Should we end the Obamacare debate?

After his party's major defeat at the hands of Democrats two weeks ago, Speaker of the House John Boehner declared "Obamacare is the law of the land", prompting many to question whether the GOP leadership would abandon its efforts to repeal. This led some pundits to concede the law is "here to stay." However, doubters would do well to brush up on their history: Even if it takes many months or years to accomplish, Obamacare would not be the first misguided "law of the land" to be repealed.

Nearly twenty-five years ago, Congress enacted a plan to reform Medicare. Once seniors learned the details of this new law, many were outraged. Less than two months after the law took effect, the Chicago Tribune reported:

"Congressman Dan Rostenkowski, one of the most powerful politicians in the United States, was booed and chased down a Chicago street Thursday morning by a group of senior citizens after he refused to talk with them about federal health insurance.....Eventually, the 6-foot-4-inch Rostenkowski cut through a gas station, broke into a sprint and escaped into his car, which minutes earlier had one of the elderly protesters, Leona Kozien, draped over the hood."

"Rosty" had a reputation as a tough Chicago pol, but he got the message. Within three months of his run-in with seniors, the Medicare Catastrophic Coverage Act-which had originally passed with overwhelming bipartisan support-was repealed.

Chairman Rostenkowski's experience was small potatoes compared to the tsunami of public opposition to Obamacare. This intense opposition first boiled over in town meetings during August 2009. By March 2010, citizens were marching in the streets, and in the days leading up to the final vote, more than 100,000 people called Congress every hour to beg their representatives to vote "No."

Progressives might like to think that President Obama's victory gives him a clear mandate to implement the law as enacted, but this would be a mistake. Public opinion is almost as much against the bill today as it was when Democrats rammed Obamacare through on a strict party line vote. On the day before the bill passed, the RealClearPolitics polling average showed that opponents of the bill (50.2 percent) outnumbered supporters (39.7 percent) by more than 10 percentage points.  In the two and a half years since the law passed, more than 135 polls tracked at RealClearPolitics.com-with only one exception- have consistently shown a majority of the public favors repeal.

And that was still the case on Election Day, November 6th, 2012.  Exit polls make clear that the president won re-election in spite of continued opposition to the law, not because voters supported it. Nationally, more voters wanted to fully (25%) or partly (24%) repeal Obamacare than those who wanted to keep it as is (18%) or expand it (26%).

Likewise state-level exit polls in key swing states such as Ohio, Florida, and New Hampshire (not to mention the president's home state of Illinois!), showed that the percentage of voters favoring repeal of Obamacare outnumbered those favoring keeping the law as is or expanding it.[1]

This bill remains unpopular, because voters recognize its problems. The law is unaffordable in the context of $279 trillion in debts and unfunded liabilities already racked up by federal, state and local governments. And for a variety of technical reasons the Exchanges- bureaucracies that will redesign health insurance and deliver hundreds of billions of dollars in ObamaCare subsidies-may prove unworkableOnly 16 states have agreed to set up Exchanges, while nearly an equal number have refused to do so and many others sit on the fence. Likewise, many states also have decided not to expand Medicaid due to legitimate concerns that the federal government will lock them into the expansion and then change its mind about the generous federal funding match. [2]

Even more important is the strong moral case against the Affordable Care Act.  The bill will kill more people than it saves and worsen health care for the nation's most vulnerable citizens: the poor, disabled and elderly. It will reduce employment prospects for the least-advantaged workers, i.e., it will increase the numbers who are unemployed, underemployed, and reduce wages. It will also create an unfair playing field among workers, providing far larger subsidies for those working in small firms compared to large firms, and amplify an already-unconscionable level of intergenerational theft.

In light of these dismal outcomes, public outrage cannot and should not be casually dismissed. Republicans trounced on Tuesday are right to reexamine their party's choices, but they would be wrong to abandon efforts to repeal.

To his credit, Governor Romney ran on a platform of repealing and replacing Obamacare; he was unequivocal on this point. In a campaign where so many things went wrong, this is certainly something the Governor got right. Let us hope it does not take long for Congress to finally recognize what the people spotted years ago: this law is a huge mistake and deserves to be repealed and replaced.[3]

Footnotes 

[1] I have been unable to locate precise exit poll information for Virginia (the fourth swing state which handed the election to President Obama), but it appears that voters there were roughly evenly divided in their opinions about repeal of Obamacare.

[2] To entice states to participate, the Feds will fund 100% of expansion costs initially, dropping down to 90% matching in subsequent years. But, of course, there is nothing to stop a future Congress from changing its mind and deciding to drop the matching rates even further to traditional levels. Indeed, a federal government faced with debts and unfunded liabilities in excess of $100 trillion arguably would be quite tempted to do just that.

[3] While the election results make the path to repeal more difficult, a long view of history is warranted. After all, it took more than half a century for the Supreme Court to reverse itself on Plessy vs. Ferguson, concluding that "separate but equal" racial segregation of schools was not really equal after all. Similarly, it took 13 years for America to overturn the mistake it made in passing Prohibition in 1920.

 

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Christopher J.
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