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The Democrats' Healthcare Conundrum (Updated)

Update: The House voted today to repeal ObamaCare, 236-181.

The battle over President Barack Obama’s plan to change the U.S. health care system is far from over. Getting a bill through the Congress and signed into law may have won him the first round -- but the debate renews with the opening of the 112th Congress.

As several legal and constitutional challenges work their way through the federal courts system, the U.S. House of Representatives, now controlled by the Republicans, has scheduled a vote (this week) to junk the whole thing. It’s likely to pass, perhaps even by a veto-proof majority if the Democrats who voted against it last year -- and who are still in Congress -- join with the GOP in pushing for its repeal.

This means, once again, that the action moves to the United States Senate where, it should be recalled, the original ObamaCare proposal languished for months until Senate Majority Leader Harry Reid could figure out a strategy to get it to the floor for a vote.

With the Democrats still in the majority in the Senate -- albeit by a narrower margin -- most political commentators expect the repeal language to die a slow, lingering death as Reid uses every parliamentary trick at his disposal to keep it from coming to the floor for a vote.

In the short run, that looks like a winning strategy. In the long run, it may hand the Senate to the Republicans in the November 2012 election. Far too many Senate Democrats occupy seats in states either carried by John McCain in 2008 or in which the GOP performed well in 2010 for them to be able to comfortably turn their backs on the health care repeal movement. Virginia’s Jim Webb, Florida’s Bill Nelson and Nebraska’s Ben Nelson, and Missouri’s Claire McCaskill are but a few of the endangered Democrats who put their re-election at risk if they ignore how deeply the American people dislike ObamaCare now that they really understand what it does.

More than a handful of states have passed or are looking to pass legislation that would block the enforceability of the ObamaCare individual mandate within their boundaries. The business community, particularly small business, is up in arms over the requirement that IRS form 1099-S be given to anyone with whom they do more than $600 in business in a given year. And the Obama administration’s back door push to enact through regulation Medicare reimbursements to doctors who provide “end of life” counseling to their patients -- a provision dropped from the original bill when it was linked to the idea of what former Alaska Gov. Sarah Palin and others refer to as “death panels” -- will once again fuel anti-ObamaCare sentiment on talk radio and in the blogosphere, keeping the same voters who were upset about it last November riled up for the election two years hence.

By blocking a vote on repeal in the Senate, the Democrats are playing with fire. The smart political strategy for the opponents of Obama’s version of health care reform, once an up or down vote on repeal is put on the bench, is to -- in the political sense -- “nickel and dime” the senators who are worried about their re-election prospects with repeated votes on the most unpleasant, unsavory and universally disliked elements of the plan that doesn’t go into effect until 2014.

How many times will vulnerable senators consent to voting on the most controversial elements of the new health care law -- putting them between the rock of the right and hard place of the left -- before they see the wisdom of breaking with Reid and voting, along with the House, to toss the whole business into the ashcan, even if they know Obama will veto the repeal?

In a sense, forcing a veto forces everyone’s hand -- but after the results of November 2010 it is highly unlikely that there are that many vulnerable Senate Democrats who are willing to fall on their sword for the president. They would much rather let him take the heat -- by vetoing repeal -- than having to time and again  calculate the proper course to take when confronted with wedge issues like repeal of the individual mandate, which the public supports and without which the whole scheme collapses in on itself.