Critical Condition

NRO’s health-care blog.

Politicizing HHS, ‘Effective Repeal,’ and a Two-Year Window for Bipartisanship


As the House of Representatives prepares to vote on repeal of President Obama’s health-care law, the Department of Health and Human Services has come out with a report saying that nearly half of all Americans have preexisting conditions that could make it hard for them to get health coverage. When I served at HHS, we tended to be careful about releasing reports that were this politically charged, lest we be accused of politicizing the agency. HHS’s credibility is an invaluable resource, especially since Americans are so reliant on HHS in case of a health emergency, such as a flu pandemic or bioterror attack.

Leaving aside the report’s curious timing, the issue of our problematic health system remains. The bill that the Democrats rammed through last year will not fix the myriad problems of our health system — over 20 million Americans will remain uninsured in 2019, and insurance premiums will rise faster than they would have without the bill. At the same time, the new law will cause other problems in the system in terms of overburdening Medicaid and limiting our spending flexibility in the future.

The GOP argument is not that our health system is fine as is. It most certainly is not. What the Republicans are saying is that the Democratic approach is flawed, uni-partisan, and in the process of being rejected by the body politic. A report in yesterday’s Politico finds that a majority of states have now signed on to the lawsuit questioning the bill’s constitutionality. This is a perfect demonstration of the concept of “effective repeal” that I laid out in this month’s Commentary. If a majority of states not only question the bill but reject it and refuse to implement it, the bill will not be sustainable.

The Republicans want to wipe the slate clean and come up with a new approach. Given that the Democrats control the Senate now but likely will not in two years, this Congress may present the best chance to come up with a bipartisan approach that both sides can live with. Unless, that is, the Democrats want to take their chances with an all-Republican Congress after 2012.


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