Obamacare 2013: Battle over Obamacare continues on law's third anniversary

Some see 2013 shaping up as 2012 all over again -- at least on the issue of health care.

The dispute over President Barack Obama's signature health reform law, which he signed three years ago on Saturday, is back on. Democrats say the law will expand access to health care and rein in the rising costs of healthcare. Republicans say the law is bad news for the health care system and the economy.

Obama was flying home on Saturday from his trip to Israel and Jordan, but noted the anniversary with a statement saying the law reflected "the principle that in the wealthiest nation on Earth, no one should go broke just because they get sick."

"Already, millions of seniors are saving $600 a year on their prescription drugs," he said, touting what he described as the law's successes. "Millions of young people have been able to stay on their family's health plan until age 26. Preventive care, like mammograms for women and wellness visits for seniors, is covered free of charge. Most importantly, for the sake of our fiscal future, the growth of health care costs is beginning to slow."

Republican opposition

But Republicans don't see successes. House Speaker John Boehner said Saturday Democrats passed the law with a "host of promises that are proving more empty by the day."

"Instead of keeping the coverage they have, an estimated 7 million Americans are at risk of losing their health insurance, including millions of low-income and minority seniors enrolled in Medicare Advantage," Boehner said.

"Far from 'bending the cost curve,' Obamacare's projected price tag has nearly doubled. Health insurance premiums have spiked and are expected to climb even further when the law takes full effect next year. The millions of jobs Democrats promised are nowhere to be found, and businesses large and small are already pointing to the impact of Obamacare as the reason for 'planned layoffs and a reluctance to hire more staff,'" he said.

Both chambers held votes this week on a repeal of the law.

Senate Republicans united behind an amendment to the Senate budget resolution which would repeal the health reform law. It failed in the Democratic-held body 55-45 while the overall budget proposal passed early Saturday morning.

The left-leaning group Center for American Progress says Senate Republicans proposed at least seven amendments to that resolution to either partially or fully roll back the law.

The main amendment for repeal was proposed by Sen. Ted Cruz, a freshman Republican from Texas. He told CNN on Friday that if it goes into effect "it could very well cause a recession."

"I intend to keep trying to repeal Obamacare and to fight for pro-growth policies every single day," he said. "The economy is not growing, and implementing Obamacare now raises a real possibility that we will push this economy into a recession."

The fight to repeal the law has fared better in the Republican-controlled House. Budget Chairman Paul Ryan included a repeal in his budget that passed the GOP-controlled body on Tuesday.

But that's where the progress stops. Even if the Senate were to do the unlikely and pass a repeal of Obamacare, the president would veto it. It appears unlikely that Republicans could muster the two-thirds majority in both chambers needed to overturn a presidential veto.

"The House Republicans have voted more than 30 times to repeal Obamacare," White House press secretary Jay Carney told reporters last week. "That seems at some point to be time not well spent."

Law was challenged in 2012

The Supreme Court heard challenges to the law last year and upheld it by a 5-4 vote. The high court found constitutional the law's key individual mandate provision, which requires most Americans to obtain health insurance or face a tax penalty.

The four conservative-leaning justices who dissented argued the majority -- the four liberal-leaning justices and Chief Justice John Roberts, who was appointed by President George W. Bush -- was rewriting the law to consider the individual mandate a tax.

That decision also paved the way for the full law to take effect next year.

It also came amid the 2012 election year politics, as the two parties were wrangling for control over the White House and Capitol Hill.

Obamacare, Romneycare and Obamaneycare

The health care law was heavily debated on the campaign trail between Obama and Republican presidential nominee Mitt Romney, who drew cheers at his campaign rallies with the promise to repeal the law. Ryan was then his vice presidential candidate and also pledged to abolish Obamacare.

The term Obamacare itself was initially seen as a derogatory term. Rep. Debbie Wasserman Schultz, D-Florida, protested Republican use of the word on the House floor in 2011, saying, "It [is] a violation of the House rule wherein members are not permitted to make disparaging references to the president of the United States."

But the president eventually embraced the term, saying on the campaign trail that yes, as the moniker implied, he did care,

and that was why he proposed the health law.

On his own road to the White House, Romney faced challenges from within his own party on the health care issue.

When governor of Massachusetts, he signed a 2006 health care law which included an individual mandate. He wasn't helped by the Obama administration, which said it drew from the Massachusetts law in crafting its own plan. The candidate defended "Romneycare" as a state-level solution for his state's issues, arguing states should design their own health care systems because a one-size, nationwide solution would not fit all.

Poll: Opinions mixed

The most recent CNN/ORC poll showed Americans are as split as Washington over the law. The January survey shows that 51% favor most or all of the proposals, while 44% oppose most or all elements of the law. Those numbers are reversed from 2011, when only 45% were in favor and 51% opposed.

A Bloomberg poll conducted in February found 55% thought health care costs would become worse in the next 12 months. Only 22% said health care costs would get better, and 21% expected costs to remain about the same.

The law remains unpopular in Republican circles, giving those who vocally oppose it an audience in the GOP.

"Ted Cruz is putting down some markers," Republican strategist and CNN contributor David Frum said Friday on CNN's "The Situation Room."

"There is a struggle to define who is going to be the next leader of the Republican Party, and a lot of people who have emerged early are people who have one strike or another against them," he said. "Rand Paul, they're too exotic. Another case is they may not have the force of character, but Ted Cruz has the toughness and brains, and he represents an important fundraising state. He is putting down his marker to be at least a Senate leader, maybe more."

Much of the law takes effect next year

There are, however, a few Republican leaders supporting portions -- but only portions -- of the law taking effect.

At least eight Republican governors have said they support an expansion of Medicaid, the health coverage program for the poor, which is included in the health reform law. The Supreme Court ruled the federal government could not compel the states to accept this portion of the law.

Some have said they only support the expansion for three years, when the federal government funds the entire cost. After that, the federal government will fund 90% and the states 10% of the program.

Governors who have accepted the program include New Jersey's Chris Christie and New Mexico's Susana Martinez, both of whom are thought by some as potential White House contenders.

Arizona's Jan Brewer, Michigan's Rick Snyder, Nevada's Brian Sandoval, North Dakota's Jack Dalrymple and Ohio's John Kasich have also voiced support for the program.

Gov. Rick Scott of Florida said he would accept it, but his state legislature voted not to.

The Medicaid expansion is one of several health care changes set to take effect next year, including the law's most high-profile elements, including the ban on dropping patients with pre-existing conditions, ban on annual benefit limits and the health insurance exchanges. About half of the states have said they will conduct their own exchanges; exchanges in the other states will be run by the federal government.

Federal agencies are already deep into the complicated rule-making process which will stand behind the actual law.

Senate Minority Leader Mitch McConnell, a Kentucky Republican, wheeled out this week a hand truck stacked with documents that towered over him.

"You know nothing sums up all the excesses of the Obama Administration like Obamacare," he said. "For example, these are the first regulations: 20,000 pages, 7 feet tall, and they're just getting started. Everything they promised about Obamacare isn't coming true."

And as people around the country start to navigate the law, expect the arguments for and against the law from both sides of the aisle to continue.

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