The Tribune Democrat, Johnstown, PA

December 8, 2013

Difficult to repeal health care law


JOHNSTOWN — Even if Congressional Republicans can ride their “War on Obamacare” to a landslide victory in the 2014 mid-terms, they will be hard-pressed to deliver on their promise to repeal the health care law.

First, public opinion does not support the total repeal that Congressional Republicans are advocating. A recent poll by Princeton Survey Research is illustrative. Although 52 percent of respondents agreed that Obamacare is fundamentally flawed and will hurt the nation’s health care system more than help it, only 38 percent supported repeal. Remarkably, that was just slightly higher than the 36 percent who supported repeal in Princeton’s July 2013 poll – well before the malfunctioning website and insurance cancellations sank President Obama’s credibility and job approval.

A recent CNN poll showed similar results. Although 58 percent of respondents opposed Obamacare, only 41 percent agreed with Congressional Republicans that the law is too liberal. In contrast, 14 percent opposed the law because it is not liberal enough. That means that about 54 percent of respondents either supported Obamacare or thought it should be made more liberal.

Second, even if the Republicans win a majority in both the House and Senate next November, Obama will be in office until Jan. 20, 2017. Although victorious Republicans may be able to muscle an outright repeal through both houses in 2015 or 2016, Obama will veto it. To uphold that veto, Senate Democrats will need only 34 votes, which is well below the 40-some senators they are almost certain to have even if the 2014 election is a Republican landslide.

The election of a Republican president and a Republican Congress in 2016 will not make outright repeal much easier. Even if enrollment

falls far short of the target by the time Obama leaves office, the law will have delivered benefits to millions of Americans who otherwise could not have afforded health insurance or who would have been denied coverage because of pre-existing conditions. Therefore, rather than

being empowered by a 2016 victory to end Obamacare completely, Republicans will be under political pressure to continue coverage for those who have been helped by the law.

The GOP has been masterful in focusing the attention of the public and the news media on every controversial provision in Obamacare and on every stumble in the law’s implementation. However, instead of proposing a realistic alternative, Congressional Republicans appear content to return to the health care system that existed prior to Obamacare. Under that system, about 15 percent of Americans had no health insurance. Furthermore, according to the Kaiser Family Foundation, the U.S. was spending much more per capita on health care than other developed countries but was not enjoying significantly better results.

Even before the enactment of Obamacare, Americans knew that the health care system needed to change. For example, nearly 40 percent of the respondents to a 2009 survey by the Deloitte Center for Health Solutions gave the pre-Obamacare system a grade of D or F; about 10 percent of the respondents had skipped getting care for an illness or injury because they were not covered by insurance, could not afford the care, or thought that the care cost too much. Furthermore, according to a study for the American Journal of Medicine, about 62 percent of the bankruptcy filers in 2007 cited the inability to pay medical-related debts or the loss of income because of an illness or injury as the reason for their filing. Significantly, 57 percent of the respondents to a 2009 CBS/New York Times poll were willing to pay higher taxes so that all Americans could have health insurance.

Nevertheless, Congressional Republicans have opposed extending taxpayer-funded health care to all Americans below the poverty line and have opposed government subsidies to bring premiums for individual policies within the price range of those Americans who do not have group insurance through their employers. In taking that position, Republicans are ignoring the pre-Obamacare subsidies to employer-provided health insurance.

With limited exceptions, taxpayers pay more than 70 percent of the cost of health care for federal employees, including members of Congress. Taxpayers also subsidize the health insurance provided by private sector employers. Not only can businesses reduce their federal taxes by deducting the employers’ share of the premiums from their profits, but their employees pay no federal taxes on the value of the employers’ contribution. The net effect is to inflate the federal deficit and create debt that all taxpayers (including those who could not afford insurance without Obamacare) will eventually have to repay.

Despite the Republicans’ rhetoric, turning back the clock is not the solution.

William Lloyd of Somerset represented Somerset County in the state House of Representatives (1981-1998) and served as the state’s Small Business Advocate (November 2003-October 2011). He writes a monthly column for The Tribune-Democrat.