At issue is an arcane process known as budget reconciliation. It's the only filibuster-proof option available to Republicans, who control the Senate with 54 seats but must still muster 60 votes to pass other legislation.
Senate precedents limit the number of reconciliation bills — one for taxes, one for spending and one to raise the government's borrowing cap — and so a major debate has begun among Republicans over what to put in it.
Hard-line conservatives want to use the process to force a showdown with Obama over the law.
Sen. Ted Cruz, R-Texas, told a Heritage Foundation gathering of conservatives last week that Republicans should "use every procedural tool available, including reconciliation, to repeal Obamacare with 51 votes in the Senate."
That's a view shared by conservative groups like the Senate Conservatives Fund and Heritage Action, and prominent voices on the right like Erick Erickson, publisher of the Redstate.com conservative blog.
"It's time to stop pussy-footing around with excuses and half-assed attempts at partial repeal, and get serious," Erickson wrote last week. "Make Obama veto the repeal of his signature legislation."
Pragmatic voices in the GOP, however, say the certainty of an Obama veto effectively means that Republicans would be wasting the opportunity given them under special budget rules that limit debate and can guarantee delivery of legislation to Obama.
"I'd like to get tax reform done. I think we could do infrastructure in that process. And I think that's something that could actually get enacted," said Sen. John Thune, R-S.D., chairman of the Senate Commerce committee. "I mean we're going to have a lot of Obamacare votes one way or the other."
A reconciliation measure can only advance after the House and Senate have agreed upon a measure called a budget resolution, which sets broad parameters for spending, revenues and curbs to benefit programs such as Medicare and Medicaid.
Democrats used reconciliation to help pass Obama's health care plan. And Bill Clinton and Republicans controlling Congress used it in 1997 to advance a balanced budget bill. Republicans, led by Newt Gingrich in 1995, tried to use it to pass a bitterly partisan 1995 balanced budget plan Clinton vetoed. Even though their budget resolution is likely to project a balanced federal ledger over the coming 10 years, Republicans are signaling they're not willing to do a party-line replay of their 1995 experience.
"The only way to do entitlement eligibility changes is on a bipartisan basis," Senate Majority Leader Mitch McConnell, R-Ky., said Thursday at a news conference at a GOP issues retreat in Hershey, Pa. "We do not intend to be offering unilateral, one party-only entitlement eligibility changes."
Republicans devoted a session at the retreat to the topic of reconciliation. A decision on what to do with it appears a ways off.
"At some point we'll decide if we're going to have reconciliation and if we do, we'll make some decision much later on," House Speaker John Boehner told reporters last week.
The view of some pragmatists is that reconciliation should be used to get a result that might get signed into law or as leverage to make Obama more uncomfortable than he would be in vetoing an Obamacare repeal measure. And some lawmakers think that an upcoming Supreme Court ruling could unravel much of the law, making them wary of wasting reconciliation on the health care law.
"It should be things like that that actually improve the long-term fiscal stability of the country and maybe provide us some revenues for things where we can agree, like infrastructure," said Rep. Tom Cole, R-Okla.
A telling episode last fall illustrates the passion over the issue.
McConnell told Fox News that repealing Obama's health care plan would "take 60 votes in the Senate .... and it would take a presidential signature." This sparked a mini-eruption on the right that prompted McConnell's office to release a statement promising to use budget reconciliation to repeal the law.
GOP divided over using budget process on health care law - Yahoo News
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