Who Really Wants To Repeal Obamacare

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It’s 2015 and the Republicans have a majority in both the U.S. House of Representatives and the Senate. And I, like a lot of people, want to know what they plan to do to the Affordable Care Act (aka Obamacare). Will they try to repeal it? Will they chip away at it by revoking components they especially do not like? Will they sit back and wait for the Supreme Court to gut the law by eliminating most of the subsidies? Will they pass their own version of Obamacare? Or, and it’s a big or, will they just leave it alone.

Well, we don’t have to wait and see what the new majority will do, they are already doing it. Senate Majority Leader Mitch McConnell and House Speaker John Boehner are going the chip away route. The House recently passed legislation to change the law’s 30-hour workweek threshold to 40-hours. A few other provisions of the bill the Republican leadership plan to change include elimination of the employer and individual mandates. They also want to ditch the medical device tax and the Independent Payment Advisory Board (IPAB).

But how will the newly elected majority’s constituents react to this approach of eliminating only parts of Obamacare. Will that be enough to satisfy their multi-year thirst for absolute repeal of the law? Probably. Survey after survey has shown that while self-identified Republicans and conservatives claim to want to repeal Obamacare they do like some of its provisions. Components of the law they like include covering adult dependents on their parents’ health plan up to age 26 and preventing insurers from denying coverage due to a preexisting condition.

So it seems as if Republican and conservatives finally agree that total repeal of the law is not necessary and that all it needs are a few tweaks. Or do they? They don’t. There is a small group of unelected conservatives who want nothing short of total repeal and replacement of Obamacare. This group of conservative intellectuals is counting on the Supreme Court gutting the law by invalidating the use of subsidies in states using the federal exchange. Obamacare adversaries like Michael Cannon, Director of Health Policy Studies at the Cato Institute, advise using this decision as leverage to force total repeal of the law. They lament that Congress is not heeding their advice.

Another one of these “regretters” is the 2017 Project. This group, headed by Jeffrey H. Anderson, is committed to many conservative reforms, one of which is total repeal of Obamacare. The 2017 Project has a healthcare reform plan that it touts as a better alternative to Obamacare and it wants elected Republicans to use it. To date I only know of one nationally known Republican who took them up on their offer and his bid for the Senate failed. Last year, Republican Senate hopeful Ed Gillespie (Virginia) included the 2017 Project’s health care reform plan in his campaign. Side thought: I wonder if elected, he would object to McConnell and Boehner’s reform approach. We may never know.

But what we do know is that conservative intellectuals feel they can win the repeal Obamacare fight, with some help from their friends on the Supreme Court. If only they can stop their chosen leaders from validating Obamacare with minor reforms... However, this may be the rarest of cases where the Congress knows better than its traditional idea providers. If nothing else, Obamacare is a lesson to the opposition of how difficult it is to provide affordable access to health insurance and health care.
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