Health Care

Defund “Obamacare”? Not as Easy as it Sounds

By Kate Pickert | @katepickert | October 19, 2010 | +

Two Republicans who have provided some intellectual leadership for the GOP have signaled in recent days that “defunding” the Affordable Care Act may sound good on the surface, but won’t really work in practice.

On Friday, the American Spectator published an interview with Rep. Paul Ryan, in which the GOP ranking member on the House budget committee said of President Obama:

I get this question every single day, ‘If you take back Congress, you have the power of the purse, just defund the thing.’ Well, yeah, technically speaking, we can put riders in appropriations bills that say, ‘No such funds can go to HHS to do x, y, or z in implementing ObamaCare.’ He’s gotta sign those things. And he doesn’t strike me as the kind of person who would sign those things.

Then last night on Fox Business, Sen. Judd Gregg, who’s retiring from the Senate, told Neil Cavuto, “I don’t think starving or repealing is probably the best approach here.” (h/t The Hill)

Gregg said that he believes Republicans instead need to “go in and restructure” the Affordable Care Act. Yet the kind of structural changes Gregg goes on to suggest – like rerouting Medicare savings, for instance – also seem unlikely while Obama is in the White House.

Still, that Ryan and Gregg are offering some counterpoint to GOP pure calls for “repeal and replace” means that under the campaign rhetoric of 2010 lies some doubt about the viability of at least one line from the party’s Pledge to America:

Repeal the Costly Health Care Takeover of 2010

Because the new health care law kills jobs, raises taxes, and increases the cost of health care, we will immediately take action to repeal this law.

Take action, maybe. But actually repeal the Affordable Care Act, not anytime soon.

Related Topics: affordable care act, judd gregg, paul ryan, Health Care, Uncategorized

  • Latest on Swampland

    2012 Election May 25, 2012

    The Phony War: Obama and Romney Are Debating Character, Not Policy

    More than five months from Election Day, the back-and-forth about Mitt Romney’s record at Bain already feels played out. Unfortunately, there’s good reason to expect the campaign continues in this vein indefinitely. Neither Barack Obama nor Mitt Romney are terribly interested in dwelling on policy platforms. Romney’s plan to slash spending and keep taxes low on the wealthy isn’t especially popular, at least not at any level of detail beyond a blithe promise to shrink the deficit. Meanwhile, Obama’s signature first-term achievements, like health care, the stimulus and Wall Street reform, are all unpopular or tricky to sell. (The Dodd-Frank bill is the most popular of these, but hyping it means offending wealthy donors.) So what we’re getting instead is a superficial duel about character–and, worse, one that’s based on the largely false premise that the better man can better “manage” the economy back to health.

    From our Partners

    Obama Administration Blocks Global Health Fund To Fight Disease In Developing NationsHuffPost Politics

    Barack Obama May 25, 2012

    Audacity of Dope: Tales of a Toking Teenage Obama

    We knew Barack Obama smoked weed in high school because he wrote about it in his books. What we didn’t know, until Buzzfeed posted these choice nuggets (I’m so sorry) from David Maraniss’s new book on the President’s younger years, were the giggle-worthy details of his “Choom Gang” lifestyle, which are right out of a buddy stoner flick. Obama and his friends drove around the lush Hawaii countryside, hot-boxing their VW bus and re-upping with a long-haired pizza-tossing dealer named Ray, whom Obama thanked in his yearbook “for all the good times.”

  • http://derekg.wordpress.com/ Derek

    If you think the Left is disappointed wait until the Tea Party sees all their candidates back tracking on their promises, once they get into power.

  • Paul-no not that one

    That is *if* they backtrack.
    .
    Either way, when things aren’t changed overnight the TPers are not going to be happy.
    .
    And the unelected (Palin, Romney, etc) will be there to fan the flames.

  • http://erieangel.wordpress.com erieangel

    There is no evidence the ACA kills jobs. As for increasing premiums–well, my premiums have been going up every year anyway. If somebody who doesn’t currently have insurance can now get it because I pay a little bit more, then that’s a just and moral thing. This goes for the claim of higher taxes as well. Insuring everybody is going to cost a lot, at least in the short term.

  • sasquatch08

    Ok, here’s the thing, which I said from day one. This plan is poorly thought out and a disaster, unless you’re trying to back-door your way past the public to socialized medicine.
    .
    First off, it was supposed to bend the cost curve down, but it doesn’t. Aetna, Blue Cross/Blue Shield, Regents and others are all hiking rates now because they can’t after November 1. Many companies are cutting services or getting out of the market because they can’t afford it. Harvard Pilgrim Health Care is stopping all Medicare Advantage services at the end of the year, effectively screwing over 22,000 seniors. At the same time Principle Insurance of Iowa is abandoning the market, leaving 840,000+ people with no insurance.
    .
    Doesn’t kill jobs? Yeah right! Even if I was on acid I’d know that was BS. AT&T reported that gearing up to comply with HCR cost them $1 Billion dollars in the first quarter of 2010 alone, Prudential Financial reported $100 Million for the same quarter. How many people could have gotten a years salary with that $1.1 Billion? And that’s just in one fiscal quarter! Meanwhile Verizon says they’ve spend $970 million so far in trying to comply.
    .
    Then just this morning Boeing announced that it’s seriously hiking the costs of health care for 90,000 workers by almost $1000 per year, and cutting benefits for another 30,000. Because I mean honestly, those fatcats working the assembly line couldn’t possibly use an extra grand for their family, while we’re at it let’s increase their taxes.
    .
    This isn’t paying a little more, it’s paying one heck of a lot. Money we can’t afford. Gallup (right wing shill’s I know) says they practically guarantee from their research that the Dept. of Labor will be forced on November 5th to announce that unemployment has risen to 9.9-10.1%, with real unemployment approaching 19%.
    .
    And the plans that do work are ending. Whole Foods provides better than average health coverage to all it’s workers (tens of thousands of them) using regular insurance practices coupled with wellness programs and Health Savings Accounts. Cost per year? About $6000 per worker, or 1/3rd the average. However as of next year that plan becomes illegal!
    .
    So the guy giving better insurance coverage to his employee’s at lower cost by being creative is a criminal next year while everyone else pushes employee’s to pay more (unless their carrier gets out of the business of health insurance all together) or drops them on the government system so the rest of us can pay for them? That makes total and complete sense… if you’re a retarded chimpanzee with head trauma.
    .
    This whole thing might be funny if it wasn’t true, and truly screwing us.

  • http://forgottenlord.livejournal.com forgottenlord

    They bring up the bill to repeal it, get it vetoed, fail the override and then go back to this. As a bonus, they get to blame Obama.
    .
    Only trick: getting it through the a Democrat controlled Senate. If the Republicans controlled the Senate, the Democrats might actually want to let it go through just so Obama can veto it and say “I’m protecting your health care from Republican plans to let your insurance deny you coverage”. In other words, politics for the sake of politics that is a win-win for both sides.

  • Paul-no not that one

    No excuses. Either you do the job or you don’t.
    .
    The TPers don’t seem to concerned with procedure, just results.
    .
    When you get your people riled up and you don’t deliver, out you go.
    .
    Ask Speaker Newt what happens when your people don’t get what they want. They turn fast.

  • m0mentom0ri

    “The TPers don’t seem to concerned with procedure, just results.”
    .
    I’m not sure that’s accurate. The only results they want right now is to stop the ‘socialism’. They’re a movement that’s defined by what they don’t want, not by what they want. All an elected Tea Party politician has do is say “I’ve stopped the March towards Marxism!”, and they’ll be lauded by the Tea Partiers as successful. Until the Tea Party has a platform that isn’t exclusively “Stop ‘X’ from happening” it’ll be an easy crowd to appease with simple-minded populous rhetoric.

  • http://forgottenlord.livejournal.com forgottenlord

    On the other hand, health care costs go up faster than inflation, or at least have been over the last decade. The imposed limit would make it so that long term inflation on health care costs shouldn’t be an issue. The abuse of companies to exploit the loopholes are a failure to address loopholes and properly prevent them rather than a failure to meet the demands required. Though in this case, I think it would’ve been impossible to address.
    .
    At some point, there is going to be a health care crisis with or without the ACA. Ok, there is a health care crisis, but it’s not seen as important because what’s 45 million people in a country of 300 million. The health care industry is rising, IIRC, at somewhere in the range of 6%/year. This is unsustainable but there is no evidence that it’s slowing down or going to slow down. Eventually, either the health care industry has to slow down its rate of growth or the system collapses completely, but since this is an industry where it is incredibly difficult to say “no” especially considering emotional states when the decision must be made, there is a very good chance that it’ll be the system that collapses first. There’s a projection that says without considerable reform (and even with ACA taken into account) and assuming the tax levels are maintained to pre-Bush Tax Cuts level, in 40 years, health care spending for Medicare and Medicaid will match the ENTIRE tax revenue for the government.
    .
    Considering that the system will likely have to collapse for a significant overhaul to be possible, I’d like that collapse to occur before Medicare and Medicaid bankrupt the government and instead have it collapse when Americans end up taking the tax over the insurance because no insurance can afford hospital costs thereby forcing hospitals and suppliers to find ways to bring costs down.

  • 53_3

    They could try to defund the HCR, but I think chaos would result. Health care represents 1/6th of the economy, and the consequences are so convoluted that I don’t think anyone can safely say that what they think is any more than an opinion. It is uncharted territory.
    .
    On the other hand, the “It was all a mistake in the first place so why not?” crowd offer a plethora of scenarios that, in truth, were already happening anyway, and were the reason behind the attempt to reform health care in the first place.
    .
    So, yes, I’m not happy with HCR, but it is better than nothing, which is what the GOPers really want, anyway.
    .
    So, I ask myself this:
    Which am I more afraid of?
    1. The things that the GOPers serve up to scare me, or
    2. The things that would have happened anyway if the GOPers had had their way in the first place?
    .
    To me, choice #1 is only their opinion, and some events would have happened anyway if HCR wasn’t done. The events that choice #2 refers to were certain to occur.
    .
    I’ll go with door number two…

  • http://forgottenlord.livejournal.com forgottenlord

    See, that’s the thing. If the Republicans can say they honestly tried but Obama blocked them, they can continue to blame Obama going into 2012.
    .
    In fact, it might be beneficial to them to not even bother trying to restructure, just keep bashing away at repeals through an entire election cycle

  • http://derekg.wordpress.com/ Derek

    Everything I’m reading suggest the Republicans plan to be constructive, if they take over, to try and prove to people that they are more than just obstructionists. If so, that means pieces of legislation will need to be passed and that will only happen if they compromise with Democrats. That act alone will be enough to outrage the Tea Party, who are already trembling with anger. It will also mean they will become part of the government and be responsible for it. If the economy is still a mess in two years I fail to see how Palin or Romney will be able to pretend they have nothing to do with it, like they try to do now.

  • stuartzechman

    That’s a really great point, Derek.

  • mfbattle

    I think you should go to the comment pages of the article in American Spectator that Kate refers to. The TPers there will not be happy with the GOP if HCR is not gone by the end of 2011. Some of them actually argue that they could override a presidential veto to repeal HCR! So procedural arguments are not going to work. If I were a GOPer I would be praying that the GOP does NOT take over the House and Senate, because then I would have to get the TPers on board and do something, and with the likes of Miller, Paul, and Angle that might not be possible. Much better to have the Democrats bogged down in inaction.

  • shepherdwong

    C’mon kids. Professional Republicans have been lying to their base to get elected for years. They know they’d be thrown into the political wilderness forever if they actually kowtowed to the mouth-breathers and did things like outlaw abortion or cutting Social Security (at least without big-time Democratic cover). At the end of the day, all the base cares about anyway is beating Democrats. After the naked destruction the country and the Constitution took at the hands of Republicans from 2000 – 2006, no one who seriously cared about the things the Teatards claim to hold dear would ever consider voting Republican again. It’s a party of authoritarian-following idiots and fools, being led by professional liars and traitors.

  • mfbattle

    shepherdwong,

    While I think you are right about the GOP in the past, I think their problem is now that they may elect members who actually believe what they say. Look at KY where McConnell has ran year in year out on the pork he brings home, and supported the same type of GOPer in the primary, but now has to face Rand Paul as his fellow senator! This is going to mean problems for them, because Angle and Paul really are crazy, not just playing crazy for votes.

  • bobell

    forgottenlord (1.5) — Obama and the Demos can say with complete accuracy that the great majority of their legislative efforts were thwarted by a minority of Republicans in the Senate. In fact, every now and then one of them does say it. No one cares. The left’s indictment of Obama is that he didn’t get done what he said he’d get done. Don’t confuse them with details like filibusters.
    .
    The Tea Partiers in the Senate probably will be part of a minority party, and it’s impossible for them to become filibuster proof. The same thing will happen to them as happened to the Demos this time around. (They might break loose a few Demos on some points, but they’ll never get to 60.) And when they try to blame the filibuster, they’ll get the same reaction from their RW base and the Demos have gotten from their LW base.

    I predict the TP base will be turning on the TP office holders as soon as February next year.

  • shepherdwong

    “This is going to mean problems for them, because Angle and Paul really are crazy, not just playing crazy for votes.”
    .
    Let’s see who gets elected first but, obviously, establishment Republicans are not happy about having to deal with yahoos who don’t understand the game. My guess is that any elected Teatards will be brought up to speed and conform to the scam in pretty short order once things are explained to them. What really should concern them is the radicalized base. If their Frankenstein’s monster were to ever get wise to the fraud being perpetrated on them by Republican leaders, they might even forget how much they hate Democrats…long enough to kick some Republican establishment @ss at least.

  • http://gum0nshoe.wordpress.com gumOnShoe

    Your whole foods example comes from a WSJ article that talks about how they use wellness accounts & high deductible plans to help cover their employees who work more than 30 hours a week.
    ↓
    I’m sure if you read between the lines, find something missing there. For instance:
    ↓
    • employees who work less than 30 and are forced into the individual market
    ↓
    • It says they’ll pay up to a certain amount using the accounts, but doesn’t talk about how often deposits are made, how much those deposits are, or how any of that is decided. Maybe it is a reasonable amount of money over time, and I’ll admit it sounds great that they get to keep the money over time, but I’m left wondering what happens to a new employee who hasn’t had time to build up that account if they get devastatingly ill. Looks to me like they are on the hook for 2000+ because of the high deductible.
    ↓
    • Speaking of high deductible’s you could barely call these insurance plans. And, even after they start paying, it was often only up to a certain amount of money. On average, people would rarely see any money come out of these while the company paid $6000 per employee, admitted by the article writer, per year.
    ↓
    • As for satisfaction. That number probably only comes from people who were eligible, something that isn’t specified, and for people who opted in. In many circumstances people who work in places like that don’t know the programs exist or miss enrollment deadlines. This is from personal anecdotal experience, but I’d love to see some numbers on how many employees actually use those programs, and what their health was for the year.

  • m0mentom0ri

    Both Angle and Paul are smart enough to run to the middle in the general election, or at the very least, soften some of their more overt libertarian leanings. They’ll be smart enough to do the same to get reelected as an incumbent (assuming they win). The hardcore nutbars, like O’Donnell, won’t win.
    .
    “Everything I’m reading suggest the Republicans plan to be constructive”
    .
    Suuuuure, they say that now. One year from now they’ll be blaming Democrats for not working with them to pass the “Social Security Privatization Act” and accusing Dems of bad faith for filibustering a Constitutional amendment banning gay marriage. All the while, the Tea Party lauds them for giving it the ol’ college try. “And it would’ve worked if it wasn’t for those treacherous Dems!”
    .
    Are our memories that short? How is the next Republican majority going to be any different than previous Republican majorities? When the GOP is the majority party, they blame the Dems for not working with them.When the Dem’s are the majority, the GOP blames the Dems for not including them in negotiations. This time will be no different.

  • http://forgottenlord.livejournal.com forgottenlord

    bobell: They aren’t filibustering. That’s the problem. A filibuster, a real filibuster, becomes headline news. If they sit in the chamber rambling on for hours, if they have the sergeant of arms validate that people are in the chamber, and they continue sitting there for 2, 3, 5 days, everyone knows about it. When Nelson says “I’m not going to vote for it until I get this” and it said to be joining the filibuster, the average voter doesn’t give a rats ass – they can’t tell that there’s a difference.
    .
    Compare that to a veto. A threat to veto – who cares. A pocket veto, who cares. An actual veto, with the stamp and signature of the President saying “I have no intention of signing this” makes the headlines.

  • http://derekg.wordpress.com/ Derek

    m0mentom0ri my read is they plan to be constructive at first, to reestablish their credibility, before they go b@t sh@t crazy. They must be smart enough to realize they are the beneficiaries of anger and a bad economy and that there isn’t any great love for Republicans in the land. At least that is what the polls are saying.

  • mfbattle

    Angle and Paul are running to the middle? What they are doing is not saying anything, but they are still mad – Angle’s new attacks on Canada is not the middle.
    .
    The real problem for the GOP is now you have a way to beat an incumbent, and everyone knows it. Bennett and Murkowski were hardly moderates, and they got beat. McCain knew it and moved to the right, and the rest of them up in 2012 know it as well, so no working with the Democrats.

  • sacredh

    I think the Tea Party candidates that do get elected are going to expect the republicans not up for re-election this year to go along with them and seniority be damned. The republican party has already purged most of the moderates in the party. The Tea Party winners could very well be looking at the average right wingers as moderates. RINOs and DINOs could soon have some company, those regarded as TPINO. I can’t see the TeaBaggers going along with the establishment republicans. If one side doesn’t give in, I think it’s still possible the party will split.

  • earljr1

    The GOP will be quite content to keep this Albatross around Obama’s neck until 2012. By then, the full ramifications of this stinker will be apparent to all and remember, Obama said he owns it. Wonderful, because this could well be his Waterloo! The insurance companies and pharmaceutical industries, in all of their greed, will make HCR untenable and highly unpopular (especially with our senior citizens) More doctors will stop seeing medicare patients and all of those “good points”? designed to help the mid term elections, will prove to be fraudulent when the buying public sees the sticker price on adding your children, or, you cannot be turned down because of existing conditions. Yes, indeed, this is NOT the panacea democrats envisioned….it is something quite different.

  • http://derekg.wordpress.com/ Derek

    The Tea Party reps. will have no choice but to conform to DC. It will be demanded by the tradition of both parties. They will be hounded by the media, to be “centrist.” Most of the people in the media won’t understand why they will hound them to be that way, but they will do it anyway.
    .
    Yes get ready for a whole whack of compromising to take place.
    .
    I hope the Tea Party will be able to handle it.

  • sasquatch08

    @Forgottenlord
    .
    It’s true that health care costs rise faster than inflation, but unlike higher education there are some easily identifiable reasons for this. I’m sure that there is some exploitation by unscrupulous companies but you’ll never get rid of that in business or government. On the other hand there are quite a number of other reasons that medical care costs so much: one of them is the fact that no matter what you get in medical care, be it drugs, a consult with a physician, tests, or something involving a scan or other medical technology there is a massive, massive liability cost built into them.
    .
    Liability insurance in this country is insanely expensive be it medical, home, car or whatever. Lawyers make millions suing people who acted in good faith. On top of that, due to the liability costs, new technology or new drugs are also insanely expensive. It costs almost $1 billion to get a drug through stage 3 clinical testing and even after that just because some small fraction of people have an adverse reaction or abuse the product lawsuits are in the tens of billions if not the hundreds. Just watch the news, you can’t get though a single set of commercials without seeing an ad for 1-800 BAD DRUG urging you to sue someone for trying to help you.
    .
    On top of that, medical billing technology has not kept up with medical technology or technology in general. The hospital here has a small army of people to push paper for insurance/Medicare/Medicaid claims, when 2-5 people with computers could do all that work, and forms could be standardized. But I digress. I posted a very long section on here months ago with 9 ways to drastically cut the cost of medicine and hence insurance, hence covering most of the uncovered now and reducing cost to government, and I won’t bore you with a rehash of that.
    .
    Ultimately the system needs to be meaningfully reformed, not “reformed” with carve-outs for unions (equal protection clause anyone?) in such a way that appears specifically designed to destroy one of the best medical systems in the world. Medicare and Medicaid need serious reform, proposals from both sides have been floated that if the best parts of each were taken would be an excellent step forward, but then AARP, ultra-liberals and the neocons scare the bejezus out of people with outrageous claims that they’re taking away your medical services and you’re going to die!
    .
    “Considering that the system will likely have to collapse for a significant overhaul to be possible”
    Not to accuse you of anything here, but you do know who Saul D. Alinsky was right? Because this suggestion is straight out of Rules for Radicals.
    I agree that there are problems that need fixing in the HC department, but “single payer” or “universal health care” are just code words for socialism, which as Europe is finding out, and has been for the last decade, works poorly at best and rapidly becomes unsustainable financially.

  • http://forgottenlord.livejournal.com forgottenlord

    First of all, before I even begin to address the thousands of other points listed, the American system is not the best in the world by any measurable standard. The medical system’s per capita costs are double the next nearest nation but the life expectancy of Americans rests near the bottom of the list amongst industrialized nations. I accept that there are those who got treatment in the US that they couldn’t have gotten in other nations, but the reverse is also true and every system will have those it screws and those that it benefits. I don’t want to get too distracted by this, but I would ask that you not try to make that sort of argument – I’m Canadian and we spend half our life explaining to everyone how our systems/society/ideas are better than the American systems/society/ideas so calling it the best system in the world will never convince me anymore than I could convince you that the Canadian system is better simply because I think it is.
    .
    Anyways, onto other issues: while I do agree that liability issues do need to be addressed, I do not agree that this is a significant health care cost savings. Most official estimates I’ve seen have suggested the benefit to health care costs would be under 1% of the total cost (normally in the 0.5% range) and I’ve never seen that disputed with anything other than emotive arguments. Honestly, I don’t believe those numbers because I think it might be feeding into one of the biggest cost escalators: the tendency for doctors to over test patients which I suspect is done in part to cover their own asses which I similarly expect was not calculated into that resulting value. However, I have a hard time believing that liability insurance or, for that matter, costs from lawsuits are escalating at 6% per year so I have a hard time buying that one.
    .
    Second, I really cannot stand your inflated numbers on costs of drugs. Back in 2000, the Pharmaceutical industry said the cost to produce a new drug was about $800 million. Statistical analysis done in 2002 comparing R&D costs for all of the industry and comparing it to the number of drugs approved over a 20 year time line determined that in 2000, it was in the range of 900 million but this was after a rapid (as in 5 fold) escalation in drug costs over that time frame – I mention that because it may mean that there were more drugs in the 10 year pipeline in 2000 than there were in 1980 and the analysis had the cost per drug increasing 3 fold over the same time period. Not that it matters. 10s of billions to get to market means that their R&D costs would have to go up 10 fold while the number of drugs approved would have to maintain pace – the latter might be true, but I highly, highly doubt the former. Hundreds of billions is just plain absurd.
    .
    The liability costs associated with these drugs, however, would probably still be measured in 10s of millions. I have never heard of a settlement for a billion dollars for ANYTHING. That’s high enough for you to put out ads for it, that’s not high enough to impact your bottom line compared to the cost of development. Either way, I think these companies need to be subsidized more heavily so the costs of research and testing can be brought down significantly – a failed drug in the final stages or a mistake on one drug could sink your company. The problem with liability caps is that severe problems stemming from the drugs, while I don’t think that should sink the company, I do think that the individuals who suffer should be entitled to reasonable compensation. But that’s a separate issue.
    .
    Billing technology needs to be more adequately developed in all countries. While I agree that it needs to be addressed and it would help deal with cost overheads, I have a hard time believing that this is part of what’s funneling into a 6% annual increase.
    .
    Finally, to address this “single payer” or “socialism” issue – Canada is not having the budgetary nightmare that is happening in *some* European countries. In fact, the Canadian government ran a budget surplus for over a decade (the longest amongst the G8) through 2008 and it’s expected to be deficit neutral again within 2 years. We have this so-called “socialized medicine”, “socialized education”, a very strong infrastructure program, a fully funded retirement program, a fully funded employment insurance program, and considerable amount of funds being provided to cities and provinces to develop their own infrastructure. And the best part? If I were living in the US, I’d be paying more in taxes. I kid you not. In the US, my income taxes would be 25%, in Canada, it’s 22% and it’s ALL deducted from my paycheck – I only get a rebate in April. In fact, I’m pretty sure we pay less at every tax bracket – even the top bracket. Figure that one out.

  • apr2563

    I agree sacred h. After all, their mentor and leader is the crazy king, Jim DeMint.

blog comments powered by Disqus