It looks like Rep. Bob Inglis (R-SC) and the other Republicans promoting repeal of the health care reform bill need some civics lessons. Here are the last four tweets to Inglis’s Twitter account in chronological order (via Steve Singiser):

-What do you do when Congress passes a bad bill? You get a new Congress to repeal it!
-There’s no bill passed by one Congress that can’t be repealed by another.
-Focusing on the good news–that no Congress can bind a future Congress.
-That means that there’s nothing written by one Congress (a health care bill) that can’t be re-written by the next Congress.

In reality, however, a new Congress is hardly enough. Slate’s Christopher Beam outlines the scenarios:

What would it take to repeal health care reform?
Realistically, a Republican majority in the House and Senate, plus a Republican president. Even if the GOP won back a majority in the House and Senate in 2010, President Obama could still veto any legislation that would repeal any part of health care reform. Republicans would then need a two-thirds majority in both chambers to override his veto. That’s unlikely.

If the Republicans control the House, Senate, and presidency in 2012, they will still need 60 votes in the Senate to overhaul the bill in its entirety. They could, however, cut off funding for it through the budget reconciliation process, which only requires a 51-vote majority. But they wouldn’t be able to tamper with any part of the legislation that doesn’t affect the budget, such as the ban on discrimination against pre-existing conditions.

What I think is less clear to most people, however, is that repealing the key provisions of the bill may be impossible for Republicans even if they take back unified control of government in the 2012 elections.

The reason is that the legislation is built around the so-called “three-legged stool” of a ban on discrimination based on pre-existing conditions (to ensure access), subsidies to help people purchase coverage (to ensure affordability), and a mandate that everyone obtain insurance (to prevent free-riding and keep healthy people in risk pools). It’s unimaginable that Republicans would repeal the pre-existing conditions provision, and getting rid of subsidies is likely to be extremely unpopular. That leaves mandates. While they may seem unpopular, getting rid of them alone would create a death spiral that would bankrupt insurance companies. As a result, the health care industry would likely unite with Democrats to block any attempt to eliminate the mandate provision.

In short, the major provisions of the new system are here to stay — I think it’s likely that Republicans will eventually scale back their apocalyptic rhetoric and focus on nudging the system in a more market-friendly direction. The problem is that their base has been whipped into such a frenzy that they will accept nothing less than full repeal. How long until reality intervenes?

Update 3/25 11:38 AM: More details and reactions are emerging. For instance, a senior GOP aide told Greg Sargent the Republican strategy will be to pursue “piece by piece” repeal:

There’s “nothing partial” about our repeal push, the senior Senate GOP aide told me, adding: “But it will be articulated piece by piece so our position won’t be misconstrued as walking away from the goals of reform.”

…Case in point: Preexisting conditions. If Republicans pledge full repeal, they risk being painted as favoring the insurance industry’s right to discriminate along these lines.

Solution: “Republicans will work to repeal the mandates forced on individuals and small businesses and replace it with market based solutions and high risk pools so that nobody will be denied coverage on the basis of pre-existing conditions,” the aide says.

But for the reasons described above, it’s not clear that you can remove mandates without creating insurance death spirals.

Also, via John Holbo, National Review’s Ramesh Ponnuru essentially concedes the point I make above about the difficulty of repeal:

Understandably, [Republican senator John] Cornyn doesn’t want to touch the most popular element of Obamacare, the ban on discrimination based on pre-existing conditions. But unless it’s modified substantially, the individual mandate has to stay too — and therefore so do the subsidies and the minimum-benefits regs. Without perhaps realizing it, Cornyn has come out for tinkering at the edges of Obamacare.

It’s only a matter of time until others realize this as well.

Update 3/25 1:37 PM: Yet more Republicans proposing partial repeal, such as getting rid of the mandate but keeping other components, without explaining how such a policy would work.