Healthcare Reform Assessed

By Author: Marcus Stalder
Total Articles: 491
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With the first of the appeal cases on the Affordable Care Act deciding the mandate is unconstitutional, the ultimate decision now rests with the Supreme Court as and when the case reaches it. Until that happens, the Act continues in force and we move on with life. Except, of course, the GOP is now going through the first steps of deciding who will stand against President Obama. Standing in the field is the Governor of Massachusetts, Mitt Romney who was responsible for shepherding his own version of healthcare reform into law. What makes his position as a GOP candidate interesting is the mandatory quality of his state's law. He's moving carefully to distinguish a statewide from a countrywide mandate. His version of the law has now covered 98% of the population but, because the law does not control costs, it has proved expensive. Even so, 67% of the population support it. Such a level of popular support makes it difficult for the GOP to completely disown the notion of a plan to give medical cover to every citizen. Indeed, it's entirely possible that the issue of Obamacare may not be the most important in the election.

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... problem for the GOP may be put simply. Unless they achieve a veto-proof majority in both legislative chambers, they cannot repeal the law if President Obama wins. To repeal the law without a supermajority, they need to win the presidential election. So far, the polls do not suggest this is likely. This makes it difficult for the campaign. If the candidates run with repeal as their main theme and the winners cannot then deliver, they lose credibility. It therefore makes better sense for the GOP to run on the issue of jobs. Unless the economy suddenly improves, unemployment could be the one issue to make life difficult for the President. That and the deficit, of course.

There's one underlying truth about Obamacare: if the economy does not pick up, there will be serious financial strains on the implementation of the Act. Now add in the deal that got the debt-ceiling raised. If the supercommittee does not come up with adequate proposals to reduce the deficit, there are automatic cuts to defense and healthcare reform. If anything happens to the budget of the Department of Health, the Act may not roll out as intended. All this means the GOP could run on the economy and the deficit, and still be in a position to see Obamacare fail simply because the deficit deal cuts the federal money available to implement it.

All this means the times we live in are likely to get ever more interesting. Health insurance and the reform of care do not sit alone. The rising cost of the premiums charged by the insurers squeezes the middle class. The need for money to implement health care reform may only be satisfied if there's agreement to raise taxes. As it stands, the health insurance market is broken. Obamacare was not a completely satisfactory way of trying to fix the problem. If the Supreme Court rules the mandate unconstitutional or the money is not available for full implementation, what will Washington do? Even if the GOP is in the majority, full repeal may not be popular unless there's a realistic plan to replace it.