Republicans won a smashing victory in this month's elections; no issue resonated more with the party's base than President Obama's health care legislation.
The House Republicans' "Pledge to America" vowed "to repeal and replace the government takeover of health care with commonsense solutions focused on lowering costs and protecting American jobs." The party won more than five dozen seats, the most in seven decades.
There is no chance this pledge will be achieved.
While Republicans have a big majority in the House, Democratic control of the Senate and the presidential veto power make repeal or major change impossible.
There is another reason.
More than a few Republicans know that while the politics of trying to nitpick provisions and curb funding are appealing, any wholesale repeal of major provisions of the health care overhaul would likely generate a backlash.
Even the Republican-leaning electorate on Nov. 2 was evenly split on repealing "Obamacare," the exit polls showed. And many of the major provisions of the bill command broad support or could expose critics and repeal advocates to embarrassing contradictions.
One such provision is the enhanced Medicare prescription-drug benefit. It was in 2003, under President Bush, that Medicare was expanded to cover drugs — a measure backed by most congressional Republicans, who chose not to pay for these new benefits.
The Obama health care bill expands and funds this coverage to cover a gap in payouts, or close the so-called doughnut hole. Under this provision, senior citizens currently affected by the gap next year will get, on average, an additional $553 of benefits.
Seniors voted 58 to 39 percent for Republican candidates in the midterm elections. Whatever the merits, there's little clamor within the party to reopen the doughnut hole.
Medicare poses a larger quandary. A central critique of the Democrats' health care bill was that it would cut back on that program.
Senate Minority Leader Mitch McConnell, R-Ky., accused Democrats of trying to "raid" Medicare. The Republican political group, Crossroads GPS, funded by anonymous contributors, ran attack ads against Pennsylvania's Democratic Senate candidate, Rep. Joe Sestak, charging he "voted to gut Medicare — a $500 billion cut."
Sestak, who lost a close Senate race, supported the health care overhaul, which seeks to temper the explosion of health care costs through greater efficiencies and checks and balances. Whether effective or not, it's not a half-trillion-dollar cut in Medicare benefits.
Yet when it comes to reducing federal spending and budget deficits, a Republican priority, there's no more important target than health care spending in general, and Medicare in particular. The proposal by Rep. Paul Ryan, R-Wis., to turn Medicare into a voucher system is designed to hold down costs. The catalyst for the 1995 government shutdown was the Republicans' attempt to foist deep Medicare cutbacks on President Clinton; it was a political disaster for them.
The reaction to the recent proposal by Erskine Bowles and Alan Simpson, the co-chairmen of Obama's deficit-reduction commission, was instructive. They offered a plan that would take the deficit down to 2.2 percent of gross domestic product in 2015, from 9 percent today.
It includes almost $100 billion of tax increases that year, which leading congressional Republicans say is unacceptable, though they embrace the objective. To achieve such a goal without new revenue almost certainly would require slashing health care spending.
The other principal Republican objection to the health care bill is the individual mandate requiring Americans to buy health insurance or pay a penalty. That has been denounced by critics as bad policy. Some have even charged it is unconstitutional, or as Sen. Jim DeMint, R-S.C., put it, "inconsistent" with "the freedoms our Founding Fathers hoped to protect."
Most of the health care moves in the 112th Congress will be more games and pandering to a hard-core base; charges of socialism will reverberate, just as they did when Medicare was enacted in 1965. Never mind that under Obamacare there is less government involvement in the health care system than in most countries.
The Republicans' real agenda is to continue the drumbeat of criticism until Obama is defeated in 2012 or — what many privately say is a more realistic hope — a Republican-dominated U.S. Supreme Court rejects the measure.