Just days after a bruising battle over the country's budget left the Affordable Care Act largely unchanged, Republicans are formulating their next round of attacks in their three-year war against the unpopular health care law.
There's a key difference this time around: The law has been rolled out, and the online insurance marketplaces that opened on Oct. 1 are providing opponents with plenty of ammunition.
The massive technical problems plaguing the exchanges are making front-page headlines now that the 16-day federal government shutdown is over, prompting President Obama himself to address the situation directly on Monday.
The problems have allowed Republicans to begin highlighting the impact that the law is having on real Americans as part of their anti-ACA strategy.
"When a visit to the Obamacare website makes a trip to the DMV seem pleasant, it's time for the President to consider delaying this rushed effort," Senate Minority Leader Mitch McConnell, R-Ky., said in a statement.
Heritage Action, a conservative group that strongly opposes the health-reform law, is collecting real-world stories about the law's failure on its website as part of a three-pronged approach to attacking Obamacare, says communications director Dan Holler.
In the coming months, the group plans to highlight the law's impact on Americans; develop a legislative strategy that GOP activists outside and inside Washington can rally around; and focus on the four red-state Democratic senators — Mark Pryor of Arkansas, Kay Hagan of North Carolina, Mark Begich of Alaska, and Mary Landrieu of Louisiana — who supported the law.
"They need to be held accountable," Holler said.
The legislative strategy would be akin to this fall's failed movement to defund the law, spearheaded by Republican Sens. Ted Cruz of Texas, Mike Lee of Utah, and Marco Rubio of Florida. The trio of senators had called on their colleagues this summer to vote against any budget bills that provide funding for Obamacare. It's too early to say what the next legislative strategy will be, Holler says. Not every GOP lawmaker supported the defunding push.
In the meantime, GOP lawmakers are calling for heads to roll over the troubled Obamacare website. Republican National Committee Chairman Reince Priebus said last week that Health and Human Services Secretary Kathleen Sebelius should be fired, and GOP lawmakers have since joined in.
The House Energy and Commerce Committee scheduled a hearing for Thursday on the law's "implementation failures." The committee said Monday that lead contractors who built the website will testify, and that Sebelius herself is expected to appear next week.
Holler says the focus on the law's implementation is tied to the GOP's opposition to the law as a policy. "It's really hard to separate the two. Folks try to write this off as a glitch. I think that's a misunderstanding of what's happening," he said. "It sort of goes into, "˜Do you trust the government to have this much control of anything?' "
The real-life impacts of the law, of course, cut both ways. Democrats can now point to concrete ways that coverage under the law is helping individuals, and when Obama spoke about the law's rollout in the Rose Garden on Monday, he was flanked by people who had benefited from its provisions.
But despite the new anecdotal information each side is citing, real data on the law's success — or lack thereof — is still absent. The White House is not expected to release the enrollment numbers until mid-November. Open enrollment stretches until late March, and many people, particularly the young and healthy, who will be crucial to the law's success but may be least motivated to get coverage, are expected to sign up toward the end of the period.
It's not yet clear whether the problems will impact the number of people who ultimately sign up for coverage. The nonpartisan Congressional Budget Office estimated earlier this year that 7 million Americans would sign up through the online marketplaces.
The administration has not given a target date for fixing the problems, but announced Sunday it was bringing in "the best and brightest" tech minds in the public and private sectors to help.
Obama, meanwhile, said Monday that the ACA was "not just a website" and emphasized that "the product is good," even if the means to buy it is having problems. He also emphasized the positive impact of the parts of the law that went into effect before Oct. 1, such as the provision that allows young adults under age 26 to remain on their parents' health insurance plan.
Meanwhile, the drumbeat of criticism continues. "[The Affordable Care Act's] failings ... are not limited to its website or its rollout," Cruz said in a statement on Monday.