WASHINGTON - Congressional Republicans insist they will do everything they can to repeal the health care overhaul, the centerpiece of President Barack Obama's first two years in office. But the GOP's chances of success are exceedingly small and many Republican leaders have not said what they would enact in its place.
"It will probably be about as challenging as making the Empire State Building disappear would be for a magician," said Duke University political scientist David Rohde.
Although voters in exit polls didn't put health care high on their priority list, and some individual provisions of the law are popular, expect the GOP to target the health care law in 2011, with an eye toward a possible repeal after 2012.
"We have to do everything we can to try to repeal this bill and replace it with common-sense reforms that'll bring down the cost of health insurance," Rep. John Boehner, who is expected to be House speaker in January, said the morning after the election.
Senate Minority Leader Mitch McConnell, R-Ky., offered a peek at the GOP's strategy.
"We can - and should - propose and vote on straight repeal, repeatedly," he told the conservative Heritage Foundation last week. "But we can't expect the president to sign it."
Rather, he said, Republicans will try to cut off money to key health care initiatives, bring up floor votes on various provisions and force administration officials - presumably in House hearings - to defend the health care law.
He also promised a continuing campaign to tell the public "about the ill-effects of this bill on individuals young and old, families and small businesses."
McConnell's office said he wants to replace the law "with the types of reforms that Americans support and that actually address the biggest problem with health care - higher costs. That includes medical liability reform, help for small businesses to purchase insurance, purchasing insurance across state lines."
Obama has promised to fight efforts to repeal health care reform, which passed in March with no Republican support.
"I think we'd be misreading the election if we thought that the American people want to see us for the next two years re-litigate arguments that we had over the last two years," Obama said in a post-election news conference.
What do the American people want? Depends on which people you ask. In exit polls, voters split on health care: with 48 percent saying it should be repealed and 47 percent saying it should be kept intact or broadened. Voters in Tuesday's midterm elections said Congress' priority should be reducing the deficit (39 percent) and spending to create jobs (37 percent.) Only 18 percent cited health care as the most important issue, according to exit polls.
Provisions that took effect this fall include banning lifetime caps on the amount of insurance coverage companies provide; preventing insurance companies from denying coverage to children with pre-existing medical conditions; and extending parents' insurance coverage to children up to age 26.
Among the potentially popular provisions that kick in next year: the start of a phase-out of a gap for seniors in drug coverage (known as the "doughnut hole") and a 50 percent discount for seniors on brand-name drugs.
"If the Republicans have ideas for how to improve our health care system, if they want to suggest modifications that would deliver faster and more effective reform ... I'm happy to consider some of those ideas," Obama said last week.
McConnell and others have said they want to target the requirement that people must have health care coverage, additional spending in the law, the additional bureaucratic institutions set up to run health care programs, and cuts made to the Medicare Advantage program, an alternative to traditional Medicare sold by private health insurance companies.
About the only specific area the Republicans and Obama appear to agree needs fixing is a tax-reporting provision that has proven to be a paperwork burden on small businesses.
The procedural hurdles for repeal are formidable.
If next year's Republican-led House passed a bill repealing health care reform, it would languish in the Senate, where Democrats still have the majority.
Even if enough support for repeal could be found in the Senate, both chambers would have to agree to exactly the same provisions to pass a final bill. It was a struggle to get both chambers, led by the same party, to agree on the law they ultimately passed.
In the unlikely event that a repeal passed Congress, Obama would be sure to veto it. Overriding that would require a two-thirds vote in each house.
"There is zero chance of repealing the legislation over the next two years," said Thomas Mann, senior fellow at The Brookings Institution, a left-leaning think tank in Washington. "Moreover, efforts to defund it could well lead to a shutdown of the Department of HHS (Health and Human Services), and the capacity of federal employees to make Social Security payments and finance the ongoing operation of Medicare and Medicaid."
Tevi Troy, a former deputy secretary of Health and Human Services under President George W. Bush, agrees the chance of repeal is perhaps zero in 2011, "but not zero overall."
The Republicans will try to not fund parts of the health care law and also use public hearings and congressional investigative powers to draw attention to problems with the law, said Troy, a visiting senior fellow at the Hudson Institute, a right-leaning think tank in Washington.
"Overall," he said, "the focus will be on building the case for repealing the current law and replacing it with a better health care system after the 2012 elections."