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Putting Off Obamacare



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The latest of the countless delays in Obamacare’s implementation is a big one. As the New York Times headline puts it: “States Will Be Given Extra Time to Set Up Health Insurance Exchanges.” And it seems the extension is not itself limited. After, as the Times tactfully notes, “finding that many states lag in setting up markets where millions of Americans are expected to buy subsidized private health insurance,” HHS secretary Kathleen Sebelius has said “she would waive or extend the deadline for any states that expressed interest in creating their own exchanges or regulating insurance sold through a federal exchange.” The deadline to express such interest has itself also been extended, in the hope that more states would sign up. And the administration has missed a great many of the law’s various deadlines for regulatory and implementation actions too. 

All of that suggests a rare patch of common ground in our health-care and fiscal debates. Why not enact a law to delay the implementation of Obamacare, say by a year? 

Such a move would be something of an embarrassment for the law’s champions, of course. But it would also be a huge relief to them — putting off the even greater embarrassment and political pain of what increasingly appears likely to be an utterly catastrophic implementation process. It would certainly be immensely helpful to the people actually charged with putting the law into effect, at both the state and federal level (as well as in the health-care industry), who are woefully behind and begging for more time and more guidance so as to try to make that implementation less catastrophic. And it would be helpful to the law’s opponents too, since we believe that the catastrophe is a function of the law’s very design (and so not ultimately avertable by delay) and that the more time we have to help people see the flaws of the statute and to advance legislative alternatives that would be more attractive the more likely we are to replace the law in time. Pushing its implementation back a year would make Obamacare no less of an issue in the 2014 congressional elections (which would be fought just before the new implementation date) and surely more of an issue in the 2016 presidential election, and it would make the law’s replacement more manageable if that election goes well for conservatives. 

So whether you are a supporter or an opponent of Obamacare, at this point you ought to see some value in pushing its implementation back at least a year. It’s happening anyway, and in some respects in violation of the law. Why not just codify what Secretary Sebelius is doing on her own authority, and thereby also take some pressure off our fiscal debates? After all, CBO says that such a one-year delay would reduce the deficit by about $160 billion over the 10-year budget window that is relevant to today’s debt-ceiling and budget negotiations.  It would just send those costs into the eleventh year, of course, but again whether you believe the law will live that long or not you ought to see that as a good thing given where things stand today. 



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