The recent election was, in the view of many, a popular mandate to reverse course on Obamacare and thwart it from centralizing American health care. A full repeal should be passed in the House ASAP. But it will be stopped cold in the Senate. But that’s okay, as that will increase unpopularity of the thwarters of the popular will, setting up 2012 nicely to be an election about repeal.
But much can still be done to prevent the law from being implemented as written, illustrated by a good piece by the CATO Institute’s Michael Tanner in the New York Post. Tanner sets out a pragmatic and methodical strategy. First, use the power of investigation and oversight to highlight Obamacare’s flaws. From “What Republicans Can—and Can’t—Do About Obamacare:
At the low end of the scale, Republicans should use their new investigatory powers to hold hearings and force officials like HHS Secretary Kathleen Sebelius to testify about the law. For example, since the law passed we have learned that health care spending will go up, not down as promised, and that millions of Americans will not be able to keep the insurance they have today...In addition, President Obama’s recess appointment of British-style rationing fan Donald Berwick as head of the Medicare and Medicaid systems expires with the new Congress. If Obama reappoints him, Republicans should use his hearings to explore how ObamaCare threatens the quality of American health care and access to it.
That would be fun. Berwick can serve another year, but after that, adios unless he is confirmed. The Democrats in the Senate refused to hold a hearing. They can’t do that again unless they want to see him gone.
Next, selectively repeal unpopular parts of Obamacare that the Senate might accept, and which could put the president on the spot:
For example, Democratic senators like North Dakota’s Kent Conrad have expressed concerns that the law’s new long-term care entitlement is “a fiscal time bomb.” Several Democrats have indicated a willingness to repeal the law’s requirement that even small businesses file a 1099 tax form for every vendor that they do $600 worth of business with. Even President Obama has indicated a willingness to revisit this provision.
Defunding is a real potential given that all money bills arise in the House:
Republicans in the House now control the power of the purse. They should refuse to fund implementation of the bill. For example, the IRS says it will need to hire as many as 13,500 additional IRS agents to administer the law’s unpopular individual mandate. Congress should refuse to appropriate the money to do so. All sorts of provisions could be subject to defunding. Theoretically, the House could go so far as to forbid HHS officials from spending any time working on any aspect of the law.
Cutting off funding risks having the Democrats shut down the government in an attempt to put public pressure on the Republicans to pass a budget with the health care funding that the president wants. President Clinton used this tactic successfully against the Republican Congress in 1996. But the public, as shown by this election, is in a very different mood now. And Obama is no Bill Clinton.
Indeed, it will be much harder to support a government shutdown to require the House to spend money on a law the people do not want.
Finally, there needs to be a positive alternative:
Republicans should also start laying out their own positive alternatives. It’s not enough to simply repeal ObamaCare. Republicans will have to show that they have their own proposals for dealing with health care costs and the uninsured. They had a number of good ideas during the debate over reform, ranging from allowing the purchase of insurance across state lines to changing the tax treatment of individually owned insurance, but those ideas couldn’t get much of a hearing while the president controlled the agenda. Now they can.
Obamacare’s ultimate fate will be determined in 2012. Opponents in both chambers can set the election up nicely as a referendum on centralized government control of health care. If they do, I think Obamacare will fall.
In the meantime, I expect the courts to gut the law by overturning the individual purchase mandate, which will require a revisiting, in any event. So, one way or the other, I think the law will be dramatically revised before it ever takes effect.
