that no Democrats defected is undoubtedly a relief to the White House, this was the first in what promises to be a long series of recurring votes on similar efforts to undo last year’s reform law.

Complete legislative repeal may be a sideshow, but legislative modification of PPACA is anything but, as demonstrated by the overwhelming bipartisan support for an amendment offered by Senator Debbie Stabenow (D-MI) to the same bill. The Stabenow amendment repealed a requirement in the reform law that businesses file a Form 1099 with the IRS every time they do more than $600 in business with a vendor. The amendment also rescinded $44 billion over 10 years, more than the amount of revenue the filing requirement was projected to accrue. The Stabenow amendment passed by a vote of 81-17, underscoring the possibility that GOP leaders have a better chance of rolling back the lawpiecemeal rather than wholesale.

Congressional maneuvering takes place in the long shadow cast by the 28 states that have filed or joined suits against the law. So far, the results have been mixed. Two judges have dismissed the suits, while two others have found in part or in whole for the plaintiffs. Just this week, a federal judge in Florida found for the plaintiffs in a ruling that essentially struck down the entire law as unconstitutional. The Florida ruling has been roundly criticized by legal scholars, most of whom believe the judge in the case substantially overreached and predict the ruling will be reversed on appeal.

In the state of Virginia’s lawsuit, a federal judge found in favor of the plaintiff’s challenge to the insurance coverage mandate, but left the rest of the reform law in place. Virginia Attorney General Ken Cuccinelli has announced that he will petition the Supreme Court for expedited review of his state’s case, bypassing the appeals process and putting the case before the Court just in time for the 2012 elections. Observers have noted that the two judges who dismissed the state lawsuits were appointed to the bench by Democrats, while the two who found for the plaintiffs were appointed by Republicans. All of which leaves considerable uncertainty about how the nation’s highest court is likely to rule.

Until the Supreme Court rules, congressional challenges to PPACA in whole or in part are likely to intensify when the House and Senate take up critical “must pass” legislation over the course of the year. This is a calculated gamble for the GOP. On the one hand, it keeps the slim Senate Democratic majority and President Obama tied to a volatile issue. On the other, only parts of the law are truly unpopular.   American voters may dislike the coverage mandate and a perceived “government takeover” of health insurance, but they support better access to health care and curbs on the ability of insurers to deny or drop coverage. Moreover, voters may quickly grow impatient if they see continued wrangling over health reform as taking congressional focus away from deficit reduction and job creation.

Regardless of the ultimate disposition of PPACA, it will loom as a large part of the agenda for the 112^th Congress as the country heads toward the 2012 national elections. In the wake of the Tucson tragedy, some of the vitriol may have been taken out of the partisanship on Capitol Hill, but the partisanship certainly hasn’t been taken out of politics.

THANK YOU for taking the time to be a part of APA's grassroots advocacy efforts!    
APA's Political Action Committee (APAPAC) is working every day to bolster the advocacy and grassroots lobbying efforts of APA members. Help us make more of an impact by joining us today at www.psych.org/pac.