More on what Republicans can do to control Obama care

While Republicans will try to defund the 150+ new health care regulatory bureaus, there are real limits to what they can do:

The Republican in line to lead the House Budget Committee acknowledged Sunday that the GOP is unlikely to get a repeal of a Democratic-backed health care law because President Obama can veto it, but said House Republicans will move forward on a vote anyway.

Rep. Paul Ryan of Wisconsin said Republicans have some opportunities to slow the advance of the Democratic plan by defunding actual rollouts, but acknowledged the president would have to sign that legislation.

Cognizant of missing a presidential signature, Republicans are still looking at court challenges and other congressional maneuvers to stop enactment of elements of the law. . . .

The NY Times has this:

But [Republicans] said they hoped to use the power of the purse to challenge main elements of the law, forcing Democrats — especially those in the Senate who will be up for re-election in 2012 — into a series of votes to defend it.

Republican lawmakers said, for example, that they would propose limiting the money and personnel available to the Internal Revenue Service, so the agency could not aggressively enforce provisions that require people to obtain health insurance and employers to help pay for it. Under the law, individuals and employers who flout the requirements will face tax penalties.

Moreover, Republican leaders said, they plan to use spending bills to block federal insurance regulations to which they object. And they will try to limit access to government-subsidized private health plans that include coverage of abortion — one of the most contentious issues in Congressional debate over the legislation.

Those are just a few examples of the ways in which newly empowered House Republicans plan to use spending bills to pressure Mr. Obama and Senate Democrats to accept changes in the law.

Given their slim majority, Senate Democrats must stick together if they want to avoid sending Mr. Obama spending bills and other legislation that he would feel compelled to veto, setting up the prospect of a broader deadlock and, in an extreme situation, a government shutdown. . . .

States might also have to get involved because the federal government is imposing such a burden on them. Texas might be leading the way. (Notice the editorializing in what passes as a "news" story in the NY Times.") This is indeed a tough step, but it shows how really bad the federal system has gotten. Texans would still be forced to pay massive federal Medicaid taxes, but then wouldn't get any of the benefits.

Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program.

Far-right conservatives are offering that possibility in impassioned news conferences. Moderate Republicans are studying it behind closed doors. And the party’s advisers on health care policy say it is being discussed more seriously than ever, though they admit it may be as much a huge in-your-face to Washington as anything else.

“With Obamacare mandates coming down, we have a situation where we cannot reduce benefits or change eligibility” to cut costs, said State Representative Warren Chisum, Republican of Pampa, the veteran conservative lawmaker who recently entered the race for speaker of the House. “This system is bankrupting our state,” he said. “We need to get out of it. And with the budget shortfall we’re anticipating, we may have to act this year.”

The Heritage Foundation, a conservative research organization, estimates Texas could save $60 billion from 2013 to 2019 by opting out of Medicaid and the Children’s Health Insurance Program, dropping coverage for acute care but continuing to finance long-term care services. The Texas Health and Human Services Commission, which has 3.6 million children, people with disabilities and impoverished Texans enrolled in Medicaid and CHIP, will release its own study on the effect of ending the state’s participation in the federal match program at some point between now and January. . . .