House Republicans Clash Over Repealing Part of Obamacare

A curious case of what happens when the parties' many policy ambitions clash: Republicans' efforts to repeal part of PPACA have revealed a divide between the states'-rights advocates and malpractice reformers.

The problems came when Republicans were preparing legislation to wipe out the Independent Payment Advisory Board, a panel created as part of the Democrats’ health-care law. Its purpose: Keep Medicare spending down.

To pay for repealing that provision costs big money, and Republicans wanted to offset the cost with medical malpractice reform — something they think can save tens of billions of dollars.

But a gaggle of Republican lawmakers came alive to the fact that changing malpractice laws at the federal level would interfere with existing state laws — in some cases, nullifying states’ constitutions. States’ rights advocates got up into a tizzy.

To make the situation more complicated, Democrats who supported repealing IPAB won’t vote for the kind of medical malpractice reform Republicans support.

And House floor rules prohibited amendments that would allow lawmakers to “vent steam” in opposition.

It’s another example of the complex ideologies that are laced throughout the House Republican Conference. Even when Republicans are on the same page, things are complicated.