Thursday, November 8, 2012

Obamacare: The Battle Intensifies

The Foundry:

Obamacare is not here to stay. Despite the 2012 election, the assumption that the health care law will stay on course is another example of the left’s wishful thinking.

Of course, efforts for a complete repeal will likely face the same fate as efforts in the last Congress did. But there are ample reasons, as well as opportunities, to change the course of this law.

Public opinion has not changed. Exit polls show that the majority of Americans still want the law repealed in full or in part. Former House Speaker Nancy Pelosi (D–CA) was absolutely right when she famously remarked in 2010 that “we have to pass the bill so that you can find out what is in it.” With continuing revelations of increasing costs, higher taxes, and a flood of directives from Washington bureaucrats, the polls have since shown that the American people still do not like the law.

There is still so much more to know—and not like. Americans know that this law was enacted in haste and that critical details are still to be decided and enforced. What is a qualified health plan? What will be in the essential benefit package? How will the employer and individual mandate be implemented? The list goes on.

The law is already becoming a managerial nightmare, as Administration officials have missed deadline after deadline, failing to provide crucial information—doubtlessly to avoid further political fallout from exposing their controversial plans, such as the contraception mandate undermining religious freedom, or because overhauling one-sixth of the economy is riddled with innumerable unintended consequences that are nearly impossible to avoid.

As these regulatory details emerge, they will generate even more public controversy and create even more practical obstacles for implementation. Naturally, these instances will provide ample opportunities for legislative remedial action.

Bipartisan opposition to the law will continue. While the House vote earlier this year pressured five Democrats to support full repeal, more significant were the various piecemeal repeal bills that gained bipartisan support. Most notable, repeal of the Independent Payment Advisory Board (IPAB), the unelected group of experts in charge of cutting future Medicare payments, passed the House and had more than 234 cosponsors—Republicans and Democrats. These efforts will likely gain more attention in the future, as will efforts to weaken other elements of the law. House majority leader Eric Cantor (R–VA) has already vowed a vote on the IPAB repeal again.

The states can and will have their say. Two of the largest elements of the health care law—the massive Medicaid expansion and the costly subsidies scheme funneled through government exchanges—are heavily dependent on state compliance. But the June Supreme Court decision reaffirmed that states are not at the mercy of the federal government.

Many state officials realize that there is little upside to joining forces with Washington in implementing this disastrous endeavor, thus further eroding the long-term viability of Obamacare.

Looming deficits bring health care back to the forefront. Entitlements are the major drivers in the country’s mounting fiscal crisis, and health care entitlements top that list. The most obvious place to start is with Obamacare. Since its core benefits are not yet in place, it is the easiest of all the federal entitlements to change. Moreover, reforming Medicare and Medicaid will be a true sign of whether Congress and the Administration are serious about fixing our fiscal future.

Major lawsuits are moving ahead. The recent Supreme Court decision was not the only lawsuit against Obamacare. There are a number of lawsuits making their way through the federal courts. The anti-conscience mandate requiring virtually all employers to finance abortion-inducing drugs, sterilization and contraception undercuts religious freedom. Today, there are already 40 suits representing more than 100 plaintiffs against it. An Oklahoma lawsuit raises a new legal question on the employer and individual penalties. More suits will certainly follow as more of the law is exposed.

Finally, there is an excellent opportunity to beat back Obamacare by advancing a more desirable alternative. Patient-centered, market-based reforms are the best antidote to Obamacare’s top-down, government-run scheme. The Heritage Foundation’s Saving the American Dream plan offers such a path.

If the election had turned out differently, it would have been easier to repeal Obamacare. But that does not mean that Obamacare is here to stay. To the contrary, the dismantling of Obamacare has just begun. The only difference is that this dismantling will now be a more protracted and messy process.

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