Republicans agree on one thing: with the Affordable Care Act in place, the patient and doctor have been left out of many decisions. At a Republican think tank-sponsored forum on Thursday in Washington, congressmen from the right weren’t unified, however, on how to change health reform in the U.S.

At the beginning of the “Fresh ideas and a new vision for health reform” event, Galen Institute president Grace-Marie Turner introduced the panel of Republicans, saying, “We won’t be referring to it as the Affordable Care Act, since it isn’t that.”

Sen. Richard Burr (R-N.C.) was adamant that “there has to be a repeal,” and Rep. Steve Scalise (R-La.) talked energetically about the American Health Care Reform Act (H.R. 3121), which would completely repeal the law. It now has 125 sponsors in the House, according to the congressman. However, Rep. Michael Burgess (R-Texas) said “the big bill is one that I don’t support” and “we can build on where we are now,” mentioning one thing he would change is the cap on health savings accounts.

Burr has also introduced a repeal option in the Senate, along with several other senators, for consideration after President Barack Obama’s term expires in January 2017.

Employers and employees

During the more than hour-long discussion, several congressmen highlighted their problems with how the ACA is affecting employees around the country and in their districts. “From an employer standpoint, from an economic standpoint, what I hear from my small businesses is that they’re modifying their hiring patterns because of the law,” said Rep. Tom Price (R-Ga.). “There’s a car dealer in my hometown, had 168 full-time employees a year ago and now he has two — 166 of those folks went to part-time. One hundred and sixty six of those people went from 40 hours a week to 28 hours a week. All because of this law.”

Scalise echoed his colleague’s point: “It literally has incentives in the law to reduce the number of employees to less than 50.” He said he sees restaurants in the New Orleans portion of his district that have also reduced staff hours.

Reality of change

Turner said in a video interview coming to EBA’s AdviserTV soon that she doesn’t think there’s any way to “fix” the current health care law. Her policy institute, along with many others represented at the event, including The 2017 Project, American Enterprise Institute and American Action Forum, has worked on the various bills and proposals already presented and planned in Congress to repeal the law.

But ex-Washington Post journalist Ezra Klein, who spoke at the end of the event about the politics of reform, says the realities are not in favor of repeal. “I don’t make [election] predictions, they’re completely worthless, but I think Republicans will get seats 2014,” but not enough. “So from the perspective of the ACA, it won’t be going anywhere until 2017,” he said. He added that while 2014 will likely have a favorable electorate demographic for Republicans, presidential election years have skewed for Democrats recently, and may especially in 2016 if former Secretary of State Hillary Clinton is the Democratic nominee.

“It’s too early to say if Obamacare is successful,” he said, noting that as he’s stepped away from the 24-7 news cycle to start his own publication at Vox Media, he’s realized how quick the media is to jump in and evaluate things. “With the state exchanges, in a year or two we’ll see where we are at that point.”

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