The Republican’s feet need to be held to the fire to fulfill their main promise to the America people
Obamacare was signed into law in March of 2010, and every day since then the Republican rallying cry has been to repeal it. But without having control of the Senate and Congress, such a repeal remained rhetoric. Last night’s landslide victory at the polls changed all that, and the question now remains will the Republicans fulfill their promise to get rid of Obamacare?
Sen. Ted Cruz (R-Tex.) tells The Post that a GOP-dominated Senate should “pursue every means possible to repeal Obamacare.” Cruz also said the first order of business should be a series of hearings on President Obama, “looking at the abuse of power, the executive abuse, the regulatory abuse, the lawlessness that sadly has pervaded this administration.”
Sen. Rand Paul said “I’m not saying we don’t have a vote on repealing Obamacare; we should have a vote. I’m not sure how far that goes but we should have a vote on it. But I also want to pass some stuff.”
The Huffington Post today notes that another option fully on the table would be to attack key elements of Obamacare without necessarily repealing the whole package. But no matter how you look at it, Republicans have a huge Obamacare promised to keep and how they handle it will have a direct impact on how well they do in 2016.
Here are 4 ways that Democrats note Republicans could make major changes in Obamacare:
The requirement that nearly all Americans obtain some form of health coverage or face a tax penalty is the granddaddy of them all. Sure, this idea originated with the conservative Heritage Foundation back in the ’90s, but it’s the least popular part of Obamacare and is an affront to liberty in the eyes of tea party types. It also was the subject of a lawsuit that went all the way to the Supreme Court, which upheld it. Undoing the mandate would devastate the rest of the law because it would take away a big incentive for healthy people to buy insurance, leaving the companies with more costly customers and forcing them to jack up prices to unaffordable levels.
The Affordable Care Act requires all companies with at least 50 employees to offer health benefits to everyone who works at least 30 hours a week. Businesses hate it. Republicans hate it. Even some leading liberal advocates for Obamacare wouldn’t mind seeing it go. Obama himself delayed full implementation of this provision from 2014 to 2016, and scraping it would have a negligible effect on how many Americans have health insurance.
Medical Device Tax
Somehow, a 2.3 percent sales tax on medical devices like pacemakers became a cause célèbre among Republicans — and Democrats from states like Minnesota that are home to big device manufacturers. Getting rid of the tax has almost happened a few times, and 32 Democratic Senators joined all Republicans voting in favor of repealing it in March 2013. Eliminating the device tax wouldn’t change any of the major parts of Obamacare, either.
Independent Payment Advisory Board
One of the many things falsely dubbed a death panel by Republicans, the so-called IPAB was supposed to be a key tool to reduce health care costs. The 15-member, presidentially appointed and Senate-confirmed panel is tasked with issuing recommendations to cut Medicare fees to medical providers to keep the program’s spending in check. If Congress doesn’t override those plans with cuts of its own, IPAB’s become law. To Republicans, it’s tyranny. To Obamacare, so far it’s been pointless. Obama never named anyone to the board, and Medicare spending has been so low lately, they wouldn’t have had anything to do anyway.
The Affordable Care Act includes provisions designed to protect health insurance companies that get unlucky and sign up too many expensive, sick customers. Wonks call these policies the “three Rs” — reinsurance, risk corridors and risk adjustment — but Republicans call them an insurer bailout, because of course they do. (President George W. Bush had no such qualms about these things when he made them part of his Medicare prescription drug law in 2003). Doing away with this protection could destabilize Obamacare’s health insurance exchanges by forcing insurers to eat big losses, and maybe scaring them away entirely.