The Republicans have taken over the House of Representatives.
Good. Fine. Way better than the alternative.
Here’s the first step they must take, if they’re serious about not acting like the sometimes-corrupt, sometimes-perverse, sometimes-cowardly, self-serving Washington-insider unprincipled useless lumps of flesh they were in the later Bush years.
(With, y’know, the human dignity of that every sinner has. Not denying them that.)
The first step they ought to take is…
WELL, ACTUALLY, the first step would be for any Republicans who aren’t freshmen to get together and issue a joint apology for having been sometimes-corrupt, sometimes-perverse, sometimes-cowardly, self-serving Washington-insider unprincipled useless lumps of flesh during their last turn at bat.
BUT AFTER THAT, the next step is to obliterate beyond human recall those provisions in ObamaCare which are…
(b.) destructive of private market choices, consumer empowerment, and medical-field entrepreneurship; or,
(c.) provide funding and assistance for abortion, euthanasia, gender reassignment surgery, sterilization, and the like,
….as quickly as they possibly can.
HOW TO DO IT…
Unfortunately the Republicans cannot repeal the ObamaCare bill (the ACA) until after they win the Senate and Presidency in 2012, if that even happens. (Granted, had 2012’s Presidential and Senate votes been held Tuesday, Obama would have lost to nearly any warm body, and the Senate would have been easily tipped to GOP control. But those races don’t happen for another two years, and a lot can change in two years.)
Anyway, repeal is every bit as much the passage of a bill as the original monstrosity was. In the U.S., that requires passage in the House and the Senate, and the President’s signature, or else an override of the President’s veto. The GOP has none of that, except the House part, and not enough of the House to override a veto.
So there’ll be no repeal any time soon; control of the House is simply not enough. (I suppose the Republicans could somehow just sort of “deem” it repealed, but let’s hope no elected official of either party would be quite that contemptuous of the process. *cough, cough*)
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. In addition, section 1005 of the ACA 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 ACA.
The ACA appropriated nothing for the Internal Revenue Service, which must collect the information needed to compute subsidies and pay them. The ACA 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.
If ACA 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 ACA 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 ACA provides funds for the DHHS to make grants to the states to set up those exchanges.
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.
The above material is from a piece (warning: it’s a PDF link) in the New England Journal of Medicine titled, “The Midterm Elections – High Stakes for Health Policy” by Henry J. Aaron, Ph.D., who actually favored the ACA (!), but has done the world a service despite himself in spelling the matter out so clearly.
Let’s hope that the new crop of GOP are both humbler and stiffer-in-the-spine than the last crop, and do as they ought.
THE RELEVANT PHRASE
It’d be nice, of course, to get more care (not necessarily insurance coverage) into the hands of more people more efficiently. In fact, if it can be done without incurring secondary consequences which are worse than the existing problem, then it becomes morally obligatory.
But of course ObamaCare (the ACA) is worse than the status quo, and in many ways runs in the opposite direction of a good solution to the existing problems.
Hence the moral obligation to gut the thing, and quickly.
After that, if policies can be found which represent improvements over the status quo, wonderful! …but first, do no harm.
(Now where have I heard that phrase, before? Hmm.)