Image: Medical doctor © Corbis-SuperStock

Related topics: insurance, health insurance, health care, insurance companies, airlines

Even as new provisions of the federal health care reform law go into effect, the fight over the landmark measure rages on.

From the halls of Congress to the court room to statehouses across the country, opponents are waging battle.

Here are the major opponents' strategies and how they could play out.

Strategy one: Health care reform repeal

Despite its passage by the Republican-controlled House of Representatives, the so-called "Repealing the Job-Killing Health Care Law Act" isn't going anywhere in the next two years, given Democratic control of the Senate and a certain veto by President Barack Obama.

Political undoing of the Affordable Care Act depends on the outcome of the 2012 election, says Ben Domenech, a fellow with The Heartland Institute, a conservative think tank, and the managing editor of the institute's "Health Care News."

But time is not on the opponents' side. Major changes will be harder to make once Americans are accustomed to the law's health insurance coverage benefits, such as prescription drug discounts and free preventive care for seniors on Medicare, effective Jan. 1 this year.

Domenech says the biggest deadline is 2014, when health care exchanges -- one-stop shops for buying health insurance -- open for business and almost everyone will be required to buy health coverage as part of the "individual mandate" requirement of health care reform.

Dr. Karen Edison, director of the Center for Health Policy at the University of Missouri in Columbia, says undoing the Affordable Care Act will be a "hard-pitched battle."

"It is the law of the land," she says. "It's not just a proposal. . . . People are already benefiting from it."

Strategy two: Chip away

Congressional Republicans will try to weaken what they consider to be objectionable provisions and delay or cut funding.

Amanda Austin, the director of federal policy for the National Federation of Independent Business, which opposes the law, sees opportunity here. The group, for instance, is fighting a new business tax-reporting requirement, which it says will create a paperwork nightmare for small-business owners.

She acknowledges addressing certain health care reform provisions may be tough, though. Because of the way some provisions are bundled. It's hard to change one thing without impacting something else.

Domenech doesn't see much chance for significant change in the next two years.

"I think many Republicans and newly elected representatives will attempt to chip away at the law, but I think very few of these things will make it to the president's desk," he says. "There's not a lot of leeway, except tweaks."

For one thing, he says, few of those measures would survive a filibuster in the Senate. For another, "it's not in the best interests of many Republicans to make this law work better."

One way Republicans could have an impact is through increased oversight on federal agencies as health care reform is implemented.

"You'll see a lot more questioning," Domenech says.