Repealing Obamacare is necessary to preserve individual liberty, maintain limited government, improve health care, and restore economic growth. Prospects for doing so hinge on a half-dozen key battle fronts, and success thereafter hinges on several, if not all, of them.
Legal: The Supreme Court could overturn the entire Affordable Care Act later this year as unconstitutional. That’s possible, but not likely. But even a partial victory — simply nullifying the individual mandate — would unravel the political glue that holds this unwieldy and unworkable law together. Congress would have to fix or replace whatever remained.
Political: It will take a new president to sign any law to repeal Obamacare, let alone replace it with better health policy. This November’s elections also will determine whether Obamacare opponents regain working control of the Senate.
Legislative: Fully repealing the entire health-care law would require 60 votes in the Senate. But a budget-reconciliation measure could remove its essential features (“debone it”) with only a narrow majority in both houses of Congress.
Administrative: Obamacare’s complex wiring for implementation could short-circuit on its own and threaten to crash most of the health-care system. Many states are refusing to submit to federal command and control. Imaginary structures and lab experiments (health exchanges, real-time income information, Washington-created “innovations”) won’t be ready for prime time. By necessity, we will have to build something else that is effective, cheaper, and sustainable.
More appealing alternatives: The time to fill in a “replace” agenda is long overdue. Good ideas exist, but they need to move from the imaginary to the practical stage and hang together as a whole.
Timing: Repeal-and-replace needs to happen before new subsidy dollars under Obamacare start flowing to millions of Americans in 2014. Our future health and prosperity can’t afford further doses of toxic medicine for another four years.
Thomas P. Miller is resident fellow at the American Enterprise Institute.