Nancy Pelosi's Fingerprints On Health Care Debate

Two years ago, Nancy Pelosi bet the House on health care and lost.

No one was more instrumental in passage of the Affordable Care Act, and no one paid a bigger political price. If the Supreme Court in June rules the law unconstitutional in whole or in part, the San Francisco Democrat and now House minority leader will have lost not only her speakership but also much or all of her largest legacy.

Still, Pelosi did not leave the majority before sprinkling defensive land mines throughout the sprawling legislation that might make Republicans careful what they wish for. Democrats made sure that the law's most popular parts would kick in first, and the least popular last.

The much-despised mandate requiring everyone to buy health insurance, the core of the GOP challenge to the law, is not scheduled to begin until 2014.

Since enactment of the health care law in 2010, Republicans have rallied behind "repeal and replace." If the court repeals the law for them, the burden would shift abruptly to the more difficult "replace" part, putting the onus on Republicans to fix failures in health care itself rather than failures in the Democratic law.

"Health care is a lot like plumbing: People know they need it, they just don't know what it entails," said GOP strategist Ford O'Connell. Striking down the law would be "a victory, but it's a victory that comes at the cost of saying, 'OK, this is not good, let me tell you what's better.' "

Read more from Carolyn Lochhead at the San Francisco Chronicle

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published this page in In The News 2012-04-02 07:00:00 -0400
Analysis & Political Strategy