OCTOBER 29, 2011
Every Republican presidential candidate has promised to repeal the Obama administration’s health-care overhaul. But despite full-throated criticism, it’s going to be hard for any of them to fulfill that pledge if elected.
Despite their full-throated pledges to repeal the health overhaul law, no Republican presidential candidate is likely to fulfill that pledge entirely if elected in 2012. Louise Radnofsky has details on The News Hub.
Standing in the way of that seemingly simple campaign promise—an article of faith among GOP voters—is a welter of practical and political obstacles. They include immovable limits on what elements the Senate can tackle, in the likely event Republicans don’t have a 60-seat majority after the 2012 election, and the party’s need to come up with spending cuts to replace savings promised by “ObamaCare,” as it’s dubbed by critics.
These and other hurdles have sparked a lively debate among the candidates over whose approach is best, with former Massachusetts Gov. Mitt Romney battling rivals who say his two-step plan is unrealistic. For now, GOP lawmakers and conservative strategists are pushing separate, piecemeal approaches.
The complications are evident in Mr. Romney’s two-step plan.
Mr. Romney has proposed signing an executive order on “day one” offering waivers to any governor who wants his or her state to opt out of the law. His rivals note that by law, such waivers can’t take effect before 2017. The move would also leave untouched the focus of conservative opposition: the requirement that individuals carry insurance or pay a fee.
Mr. Romney said he would follow this on “day two” with legislation to repeal the law, using a Senate tactic called budget reconciliation. That would require only 51 votes to succeed, a total the GOP might reach after next year’s election.
But under the rules, such a bill would tackle only parts of the legislation that relate directly to the budget. Anything else would require 60 votes to overcome a Democratic filibuster, and few see Republicans notching that number.
Presidential contenders Rick Perry and Jon Huntsman have attacked Mr. Romney’s approach, particularly the first step of his plan.
“Ultimately there are no administrative silver bullets that can roll back the core provisions,” said Tim Miller, a spokesman for Mr. Huntsman. Mark Miner, a spokesman for Mr. Perry, said the candidate would do “as much as is possible through executive order, but will focus on leading Congress to pass a full repeal.”
In addition, some provisions of the law are linked with others and would cause problems for health insurers if dismantled. Moreover, while polls show a plurality of the public backs repeal, people also favor certain pieces of the bill.
In a March 2011 survey by the non-partisan Kaiser Family Foundation, 74% said they thought lawmakers should keep provisions that prohibited insurance companies from denying coverage because of a person’s medical history. But a new poll just released by the foundation found that 51% of respondents have an unfavorable opinion of the law, up from 46% in the March survey.
In the coming election campaign, Democrats are expected to highlight such provisions, including a mandate that insurance companies issue coverage for children even if they have pre-existing medical conditions.
“The few policies that aren’t loved, such as the individual requirement to purchase insurance, make the overwhelmingly desirable provisions, such as the insurance-reform protections, workable and affordable,” said Chris Jennings, a former senior health adviser to President Bill Clinton.
Another potential problem: The Congressional Budget Office initially found that the law narrowed the deficit, thanks to its tax increases and Medicare cuts. Opponents say such savings are illusory because they expect Congress to put off those provisions. Even so, reconciliation rules require Republicans to provide offsetting cuts.
When the health care overhaul passed in 2010, CBO calculated it would reduce the deficit by $124 billion over 10 years. Since then, the Obama administration has shelved the law’s long-term-care insurance program, which CBO originally estimated would save $70 billion over that time period.
CBO declined to comment on future projections.
Proponents of repeal point out that the law’s deficit-reduction projections are likely to diminish substantially by 2013.
Conor Sweeney, a spokesman for House Budget Chairman Paul Ryan (R., Wis.), said analysts used gimmicks to arrive at their original estimates for the overhaul’s deficit reduction, and that the demise of the long-term-care program leaves a more manageable budget gap to fill.
In the Republican-controlled House, Mr. Ryan has led efforts to repeal the legislation in its entirety. He has said he believes it can be replaced with other measures that would contain the cost of health care, such as changes to the structures of Medicare and Medicaid. He also wants to keep insurance companies from being able to deny coverage based on a person’s medical history.
Choking off the law’s funds, which some Republicans recommend, could help thwart the overhaul in 2013. But it would leave the law on the books for Democrats to revive funding for it in the future.
In the Senate, where the procedural problems are most acute, Sen. Orrin Hatch of Utah, the top Republican on the Senate Finance Committee, is pushing smaller bills to address specific pieces of the law, including requirements for individuals and employers to purchase insurance or pay a fine, and a tax on medical devices, according to spokeswoman Julia Lawless.
James Capretta, a top budget official in the administration of George W. Bush, said if drafters were “creative” and went after every provision that had spending implications, they could remove most of the law or make it irrelevant using the budget reconciliation process. “It would take a fair amount of work, but it’s definitely doable,” he said.
Senior GOP leadership aides said it was too early to know for sure how they would go about using the reconciliation process, and neither they nor the presidential candidates have specified how they would plug the budget gap.
This Article on Wall Street Journal