It's no secret Republicans don't like the Affordable Care Act.
Not a single one voted for the health care reform act, known as Obamacare, when it was signed into law in 2010. And the bill is scarcely more popular with small business owners, many of whom say they resent the extra cost and complications of compliance.
Still, last Thursday congressional antipathy to the health care bill reached a new level when, using a budget reconciliation procedure, senate Republicans successfully voted to gut key provisions of Obamacare. The vote, the first successful one against the ACA in the Senate, included provisions for removing the business and individual payer mandate, as well as the so-called Cadillac Tax. The latter is the tax on high-value individual plans in excess of $10,000, whose revenues provide a critical source of funding for the health care law.
Combined, those three provisions would gut the ACA, government policy analysts say. Yet in all likelihood, President Obama will barely glance at the bill before vetoing it when Congress hands him a version of it, most likely before the end of the year. Not only is the ACA the president's signature domestic achievement, some 17 million consumers and business owners have gotten access to health care through it.
So what's going on here?
More than anything, the vote is a strategic bid to shore up Republican support as the election season kicks off for 2016, political experts say. During presidential debates, every Republican candidate for president has said he or she would repeal the ACA. Similarly, senators need to make good on promises to their constituencies to overturn the ACA, says Molly Reynolds, a fellow in governance studies at Brookings Institution.
And the gambit is likely to appeal to a segment of small business owners, as well as the lobbying groups that represent them, other political experts say. But it's a controversial maneuver, and one that could backfire.
"We recognize that we are not going to be able to change the Affordable Care Act until we get a new president, but I think it was an important statement to make," John Cornyn, (R., Texas) told the New York Times last week.
Certainly, Republicans are appealing to their bases as well as numerous small business owners through such statements. Many business owners, after all, vocally opposed the ACA through lobbying groups including the National Federation of Independent Business (NFIB) and the U.S. Chamber of Commerce. NFIB, for example, was the lead group that sued the federal government to overturn the health care act the year it became law. And it supports the most recent Senate vote, according to a spokesman.
"The large majority of small business owners have had their premiums rise and their [health care] choices shrink every year since the plan was enacted," the NFIB spokesman said in an email. "For obvious reasons people who make a living running a business support repealing the taxes and mandates."
(The U.S. Chamber was unavailable to comment by deadline.)
There's a further calculation at play, says Reynolds. Last week's vote was joined by Senators whose seats are up for grabs in 24 states where, on average just 2.6 percent of residents receive some form of premium subsidy to buy health care, as a result of their low income levels. Such voters, historically, do not turn out in large numbers to vote, so senators are not likely to be punished at the ballot box.
"Republicans will be able to say while campaigning for re-election, 'We told you if you sent Republican members to the House and Senate we would do everything we could to repeal the laws,'" Reynolds says.
Still, there are political dangers from such maneuvering, says Jim Kessler, senior vice president for policy and co-founder of Third Way, a policy think tank. One of the prime dangers would be provoking voter anger by taking away health insurance from the millions of consumers who now have it.
"Like a lot of what politicians do, the hope for most of these candidates is to oppose [the ACA] and pray they fail," Kessler says, adding a repeal of the ACA could create turmoil for small business owners too.
Indeed, Republicans will need to have a plan, to replace the ACA with an alternative, although what that might look like is anyone's guess. Republican candidates have suggested options that include health savings accounts, or letting the individual states come up with their own solutions. And some senators also see a replacement strategy as necessary.
"Completely unraveling [the ACA] would be difficult if you don't have a plan to replace it," Senator Susan Collins (R., Maine), who voted with Democrats on Thursday, told the Times. "You have millions of people in this country who now are dependent on the subsidies that are in Obamacare or who are receiving help through Medicaid...and you have to recognize that that's a reality."
The really hard part, for Congress and the presidential candidates, will be figuring out what a new plan actually looks like.