WASHINGTON When he talks to Republicans in Congress, Scott DeFife, a restaurant industry lobbyist, speaks their language: President Barack Obamas health care law is a train wreck well down the track. There will be collateral damage if changes are not made. Friends of the industry cannot sit back and let that happen.

Speaking to Democrats, he puts on his empathy hat: The Affordable Care Act is the law of the land. Its goal of universal insurance coverage is laudable, but its unintended consequences will hurt the cause.

Almost no law as sprawling and consequential as the Affordable Care Act has passed without changes significant structural changes or routine tweaks known as technical corrections in subsequent months and years. The Childrens Health Insurance Program, for example, was fixed in the first months after its passage in 1997.

But as they prowl Capitol Hill, business lobbyists like DeFife, health care providers and others seeking changes are finding, to their dismay, that in a polarized Congress, accomplishing them has become all but impossible.

Republicans simply want to see the entire law go away and will not take part in adjusting it. Democrats are petrified of reopening a politically charged law that threatens to derail careers as the Republicans once again seize on it before an election year.

As a result, a landmark law that almost everyone agrees has flaws is likely to take effect unchanged.

I dont think it can be fixed, Sen. Mitch McConnell of Kentucky, the Republican leader, said in an interview. Everything is interconnected, 2,700 pages of statute, 20,000 pages of regulations so far. The only solution is to repeal it, root and branch.

Sen. Max Baucus, D-Mont., one of the laws primary authors, said: Im not sure were going to get to the point where its time to open the bill and make some changes. Once you start, its Pandoras box.

As the clock ticks toward 2014, when the law will be fully in effect, some businesses say that without changes, it may be their undoing.

Are we really going to put the private sector in a situation where theres a real potential mess for posturing points? DeFife asked.

The rest is here:

Changes to health care law thwarted