HEADLINES

Thursday, November 4, 2010

How The GOP Stops Obamacare Easily; Repealing Not An Option But De-Funding Is

 
 

Sent to you by Jay via Google Reader:

 
 

via Red White Blue News by ThePundit on 11/3/10

Senate Republican leader Mitch McConnell says he'll push to repeal the "monstrosity" called the "Affordable Care Act" (ACA) or  "Obamacare" as it's known by most Americans and if that fails he'll try to undo the law "piece by piece."

WHY REPEAL IS UNLIKELY

As the New England Journal of Medicine (NEJM) points out, Repeal of the Obamacare before 2013 is unlikely. Both houses of Congress would have to enact repeal legislation, which President Barack Obama would surely veto. Then, two thirds of both houses would have to vote to override that veto. After 2012, however, repeal could occur if Republicans win the White House and both houses of Congress and stick by their pledge.

Mark Levin points out an article written by Dr. Henry J Aaron Ph.D. in the New England Journal of Medicine (NEJM) which explains how de-funding the belly of Obamacare will stop the "monstrosity" in it's tracks. I just hope our newly elected politicians know that we Americans understand there is a path to stopping Obamacare……and we are watching.

What makes this article so Great and "on the money" is because it comes from the point of view of the NEJM and a Doctor that are Pro- Obamacare. The article from the NEJM shows you how concerned the Pro-Obamacare supporters were of a republican Tsunami of the House and closing the gap in the Senate. They KNOW Republicans can slow down and stop Obamacare and The GREAT thing is they explained how to do it coming from a Pro-Obamacare point of view. This is what we Americans need to watch for coming from our newly elected officials.

This article was written prior to the Tsunami on Nov 2nd so their worst nightmare has come true. You can see Dr. Aaron concerns as he points out in the article: "The stakes for health policy in the 2010 congressional elections are higher than they have ever been. The political parties are polarized. Policy divisions are deep. The challenges of implementing the Affordable Care Act (ACA) are enormous. The outcome of the 2010 congressional elections may well determine whether this landmark legislation succeeds or fails. Whatever the electoral outcome, the political battle over health care reform will continue into the 2012 presidential elections and probably beyond."

Dr. Aaron then lays out the groundwork on how major legislation like Obamacare needed both party's cooperation in order to pass congress and become law. He gives examples about " how a majority of both parties ended up voting for the original Social Security Act, although Republicans had campaigned actively against it. Many members of both parties voted for the legislation that created Medicare and Medicaid, that revamped welfare, and that created Medicare drug coverage (Part D). Not so in 2010. Heavy Democratic majorities but not one Republican in the House or Senate voted for the ACA."  Although current political polarization is extraordinary, it is the substantive policy differences that have raised the stakes in the 2010 election. The most urgent question is how — or even whether — the ACA will be implemented.

I was not joking when I said this article was "Pro" Obamacare. Here, Dr. Aaron will explain all the Great things about Obamacare and how it requires a lot more work to be implemented:

The ACA is nothing if not ambitious. It proposes to enroll tens of millions of people in private health insurance plans through yet-to-be-created health insurance exchanges. It will provide millions of Americans with subsidies tied to income and health insurance costs. It will greatly expand Medicaid. It will set and enforce standards for private insurance. It will expand comparative-effectiveness research and accelerate the application of health information technology. It will create a new commission to oversee Medicare. It will field experiments and pilot programs to help control spending. And this menu is but a partial listing of the provisions of the 906-page bill. If permitted to run its course, the ACA promises to transform the U.S. health care system. But successful implementation poses remarkable challenges and will require adequate funding, enormous ingenuity, and goodwill from federal and state officials, as well as cooperation from private insurers, businesses, and private citizens.2

The NEJM also points out how there can be no compromising on "just the good" parts of the bill like many Republicans are wishing for because Obamacare can NOT FUNCTION without the Mandates and Federal Funding. This is something we must all remember and keep in mind when we hear them speak of "Compromising". The NEJM also points out a major flaw in the bill that many Americans were questioning from the beginning and assumed it would be used for an excuse to on have only Government ran healthcare down the road:

"In reality, however, this promise cannot be sustained without also retaining mandatory subsidized coverage. If insurers must sign up anyone who applies for coverage, and if variation in premiums is limited, people would have a powerful incentive to wait until the onset of serious illness to buy insurance at the regulated price. Such behavior would make it financially impossible for insurers to survive. Thus, sustaining insurance-market reforms virtually forces the government to implement a requirement that people carry insurance. And to make such a mandate affordable, subsidies are necessary to avoid causing gross hardship. In brief, the pledge to keep insurance-market reforms without both mandated coverage and subsidies is untenable."

A more serious possibility is that ACA opponents could deliver on another pledge: to cut off funding for  implementation.

Here is how such a process could work: Customarily, substantive legislation "authorizes" spending, but the funds to be spent must be separately "appropriated."

The ACA 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. None of these funds will flow, however, unless Congress enacts specific appropriation bills.

JUST A FEW THINGS CONGRESS CAN DE-FUND IN ORDER TO STOP OBAMACARE

1. Section 1005 of Obamacare appropriated $1 billion to support the cost of implementation in the Department of Health and Human Services (DHHS). This sum is a small fraction of the $5 billion to $10 billion that the Congressional Budget Office estimates the federal government will require between 2010 and 2019 to implement the Obamacare.—-One appropriation if De-Funded will cause major trouble for Obamacare.
2. Obamcare appropriated nothing for the Internal Revenue Service, which must collect the information needed to compute subsidies and pay them——Opps….sucks to be you De-Fund!
3. Obamacare also provides unlimited funding for grants to states to support the creation of health insurance exchanges (section 1311). But states will also incur substantially increased administrative costs to enroll millions of newly eligible Medicaid beneficiaries. Without large additional appropriations, implementation will be crippled.——-This is an easy one. States can't afford this and the Federal Government certainly can't……De-Fund!
The NEJM then points out this great Fact: If Obamcare opponents gain a majority in either house of Congress, they could not only withhold needed appropriations but also bar the use of whatever funds are appropriated for Obamacare implementation, including the implementation of the provisions requiring individual people to buy insurance or businesses to offer it. They could bar the use of staff time for designing rules for implementation or for paying subsidies to support the purchase of insurance. They could even bar the DHHS from writing or issuing regulations or engaging in any other federal activity related to the creation of health insurance exchanges, even though the Obamcare provides funds for the DHHS to make grants to the states to set up those exchanges.

WHAT WILL HAPPEN IF CONGRESS DE-FUNDS
NEJM says that would set the stage for a high-stakes game of political "chicken." The president could veto an appropriation bill containing such language. Congress could refuse to pass appropriation bills without such language. Failure to appropriate funds would lead to a partial government shutdown. In 1994, leaders of the Republican Congress who pursued a similar tactic during the Clinton administration lost the ensuing public-relations war.
In the current environment, however, one cannot be certain how political blame — or credit — for such a governmental closure would be apportioned or which side would blink first.
RWB News Knows what side better not blink. STOP THE FUNDING THEN WE STOP THE MONSTROSITY.

swenbwr

 
 

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