New health care measures go into effect this week that will have profound implications for all Americans and on the U.S. health care system. But Republicans are still fighting for the repeal of the bill that has become one of the biggest and most controversial health care laws in history.
Repealing a major bill like health care is no easy task, even if Republicans were to take back control of the House and possibly even the Senate, as some polls indicate.
But a full repeal isn't completely out of the question. The Medicare Catastrophic Coverage Act, which would have been the biggest expansion of Medicare since the 1960's, was repealed in 1989, just one year after it passed.
A full repeal would require a bill to pass in both the House and the Senate, and would need a majority in both Houses. Even if Democrats lost majority control, they still would be able to filibuster it. And even if the repeal bill were to pass both Houses, it could most likely be vetoed by President Obama. A presidential veto can only be overturned by a two-third majority in both the House and Senate.
A more plausible option that Republicans are considering is rejecting funds for various parts of the health care bill and striking down some measures specifically, such as the mandate that would require all Americans to have health insurance. But, again, that would require that Republicans have full control of Congress.
Even though 35 House Democrats did not vote for the health care bill, only one -- Rep. Gene Taylor, D-Miss. -- supports repeal.
Republicans themselves admit that repealing the entire bill is virtually next to impossible.
"I would like to repeal it and replace it," Senate Minority Leader Mitch McConnell, R-Ky., said recently. "What can we do? We can make narrow, targeted efforts to go after the cost problems. Without the president, we can't repeal it. But we can go after portions of it aggressively."
Even House Minority Leader John Boehner, R-Ohio, an outspoken proponent of repeal, refused to use the word when posed the question at a press conference last week.
"I am committed to doing everything that I can do and our team can do to prevent 'Obamacare' from being implemented," Boehner said. "I believe that this bill will ruin the best health care system in the world, and I believe that it will bankrupt our country. And when I say everything, I mean everything."
Republican leaders say they don't expect to make an impact overnight, and insist that this is a long-term strategy. By chipping away at the bill piecemeal, they can reduce its overall effectiveness and make it so weak that it essentially doesn't work.
"Eventually, you have something that looks like Swiss cheese and will, frankly, be about as sturdy as Swiss cheese," Rep. Bill Cassidy, R-La., a practicing physician and assistant whip for the Republican Conference, told ABC News. "And then that will be the point where you replace it with something that achieves the goals of controlling cost, expanding access to quality health care but also reflects the value of the American people."