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Michigan Democrat May Join With GOP on Health Law Tweaks

Senate Republicans lacking a filibuster-proof majority next year will need to attract crossover votes from a shrinking pool of centrist Democrats if they are to have any hope of making legislative changes to the health care law. 

They could find a willing partner in Michigan’s Gary Peters, the lone Democrat in the Senate freshman class, who as a congressman voted with Republicans to weaken penalties on businesses and individuals that don’t comply with the law’s coverage requirements and who maintains the law can be improved.  

“I’ve had the experience of being in the minority more than I like, but I believe you have to build personal relationships and find common ground to make things work,” Peters said in an interview, adding with a laugh that he’ll have ample opportunities at new member orientation. Addressing the law’s implementation, Peters said, “We need to move forward, but that doesn’t mean you can’t go back and revisit it and make it work better … Nothing is carved in stone.”

Largely known for his work on manufacturing issues and the economy, Peters will succeed departing Michigan Democrat Carl Levin. In the House, he already has collaborated with Republican Sens.-elect Shelley Moore Capito of West Virginia and Cory Gardner of Colorado on efforts to overhaul student loans and streamline government programs, respectively. He also is co-chairman of the bipartisan Congressional Automotive Caucus.

Peters supported the passage of the 2010 law (PL 111-148, PL 111-152). But he broke from his party to vote in favor of a House Republican bill (HR 3522) that would allow companies and workers to keep health plans not in compliance with the law’s coverage standards. He also backed legislation (HR 4118) to delay the penalty for individuals who fail to obtain health coverage, as well as a measure (HR 3811) that would require people to be notified if their personally-identifiable information has been compromised due to security problems within the law’s insurance marketplaces, or exchanges.

“You always have to be thinking about representing your constituents first,” Peters said. “It should not solely be about party, as long as I feel comfortable, do my homework and can stand up and say why I voted that way.”

Peters is hardly a shoo-in for all of the Republican tweaks that are expected to be proposed in the next session. He voted against a House measure (HR 2575) that would change the health law’s definition of a full-time workweek from 30 to 40 hours and fought numerous attempts to repeal the law altogether, indicating he would do the same in the Senate.

But he’s likely to be a much-courted figure following the departure of some Senate Democrats who backed reopening the law to changes, including Kay Hagan of North Carolina, who cosponsored legislation (S 232) to repeal the law’s medical device tax, Mark Udall of Colorado, who introduced a measure (S 1699) to allow health plans not in compliance with the law to be offered for two more years, and Alaska’s Mark Begich, who backed a package of Democratic bills that would have tweaked the law. Louisiana’s Mary L. Landrieu, who introduced a measure (S 1642) that would have allowed people to keep their existing health insurance policies indefinitely, still faces a runoff election in December. 

Common Ground Elusive

“I don’t think they’re going to find much common ground around the Affordable Care Act” in the next Congress, said Robert Blendon, senior associate dean for policy translation and leadership development at Harvard School of Public Health. “The issue is that there will be no blatant support [for changes] from the Democrats. There is nobody left on that side.”

Minority Leader Mitch McConnell, the next presumptive majority leader for the 114th, acknowledged in a post-election news conference that they do not have the 60 votes necessary to repeal the law. The Kentucky Republican said he does, however, plan to use the “power of the purse” to narrow its reach through spending bills and policy riders.

Beyond Peters, Democratic swing voters may include Joe Manchin III of West Virginia, Heidi Heitkamp of North Dakota and Mark Warner of Virginia, all of whom supported the Senate package of Democratic health care law changes. Joe Donnelly, D-Ind., has also been a vocal supporter of legislation (S 1188) to change the definition of full-time workers.

Democrats, such as Amy Klobuchar and Al Franken of Minnesota, from states with medical device makers have endorsed legislation to repeal the law’s 2.3-percent excise tax on the devices. “This issue has been able to unite normally polarized members of the Senate in giddy camaraderie,” said Robert Moffit, senior fellow at the Heritage Foundation’s Center for Health Policy Studies.

The GOP still faces roadblocks from within its own ranks, where more conservative lawmakers are likely to refuse supporting changes to a law they view as inherently flawed. Senate Republicans could force changes using budget reconciliation, where only a simple majority is needed. But even that process has limits, meaning that some compromise will still be necessary.

Jonathan Oberlander, a professor of social medicine and health policy and management at the University of North Carolina at Chapel Hill, said that altering the health care law could prove risky for Republicans, who have highlighted unpopular provisions to attack Democrats. Whether or not Republicans ultimately draw enough support, he said, could come down to strategy.

“If the end goal is to change the law, than you focus on the parts where you know you can peel off enough Democrats to do it,” Oberlander said. “But if your focus is to put vulnerable Democrats on the record or force the president’s hand, than you don’t care as much about getting to 60 votes.”

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