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Did midterms doom health reform?

By Jay MacDonald ·
Friday, November 5, 2010
Posted: 10 am ET

America pivoted hard right in Tuesday's midterm elections as angry voters joined the Republican-Tea Party crusade against perceived federal socialism by the Obama administration. Health care reform rivaled unemployment as a hot-button issue with many voters. So how will Republican control of the House affect the fate of the Affordable Care Act, or ACA?

According to a recent article in the New England Journal of Medicine by Brookings Institution economic analyst Henry J. Aaron, Ph.D., health care reform is essentially caught in an abusive relationship between the Party of Yes and the Party of No. Aaron points out that, unlike the legislation that created Social Security, Medicare and Medicaid, not one Republican in Congress voted for the ACA, which leaves little hope for smooth sailing toward full implementation by 2014.

Aaron, who finds much to like about the historic health care reform, says the fatal flaw in the obstructionist viewpoint is that to enact just the insurance-market reforms (no denying or canceling coverage, lifetime benefit caps, etc.) without mandated coverage (everybody in the health insurance pool), as the Republicans have suggested, would not be economically feasible for the insurance industry. Furthermore, mandated coverage without subsidies for those who can't afford health insurance would be grossly unfair.

Republican vows to repeal the ACA will remain toothless taunts, at least through 2013, according to Aaron. That's because both houses of Congress would have to initiate such legislation, unlikely in the face of Democratic control of the Senate -- and even if they did, President Barack Obama's almost-certain veto would require two-thirds majorities of both House and Senate to override.

Of course, should Republicans unseat President Obama in 2012 and wrest control of the Senate, repeal might then become a possibility.

Aaron's deeper concern is that the ACA might suffer the death by a thousand cuts if obstructionists manage to block its funding. He notes that the health care reform contains 64 specific authorizations to spend up to $105.6 billion and 51 general authorizations to spend "such sums as are necessary" over the period between 2010 and 2019.

If obstructionists in either house of Congress hold sway and block funding, the ACA could become what Aaron terms "zombie legislation, a program that lives on but works badly," a true lose-lose-lose scenario for both parties and the nation.

"Such an outcome would trouble ACA opponents: their goal is repeal. It would trouble ACA supporters: they want the law to work. But it should terrify everyone. The strategy of consciously undermining a law that has been enacted by Congress and signed by the president might conceivably be politically fruitful in the short term, but as a style of government it is a recipe for a dysfunctional and failed republic," he writes.

What are your thoughts on the future of health care reform?

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November 10, 2010 at 4:54 pm

A majority of the American Populace (55%) wanted this legislation repealed. It's full of pork and direct bribes to states. It's Chicago style politics with no clear vision, sets up over 100 different agencies/committees, and there are reams of unintended consequences we have not experienced.

Right now the majority have exactly 2 solutions: armed revolt or legally underfunding legislation. I would humbly suggest that legally under funding it would perhaps be the least intrusive and by far the most democratic.

And to mandating coverage: I'm young and healthy and spend a great deal of time and money investing in our health. I *am* willing to buy insurance and we have over a decade. I understand the concept of risk sharing.

However, I'm already planning that at some point it will be significantly cheaper for me to drop coverage and pay the tax thanks to everything insurance will have to cover by 2014. If I drop health insurance, after 2014, my tax bill goes up by $2K automatically, which could have easily bought a gym membership (which we use)and more nutritious food.

But we don't get that choice with the money we've worked hard to earn. Because it's not "fair" to the couch potatoes. They need our money to buy their insulin, Doritos, and beer. :(

November 06, 2010 at 1:13 pm

I wish more articles like this would appear in every news source. The biggest obsticle seems to be understanding facts and addressing false rumors. I also worry about the states responsibilities setting up the exchanges. Alabama with a new, doctor, governor & 99.9% republican state gov't does not bode well. And seniors really need valid info on the Medicare cuts and rationale behind cutting the 'advantage' middle-men out of the costs. We need honest discussion.

November 05, 2010 at 1:18 pm

It is too bad the Republicans don't have anything better to do than to try to dismantle something that is long overdue in this country. I wish they would find something positive to do. They are such lying hypocrits. They talk about how horrible the deficit is, but they want to make it even larger by continuing a give away (tax cuts) to the wealthiest. This giveaway does NOT create jobs, it lines the pockets of CEOs, while they out-source jobs to other countries. I wonder if there is any hope for our country after the recent supreme court decision that gives corporations and foreign interests the power to buy our votes.

November 05, 2010 at 10:38 am

Don't be so dumb. The repubs can't block it, or even its funding, at this point. Most of the things haven't touched anyone in a positive way yet, and once the anecdotes start to flow, it will be institutionalized. Plus, the thing is crammed with repub ideas anyway. They lied about it to get the useful idiots (ie "their base") all riled up, to put down their beers, get off the couch and vote on their way to 7-11 for cheez-doodles. Last time it was immigrants, before that gay marriage, and in 1856 it was anti-Irish.