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Can Obamacare Be Undone?
The reality of repeal.

Rep. John Boehner speaks behind a version of Obamacare in October 2009.

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SALLY PIPES
The question is not whether Obamacare can be undone but when. It must be undone. Repeal and replace is the only solution for bringing about affordable, accessible, quality care for all Americans. As Obamacare celebrates its second anniversary today, it is still unpopular with Americans — 56 percent are still in favor of repeal. This is not good news for the president and probably one of the main reasons that he devoted only 44 words to health care in this year’s State of the Union address and that he is not going to give an address celebrating the health-care law’s anniversary from the Rose Garden.

The Supreme Court begins a record three days of hearings on Monday. The Court will be considering the constitutionality of the individual mandate, the issue of severability, the federal government’s forcing states to expand their Medicaid programs, and the question of whether the mandate is a tax.

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Regardless of how the court rules in June, it is essential that repeal-and-replace be the prime goal. The Congressional Budget Office released a report last week showing that the cost of Obamacare is going to reach $1.76 trillion over the decade from 2012 to 2022. This is a far cry from the original estimate of $940 billion over ten years. The president’s goal of bending the cost curve down is unattainable. The CBO also forecast last week that up to 20 million Americans will probably lose their employer-based health coverage and be forced into state-based exchanges. So much for President Obama’s oft-repeated statement “If you like your health insurance and you like your doctor, nothing will change.” Americans know that things are changing and they do not like the prospects for their future health care.

In January 2011, the House voted to repeal the law, but the bill did not make it through the Senate. The House has also voted to repeal the CLASS Act and IPAB, but neither will likely be taken up by the Senate. While piecemeal fixes are fine, we must not take our eye off the real goal: repeal and replacement of the entire law. And there is still time to reverse course. In early 2013, our congressional leaders can repeal Obamacare and replace it with market-based reforms that expand access to coverage, provide quality care, and lower costs.

Most of the cost drivers in the legislation do not go into effect until 2014. If Obamacare is not repealed before that date, it will be very difficult to reverse course. You just need to look at the experience of the government-run systems in Canada and Britain. Politicians know that changes are needed if they are going to eliminate long waiting lists and rationed care. But the path is not an easy one. Let’s hope we make the changes before it is too late.

— Sally C. Pipes is president and CEO of the Pacific Research Institute. Her latest book is The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare.


MICHAEL RAMLET
Regardless of the Supreme Court decision, the Affordable Care Act will ultimately be undone, because it’s bad economics, bad budget policy, and bad health policy.

And it will be undone by the nation’s governors as Congress remains stalemated.

If the Supreme Court strikes down the law, the nation’s Republican governors will be the first to release a comprehensive replacement plan (Replacement Principles). If the law stands, it is the governors who are in the best position to delay, obstruct, and pursue alternative health-care reforms.

With the ACA already shifting $12 billion in hidden regulatory costs to states and the private sector, it will be more than just Republican Governors who will be compelled to undo the ACA. By 2019, governors of all political stripes will be required to slash education, transportation, and other state budget priorities to afford the federal government’s coercive Medicaid expansion.

Thankfully, America could not ask for better leadership in undoing the failed ACA. Instead of a one-size-fits-all federal approach, we can give the job to the governors who are best able to make decisions about the design of their states’ health-care systems based on the needs, culture, and values of their citizens.

— Michael Ramlet is director of health policy at the American Action Forum.




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