LOPEZ: Will there be a second anniversary?
TOM MILLER: It’s very likely, despite the wishes of many Americans. The current political lineup in Washington means that Capitol Hill Republicans can harass, educate, and nibble away on the edges — but it will take a new president (accompanied by a very likely Republican takeover of the Senate) to change what only appears to be “permanent law” at the moment. But don’t count on a third anniversary.
We might hope for a deus ex machina rescue from the Supreme Court next year, but there is a lot of terrible, older case law to overturn. The high court is just as likely to deliver a 7–2 ruling upholding the health law as declaring its individual mandate unconstitutional by a 5–4 margin. We will have to, can, and will win this one “old school” — at the ballot box.
: What if it isn’t repealed — a likely scenario for the time being?
CAPRETTA: Repeal and replace is going to be a multi-year endeavor. Those who oppose the new law need to dig in for the long haul, because this is going to be a protracted battle. Between now and the 2012 presidential election, the key is to make sure Obamacare’s flaws remain front and center in the public debate. House and Senate opponents of Obamacare can help in that regard by targeting some provisions for repeal in ways that bring public attention and highlight the law’s deficiencies. For instance, they could take up a bill that repealed the worst of the Medicare cuts and thus force postponement of the rest of the law.
LOPEZ: What do you find people are most surprised to learn about it?
TURNER: Early readers of the book say they found many things they didn’t know. Seniors, for example, know that this law is bad for Medicare, but many are surprised to learn that Obamacare takes more than $500 billion out of Medicare to pay for two massive new entitlement programs. They know that they will have an even harder time getting the care they need. People are shocked to learn that the law doesn’t even come close to universal coverage but will leave at least 23 million people uninsured. And they are surprised to learn that Obamacare will be particularly disadvantageous to vulnerable Americans, especially those on Medicaid today who already have an incredibly difficult time finding a physician to see them — which is why they have to wait for hours in hospital emergency rooms to get even routine care. Seniors fear that is the fate they are facing as well.
LOPEZ: What is the most prevalent myth?
ROBERT MOFFIT: The most prevalent myth is that Congress dropped the “public option” from the final version of the bill before it became law. In fact, it re-created the public option in a new form: In 2014, the federal government will sponsor at least two health plans, operating under unique rules, to compete directly against private health plans in every state in the nation.
LOPEZ: Is the judiciary a good or hypocritical conservative strategy (we don’t want policy made by courts, after all)?
TOM MILLER: The new health law was jammed through Congress “by any means necessary.” It needs to be overturned and then drastically replaced by every legal, political, and persuasive tool available. In this case, conservatives are seeking relief from the courts as a defensive shield against a full-fledged assault on their rights, the fundamental structure of our Constitution, and the necessary and proper limits on the role of government in our lives. Courts are not “making policy” when they just return to interpreting the Constitution properly. That said, I would not recommend over-investing solely in a court-based strategy. We still face a much bigger set of problems in health policy to address and solve than any favorable court ruling can handle.