Obamacare: it's toast.

• Author: Pollack, Harold
• Position: WHAT IF HE LOSES?

Like everyone else who supported passage of the Affordable Care Act (ACA), I've been worried about what will happen to Obama's signature legislative accomplishment if he loses in 2012. Specifically, I'm wondering if a new president would really overturn the law, as all Republican candidates have vowed to do.

It's easy to see Newt Gingrich following through on that promise, given his record of radicalism. (Remember the 1995 government shutdown?) But what about Mitt Romney, the GOP candidate with the best chance of actually beating Obama? Might he turn out to be a problem-solving moderate sheep in a conservative wolf's clothing? Sure, he is now spouting the conservative rhetoric of Republican primary voters. But in his last political job, Romney shepherded through the precise precursor to the ACA. Tim Pawlenty's sobriquet "Obamneycare" strikes me as an entirely fair description of both measures.

I suspect that if it were up to Mitt Romney alone, we would see surprisingly incremental changes to the act. For most of last year, the main way he promised to overturn the ACA was to sign an executive order on his "first day in office" that would give states waivers from the law's mandates. The ACA already allows states to seek waivers in 2017 provided that they provide coverage as strong as what the federal law affords. Romney's policy would be merely to grant those waivers immediately, and most experts think he won't have the power to do even that. It's hard not to wonder whether this is a pledge Romney trots out to make GOP primary voters think he'll wipe out "Obamacare" if elected but that is actually calibrated to allow him to evade the task.

In any event, such speculation presumes that a potential President Romney's policy preferences are the critical variable. They aren't, because he won't be the Republican decider regarding health care reform. As I write, the online prediction market Intrade lists President Obama as having a 51 percent probability of reelection, and gives Romney a 35 percent chance of being the person to unseat him (Gingrich's chances are listed at 4 percent). Meanwhile, Intrade gives Republicans a 75 percent probability of taking over the Senate, and a 74 percent likelihood of retaining control of the House.

With majorities in both houses, Republicans would surely try to pass a full repeal of the ACA. If Obama is reelected, he will veto it. Yet if Obama loses, what leverage or incentive would President Romney really have, come January 2013, to wage an internecine party fight to preserve elements of his predecessor's...