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February 10, 2011

Repealing the big cost-drivers of ObamaCare

Joseph Smith
"Liberals might be starting to panic" as support for ObamaCare "melts away," writes Jennifer Rubin for the Washington Post. 

Democrat fence-sitters such as Sen. Joe Manchin (D-WV) are scrambling to find a way out of the individual mandate, which Manchin acknowledges is the "lynchpin."

As Rubin points out, however, Republicans are not about to vote to replace the mandate just to save the bill, leaving Senate Democrats two unpalatable choices: repeal or defend their bill.

Opening a new front this week, Governor Mitch Daniels of Indiana sent a letter, signed by 21 Republican governors, to HHS Secretary Sebelius, requesting major revisions regarding the exchanges and Medicaid, opening with

...we believe the system proposed by the PPACA is seriously flawed, favors dependency over personal responsibility, and will ultimately destroy the private insurance market. Because of this, we do not wish to be the federal government's agents in this policy in its present form.

In a Wall Street Journal op-ed Gov. Daniels gets right to the point:

Unless you're in favor of a fully nationalized health-care system, the president's health-care reform law is a massive mistake. It will amplify all the big drivers of overconsumption and excessive pricing...


All claims made for it were false. It will add trillions to the federal deficit. It will lead to a de facto government takeover of health care faster than most people realize...

Not to be outdone by the opposition, HHS Secretary Sebelius has penned her own defense today of how the so-called Affordable Care Act "empowers the states."

In her piece Ms. Sebelius dismisses the effect of Medicaid expansion on the states:

...nonpartisan experts suggest that states will save money overall

The governors may disagree here with Secretary Sebelius.  Daniels goes on to note in his op-ed that Indiana alone faces Medicaid cost increases of $2.6-3.0 billion over the next ten years.

ObamaCare increases the eligibility for Medicaid in all states to 138 percent of the poverty level.  While some of the more liberal states are currently close to or above that level, many states outside of the Northeast are now at less than half that level, and would see large increases in enrollment and costs.

The Heritage Foundation, noting the severe budget pressures facing the states, cites studies finding that state administrative and benefit costs for Medicaid expansion would increase by $33 billion for the 2014-2020 period.

Heritage also notes estimates done by the states, including Texas at $27 billion for ten years and Florida at $5.2 billion for 2013-2019, among others.

Karl Rove's Wall Street Journal column this week focuses on repealing ObamaCare's "big-cost-drivers," such as the Medicaid expansion, through reconciliation, assuming the Republicans can pick up four more Senate seats in 2012. 

Rove notes that "even Democratic governors in swing states are critical of ObamaCare's Medicaid expansion," and makes the case that budget reconciliation rules could enable a simple majority in the Senate to knock out the biggest spending items in the bill:

Democrats harp on the 60-vote threshold and ignore the reconciliation option because they want Americans to accept the inevitability of ObamaCare. But its roots are clearly in shallow soil.

Of course, a 51-vote Senate strategy would also require a Republican president who would sign a reconciliation bill. All of which means that ObamaCare will be a central issue in the 2012 election. The president may not want to "re-litigate" ObamaCare, but Republicans-and a majority of Americans-do.

There is a will and there may be a way...

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