The ACA or (Affordable Care Act) is the law of the land. It cannot be repealed without congressional action. It cannot be repealed by executive fiat. Can they work together to kill it? Yep. But... as in most things it just isn't that simple. Lets take a look.
The president CAN stymie key elements of implementation of the legislation through control of the executive branch and related bureaucracies. Some of this can be expected I imagine. Our current president has done this by delaying some key provisions of the administrations signature act. So just the fact this happens is not cause for undue alarm... there could be legitimate reasons for doing this. The legitimacy of those actions is not subject to whether or not you agree with them.... well not of anyone likely to read these words. New leadership WILL make new compromises. That is inevitable. Many have questioned the current administrations choices, and many will question the next. But simply making different choices is not in and of itself malicious. The proof will be in the pudding on any decisions made.
The thing is to focus on the leaderships decision only is to ignore the important part here. For the leader of the executive branch to do this legitimately or capriciously comes at a cost if it creates real problems with real peoples health care. Make good choices reap the rewards. Make bad choices and reap the 'rewards'. The checks and balances of our system are not just at the institutional level of the branches of Government. The republicans did not waltz their way into the executive branch leadership. They squeaked in with only the 5th election in our history that had a split outcome between the popular vote and the electoral vote. Even if the current administration does not feel overly tied to the Republican party there is still a massive incentive to not upset the apple cart and risk a voter revolt against them at the mid term elections in two years handing them a hostile house, and possibly a hostile Senate.
You may have noticed that political attacks against the ACA are not targeted at the people covered, but most are (correctly) targeted at the ballooning costs of that coverage. A likely tact going forward are decisions targeted at changing those ballooning costs. Does that really sound so bad? Done right it will be a good thing. Also, the rhetoric of the campaign trail is far removed from 'official' action. It is not political candidate flakiness that causes this. Politicians have an impossible task of tailoring a message that will cut through the noise to reach voters... and the methods of doing so are by and large devoid of the nuance of reality. The issues of ACA are Rube Goldbergian in nature and you can spend years trying to understand all of the inter related issues of government surrounding the passage of any kind of legislation of its nature.... and still not understand it all. A 30 second sound bite position it is not when it comes to the actual nitty gritty dirty details of actually trying to enact it, repair it, or repeal it. Contrary to popular belief legislators do not spend all day in front of the cameras. They spend the majority of their time working on the logistical agreement details of these insanely complex pieces of legislation and the down and dirty details tend to be worked by an army of staffers.
But the republican party holds both houses of congress and the white house? Can't they do ANYTHING they want?
To a certain extent yes. In theory there is a great deal they can do that is subject only to a judicial review (more on that topic to come in future posts). Basically any act that can pass short of super majority requirements. But.... make that BUT, any legislation they pass purely on the back of their legislative majorities without fear of veto from the executive runs afoul of the same problem. They have been complaining about the ACA and fighting in various ways to either cut it or alter it. But they have not owned it. Like it or not, as law of the land, it has now gotten established and to simply yank it out of the books and revert back would probably be political suicide, result in chaos in the health care market, and most likely toss another log on the fire of civil unrest. Also... while it is presently far more likely than it has been during just about any time in our history for all legislative members to vote in party lockstep.... it does require that to actually happen. Current members of the party in more moderate districts will as always have to consider whether not voting for legislation that could swing their electorate will allow them to vote in favor purely on a party line basis. I do not envy these members but I also feel zero pity for them. It is their job. They have to balance party leadership and their voters. One of those is a constitutional duty. The other is tradition. If you do not know which is which you should brush up on your civics knowledge. I personally think a growing abdication of that duty to their electorate (even for extremely good causes) is part of the current problem we are facing. Governments job is to be a parent for the electorate and to make decisions best for all of us in theory. In practice it is a complicated and painful process to determine what exactly that path is.
The reality (at least as I see it in all my sophomoric "wisdom") is that the republican party is going to try and find a way to disassociate the whole package of US federal government health care legislation from its current democratic party signature status. In short they do not want the ACA to become enshrined as did acts like the "new deal" or the "great society" without their party being able to claim ownership or at least a major role. Right now I imagine the scheming is to ultimately be seen as the 'Savior' of universal health care in the US. The current administration rightfully or wrongfully has the image of having strong armed this legislation through and while they are taking plenty of flack for the problems, I think it is safe to say at this point the positives of the ACA are far out weighing the negatives. In other words... it is a good problem for the democrats to have. For the republican party to accomplish this they have to make changes in such a way that there is a clear net benefit to the MILLIONS impacted by their actions that they can lay claim to. As news stories have begun reporting... that means there seem to be a few 'untouchables' emerging in the new round of DC tango over health care legislation. The protection for those with prior conditions to not be denied coverage or to face sky high premiums targeted at them looks like it is untouchable. The allowance of children to remain on their parents policies up to the age of 26 is another one. These are some pretty important elements of ACA. For me personally the change regarding what insurance companies were allowed to do regarding prior existing conditions was worth quite a bit of the pain and suffering of the whole thing. Why congress didn't just pass that as stand alone legislation YEARS ago is something that never ceases to baffle me. Really, after those two what you are looking at remaining are the mandates for citizens to have coverage at a minimum defined level, Mandate for more employers to offer it to all employees at a minimum defined level, and the markets for non employer based plans.
So what is most likely about to happen is that the ACA is dead.... but long live the ACA. If you are not familiar with that particular saying as regards the transition of power of monarchs (the king is dead, long live the king). It means it will change, but there will be something doing the same job in its place. Here is hoping those changes will be for the better.
