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Jim Capretta: Health Policy After The Election November 9, 2012

In the short time that has passed since the election, there have been numerous pronouncements that the struggle over the future of American health care is now more or less settled.  And it is certainly true that, over the next four years, full-scale repeal and replacement of the Patient Protection and Affordable Care Act (PPACA) is not in the cards.  The president is determined to move ahead with full implementation, of course, and he will not readily sign onto major changes to his signature domestic initiative.

But the 2012 election did not produce a return to 2009.  The Democrats do not have supermajority control of the House and Senate, as they did in the 111th Congress when the PPACA was passed.  Indeed, in 2013 and 2014, Republicans will have a rather sizeable majority in the House, along with 45 votes in the Senate.  In addition, there are now 30 Republican Governors in the states, who will have much to say about health care policy in the coming years, too.  So, unlike the birth of the PPACA, its implementation will proceed at a time when Republicans are controlling many levers of power.

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