Former senator Norm Coleman, a prominent Romney backer, suggested that the full repeal of Obamacare was probably not going to happen but the law would see “major changes” if Republicans take the White House next year. A Romney spokeswoman said that while the candidate respects Coleman he disagrees with this assessment.
Getting Obamacare repealed will be very difficult. But it’s not clear what alternative Coleman has in mind, or could have in mind. Some Republicans have talked about getting rid of the law’s least popular provisions, notably the individual mandate, while keeping its most popular provisions, especially the command that insurance companies not take account of customers’ pre-existing health conditions. Coleman himself suggested that the courts might strike down the mandate and Congress might strike down IPAB (the Medicare cost-cutting/rationing board). But if the mandate goes, the insurance regulations have to go too: There’s no way insurance markets could work if you could wait until you were sick to buy insurance. The subsidized exchanges wouldn’t work either if people could jump on them when convenient. Take out IPAB, too, and all that’s left of Obamacare is the expansion of Medicaid. It’s hard to believe that you could build a legislative coalition to get rid of all of Obamacare except for that-especially since undoing that expansion would be key to any Republican bill’s claims to cut the deficit and thus to qualify for the “reconciliation” process needed to avoid a filibuster.
Obamacare could be tweaked by, for example, changing its funding streams. It could be moved leftward, through the introduction of a public option. Or it could be left alone entirely. Those are the options: Repeal, tweak, expand, or do nothing. Which option Republicans should choose is not a hard call.
"Former senator Norm Coleman, a prominent Romney backer, suggested that the full repeal of Obamacare was probably not going to happen..."
Congratulations Ramesh! It didn't even take you a single sentence to begin disingenuously shilling for your guy Romney. That's a new personal record. Norm Coleman isn't just "a prominent Romney backer." He's one of Romney's own advisers!
Reply to this commentLinkReport AbuseWhen Obamacare was still being legislated, one of my conservative friends (a huge Romney supporter no less) asked me why it was important to repeal Obamacare quickly. I simply responded that if Obamacare was not repealed quickly, Republicans would drop the pretense of wanting to fight against the program and eventually support it. Now, events have proven me to be Cassandra's husband.
If elected, Mitt Romney has no intention of making a fight to repeal Obamacare, whether there be an all-Republican Congress or not. His "waiver" idea would only be as good as he is in office, or until he decides it is no longer necessary to keep up the pretense that Obamcare was a bad idea. He has already stated that he wants to find "what works" with Obamacare and now we have his surrogates stating the same thing.
There are only so many times the walking and quacking of a duck forces to acknowledge what is right before us. Romney is a technocrat that is more interested in tinkering than in preserving anything about this country, business experience be d*mned.
Reply to this commentLinkReport AbuseAssuming arguendo that what you say about Romney is absolutely correct, how exactly is the political landscape going to change for a President Gingrich?
Keep in mind that the provision Ramesh highlighted - the one that forces insurers to cover preexisting conditions - enjoys OVERWHELMING public support. A CBS poll from early last year indicated that less than (wait for it) 1% wanted to repeal that specific provision.
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I haven't see a poll on that particular questions that garners less than 80% support for that provision. Even the part that says children must be covered until age 26 enjoys robust popular support.
There is a tremendous delusion among some conservative circles that says that Obamacare is highly unpopular. That's not the case. The mandate is highly unpopular and the cuts to Medicare are highly unpopular. Everything else - not so much.
As Ramesh correctly points out, how can private markets continue to function correctly when the government mandates that they must cover anyone who wants insurance irrespective of what ailments that customer had before they walked through the door? Unfortunately, that is exactly how Americans want it to work - almost universally.
Reply to this commentLinkReport AbuseOh, I'm not saying anything about putting support towards Newt either. I've already stated that if either Newt or Romney gets the nomination, conservatism will be set back for years.
"There is a tremendous delusion among some conservative circles that says that Obamacare is highly unpopular. "
Polls after polls have consistently shown that Obamacare is unpopular. Then again, you don't need polls: All you need to do is listen to the rhetoric of the President and his lackies. When Obamacare was in its infancy, it was fine to call it such. Now that everyone don't like it, none will call it that and will excoriate those who use that term. On top of this, politicians of a Democratic stripe continue to run away from it.
But let's say for the sake of argument that only the mandate and cuts to Medicare is unpopular. What you are effectively arguing is that if we cut the mandate and keep Medicare spending the same is that Obamacare would be even WORSE on the federal fisc, seeing as how not forcing people to buy insurance would cause the entire thing to collapse under its own weight along with the added trillions of a burgeoning Medicare cancer. Are you saying that this would be a preferable outcome to just repealing Obamacare as a whole? It seems that you are.
Reply to this commentLinkReport Abuse"Polls after polls have consistently shown that Obamacare is unpopular. "
Actually, the point the person you were responding to was trying to make, is that poll after poll has shown that the vast majority of individual elements of Obamacare are in fact quite popular. The mandate is not popular; and when you wrap the whole thing up and call it 'Obamacare,' it is much less popular.
This is a result of excellent messaging and branding on the part of the GOP. It shouldn't be mistaken for overwhelming opposition to the elements of the law itself; and it does highlight the difficulty of either a full repeal or a partial one.
I would also point out that there exist no cuts to Medicare in the ACA. What was cut was Medicare Advantage, a program which actually cost the gov't a lot of extra money (for little extra result).
Reply to this commentLinkReport Abusewell if Newt or Mitt will set the conservative movement back than maybe we should all just stay home and watch Obama coast to victory (which he might do anyway).
There isn't anyone else.
Reply to this commentLinkReport Abuse"Are you saying that this would be a preferable outcome to just repealing Obamacare as a whole? "
No. What I'm saying is that the political reality with respect to federal health insurance regulation in America is quite different from the fantasy land that some conservatives are living in.
Let's say Obamacare is gone; either fully repealed or fully stricken by the Supreme Court. Then what? We still have an overwhelming majority - I mean REALLY overwhelming - of Americans that want government prohibitions on private insurers from denying payment for preexisting conditions. How is that remedied or addressed? I have yet to hear a single conservative commentator or politician address this reality in ANY substantive way.
Even Ramesh, who has forgotten more than I'll ever know, tip-toes around this as well. He cedes that there are popular provisions in Obamacare, but he doesn't really address how those provisions should be tackled moving forward.
"But let's say for the sake of argument that only the mandate and cuts to Medicare is unpopular. "
I'm not trying to be argumentative here, but have you seen or can you cite any poll that suggest otherwise? I have looked, and I sure can't. I would add the "Cadillac Tax" is unpopular too. Not surprising, any funding mechanism of any legislative Bill/Act is going to be unpopular with someone.
More directly to my personal preference - I would prefer that this insurance mess be handled entirely by the states. If a state like MA wants to provide near universal private insurance coverage through implementation of a mandate, more power to them. If TX wants to do nothing and see the the percentage of uninsured climb to 25% or more, more power to them. But, I also recognize that my personal preference is likely impossible to achieve because most Americans don't share my love of Federalism. And I also realize that saying Obamacare must be repealed without offering a competing plan or solution, is - in the long-term - a losing proposition, but that's exactly the position the Republicans find themselves in.
Reply to this commentLinkReport AbuseYou are trying to be argumentative, but since you want proof, here is the Real Clear Politics averaging of the polls on Obamacare (and yes, this is on the entirety of the program, not on specifics, which polled independently do garner support. Of course, the caveat is that you need Obamacare in order to get the specifics):
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You'll see that the opposition to Obamacare is consistently strong to the point that by there is almost a 5 to 1 relationship (probably stronger) between polls that are against Obamacare and polls that are tied or favorable to it. But as I've said, there is no need for polls when you can use reality: No Democrat, anywhere, runs strongly for support of Obamacare, not even the socialist Bernie Sanders (isn't it strange that Bernie Sanders exclusively caucuses with the Democrats and calls himself a socialist? Never mind).
What Americans want and what should be done are entirely two separate things. Wanting to cover pre-existing conditions is the fantasy, not the reality. Maybe if we gave hospitals and doctors the ability to, oh I don't know, price their services according to their market value, then maybe we can find a way to provide services for those with pre-existing conditions without calling on the need to insure things that are by their nature uninsurable (sic). It is the Democratic sleight-of-hand when we start saying that some parts of Obamacare are popular: If this is the case, repeal all of Obamacare and provide legislation on the parts that are appealing. That still will not change my view that trying to cover pre-existing conditions, simply because they are "popular with Americans" will solve any problem.
In effect, what you are arguing is that Americans want socialized medicine by any means necessary. If that's what you want to argue, fine. But don't try to state that "Obamacare is popular" because some of it is, but the majority of it isn't.
Reply to this commentLinkReport Abuse"Wanting to cover pre-existing conditions is the fantasy, not the reality."
It's not a fantasy under the current law of the land, so I think this is a really inaccurate statement to make.
"Maybe if we gave hospitals and doctors the ability to, oh I don't know, price their services according to their market value"
Hah! How do you determine market value of medical services? You make it sound as if these are easy problems to solve, and nobody really thought of this until now. I assure you, they are not easy questions to solve - and certainly not by individual actors in the market.
Reply to this commentLinkReport Abuse"It's not a fantasy under the current law of the land, so I think this is a really inaccurate statement to make."
Fantasy is fantasy, law or not. It is not an inaccurate statement to state that wanting to cover pre-existing conditions is a "fantasy". And actually, no, many pre-existing conditions are NOT covered under current law, which is why there is Obamacare in the first place.
"Hah! How do you determine market value of medical services?"
The same way you do for an Apple iPad. The problem is easy to solve, but the solution is hard to swallow, as attested by you.
"I assure you, they are not easy questions to solve - and certainly not by individual actors in the market."
Yep, because "individual actors" don't know their own bodies or their own level of expertise or their own value in the marketplace. We can go through the litany of private decisions that "individual actors" make without any type of government involvement (despite heavy government regulation), and do just fine, but I think you are far past needing of convincing in that regard and would tune them out anyway because you've already got your mind made up as to what you want the healthcare system (funny, we have that and not a market) to be.
Reply to this commentLinkReport Abuse"And actually, no, many pre-existing conditions are NOT covered under current law, which is why there is Obamacare in the first place. "
Obamacare IS the current law of the land - have you forgotten this fact? And under that program, pre-existing conditions basically do not exist. A system is in place under this same program to fund this; so, I have to conclude that you are totally wrong to say it's a 'fantasy' that such a thing could come about. It HAS come about and people want it to stay that way; polling couldn't be clearer on that issue.
"The same way you do for an Apple iPad. The problem is easy to solve, but the solution is hard to swallow, as attested by you. "
BS, you know nothing about how health care works to say such a thing. Health care isn't a product you shop for on Amazon to find the best price.
I really think the burden would be on you, as to explain how - politically - the GOP should go about getting rid of the popular parts of ACA and replacing them with nothing at all.
Reply to this commentLinkReport Abuse"Obamacare IS the current law of the land - have you forgotten this fact? And under that program, pre-existing conditions basically do not exist. A system is in place under this same program to fund this; so, I have to conclude that you are totally wrong to say it's a 'fantasy' that such a thing could come about. It HAS come about and people want it to stay that way; polling couldn't be clearer on that issue."
Now you are arguing fantasy. Pre-existing conditions existed BEFORE Obamacare, thus the reasoning for Obamacare. I will concede the point that Obamacare is the law of the land, but that law does not fully go into effect until January 1st, 2014. At that point, all insurance companies will be required to cover pre-existing conditions. As it stands, insurance companies are only required to cover some pre-existing conditions, not all of them. And of course, even at January 1st, 2014, not all pre-existing conditions would be covered. Right now, the HHS secretary has not given clear guidelines as to what will or will not be covered, except for those that primarily have to deal with women's health (mammograms and birth control, but those aren't exactly "pre-existing" are they?).
And I have already proven that people do NOT want it to stay that way, especially if Obamacare is the vehicle.
"BS, you know nothing about how health care works to say such a thing. Health care isn't a product you shop for on Amazon to find the best price."
Isn't THAT the problem, though? There is no pricing mechanism in the health care industry. Why shouldn't it be another product that can be shopped around for the best price. In fact, there are several websites, such as WedMD and DocZoc, which does this very thing, but that is only to help you find the best doctor, irrespective of price. Why can't there be an Amazon-like website that has doctors and their services listed and the pricing for those services?
"I really think the burden would be on you, as to explain how - politically - the GOP should go about getting rid of the popular parts of ACA and replacing them with nothing at all."
Oh, how we go about flipping things about. The burden is ALWAYS incumbent upon those who wish to socialize our healthcare system, but of course, as long as its "popular" it should not be touched. Of course, the Democrats never explained how Obamacare would benefit anybody, they just forced it upon Americans. Now we are to accept the violation whole cloth without complaint. Glad that you and Scott Wilson are ineffectively making this argument.
Reply to this commentLinkReport Abuse"What Americans want and what should be done are entirely two separate things."
What should be done and what will be done are two entirely separate things.
You continue to fail to address the unassailable truth: Americans, by an overwhelming majority, want the government to force private insurers to cover preexisting conditions. Less than 1% want that provision to be repealed. And, an almost equal number want their children covered on their parent's employer's policy until age 26.
What people don't want to do is see their taxes go up, or having their choices limited or government expand it's control over health care or have Medicare reduced. It's the very definition of cognitive dissonance, but it is what it is.
This is the same problem we see with so many other government programs. There is nothing close to a consensus with respect to what programs that people want to cut or eliminate. But, there is near universal consensus that people want what they're individually getting from the government, and they want someone else to pay for it.
Reply to this commentLinkReport Abuse"You continue to fail to address the unassailable truth: Americans, by an overwhelming majority, want the government to force private insurers to cover preexisting conditions. Less than 1% want that provision to be repealed. And, an almost equal number want their children covered on their parent's employer's policy until age 26."
Now it is your turn to show your polls that support your assertion. To be sure, I clicked only in those polls that showed a favorable view of Obamacare at that RealClearPolitics link. None of those polls asked an individual question about covering pre-existing conditions and "children" being able to stay on their parent's employer's policy until 26 (it's sad that you would even call adults children).
So please show me your polls to support your assertion that the things you've cited are popular.
Reply to this commentLinkReport AbuseI did. Look at my very first post to you.
Reply to this commentLinkReport Abuse1) That's one poll. I gave you many.
2) Your poll is not even current. The last date of this poll is Jan. 2011. The RCP takes into consideration all of the polls since the inception of Obamacare until Jan. 25, 2012.
3) At question 67, you cannot infer that "less than 1%" want to not have pre-existing conditions covered as there are some where there are not even a registration and DK/NA polls higher at 14%.
4) Question 68 completely invalidates question 67 as even with knowing that insurance companies would no longer cover pre-existing conditions, more Americans still want the law repealed.
5) Question 70 shows a vast majority of Americans who have not personally benefited from the changes to Obamacare.
I'm sorry, but the poll you've posted does not support your assertion and in fact argues against it, Scott.
Reply to this commentLinkReport AbuseOf course. You're right. Which is exactly why the official Republican alternative to Obamacare promises that they'll be prohibitions against preexisting conditions discrimination, as Reno_Dave points out. Wait, what?
Does that make sense? Do you think that the GOP would actually insert this caveat into their marketing literature if this kind of prohibition was unpopular?
But, if it makes you feel better, here's another poll from November..
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In it, there's a breakdown of about a dozen or so provisions contained in ACA. While the ACT itself is still seen negatively by a comfortable margin, almost all of the individual elements of the Act are popular - not the least of which is the "Guaranteed Issue" requirement, which according to this poll, enjoys 67% approval. Certainly, it's not as positive as the Times poll from earlier this year, but you would be hard-pressed to find any other issue today that enjoys 67% support. Even 57% of Republicans either "very" or "somewhat" support that provision.
To Dave: Yes, I was aware of the Party's position, but what I was (and am) questioning are the details of that plan. If you tell insurers you cannot discriminate against preexisting conditions, what's to keep people from not buying insurance until they actually get sick? Is that model financially sustainable without any kind of mandate? I don't think so, but I'm open to suggestions.
Reply to this commentLinkReport AbuseAgain, it is only one poll compared to many, but at least this poll is more substantial than your first. That being said, this poll is skewed to make it seem that "pre-existing condition" is popular and should be covered. For instance, in the section that states that Americans believe those with pre-existing conditions will benefit from Obamacare, 48% believe this. What is NOT being said is that exactly 41% believe otherwise, with the other 11% saying that they don't know or refuse to answer. This is as good as saying that more than half of Americans do not think that trying to cover "pre-existing conditions" should be a goal of any federal healthcare law. And if we go back to the chart of "individual elements that are popular" (I can't even believe we are playing this game as NONE of the elements are individual and all are part of a law that the majority of Americans want repealed), only 47% favor guaranteed issue, meaning that 53% is assumed to not favor it, have no opinion of it, or don't know (and I'm being generous to you here).
Now, as for Republicans wanting to offer something, maybe they can just offer something that is completely different from what the Democrats are offering. After all, the problem that Republicans have now (and one presidential candidate in particular) is that they are seen as Democrat-lite. Again, simply because the American people (or mostly Democrats who are given high priority among the American people) believe that pre-existing conditions should be covered (and define what "pre-existing conditions" means anyway) does not mean that there needs to be a policy to ensure this comes about, especially if it will be a financial drain (which trying to cover "pre-existing conditions" will be).
You still haven't convinced me that your position should be taken as truth, Scott.
Reply to this commentLinkReport AbuseYou continue to fail to address the unassailable truth: Americans, by an overwhelming majority, want the government to force private insurers to cover preexisting conditions. Less than 1% want that provision to be repealed.
The Republican plan offered before Obamacare was passed would have covered preexisting conditions:
"Health care should be accessible for all, regardless of pre-existing conditions or past illnesses. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick. We will incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans."
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Early in 2010, HR 9 was passed that instructed various committees to work on a replacement for Obamacare. One of the provisions was that the replacement:
"provide people with pre-existing conditions access to affordable health coverage"
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I do not know the status, but as there's no hope of repeal before the 2012 election, I doubt they've put a huge amount of time into it. Perhaps we'll hear more as we approach the election.
The point here, is that Republican, in an effort to repeal and replace, do consider coverage for pre-existing conditions important.
Reply to this commentLinkReport AbuseCorrection: H.R. 9 was passed in early 2011.
Reply to this commentLinkReport Abuse