Like hungry predators contemplating a particularly appetizing prey, House Republicans arrive in Washington this week with drool practically dripping from their chins. For most, the question is not whether they will try to repeal federal health care reform once Congress convenes Wednesday but how quickly, savagely and completely they can thwart President Barack Obama's signature program.
But if they can wrest themselves from public denunciations of socialism, Medicaid recipients and "death panels" — or from partisan strategy sessions where the merits of repeal versus investigative attack hearings are no doubt being explored exhaustively — they may want to consider their biggest obstacle: the American people.
That's because for most Americans, health care is not some political cause or theoretical public policy debate, it's a scary reality where millions live without insurance, many more have insufficient coverage and untold others live one paycheck or lost job away from losing health insurance, too. The so-called "rationing" of health care already exists, particularly for working people who don't have access to decent health insurance plans.
The legislation that the 111th Congress approved and President Obama signed into law last March has already provided considerable benefits that people will be loath to give up. Most prominent among them is the requirement that insurance companies not refuse coverage for people with pre-existing medical conditions.
But there are many more: a limit on out-of-pocket charges to patients, mandated coverage of preventive care, a prohibition on insurers from dropping coverage for the seriously ill, no lifetime caps on coverage, and coverage for children on their parents' policies through age 26. Those are important, tangible benefits that the repeal effort now threatens.
Admittedly, Democrats have not been particularly effective defenders of the law. Many candidates from that party practically ran away from it, fearful that GOP attacks portraying the reform bill as a takeover of health care (or a threat to Medicare) had poisoned public opinion beyond hope.
Yet it's one thing to make campaign speeches and play politics with health care; it's quite another to start taking away benefits. How will people react to their health coverage being threatened for partisan purposes? Not well, one imagines.
It's not as if a repeal of health care reform reduces the deficit — allegedly the top priority of the tea party insurgents, after all. As the Congressional Budget Office noted, health care reform cuts the deficit by billions of dollars while simultaneously expanding insurance coverage to millions of Americans who are currently uninsured.
Are there ways the law might be improved and rising health care costs capped further? Undoubtedly. If Republicans from the House, Senate or even Fox News death-to-reform squads want to make the legislation more effective, they should do so with all the energy and resources they've invested in their misguided repeal crusade.
But don't count on it. If there's one thing the GOP learned in the 111th Congress, it's the upside of extremism. Better to attack health care reform as irredeemable and be thwarted by Democrats than ever acknowledge that a complex problem requires a complex solution.
The only problem is that this time, they will be messing with insurance benefits that a lot of Americans hold dear. If Republicans want to take them away, to the enrichment of insurance companies and the expansion of the federal deficit, their recent revival to power will likely prove short-lived.