The great US national health care reform debate is now entering its second, and I think, climactic phase. For the next two years the Republicans and a few Democrats will attempt to “repeal, replace, and defund” Obamacare. The final decision will probably come with the 2012 election.
So, I am opening a new subject identifier here that I will call “Obamacare Repeal.” That subject will deal with the political debate over the coming attempts to undermine and eventually, replace the law with something better. I will attempt to distinguish that discussion from “Obamacare,” which will deal with the law itself.
This week the House of Representatives will successfully vote to repeal the law. The only question is the size of the bipartisan margin. Some Democrats will join Republicans, but I don’t think any Republicans will vote no. Repeal will then die in the Senate.
The point of repeal is to set up the next two years’ debate. After that, it will become trench political warfare, with much of the action aimed at defunding bureaucratic enactments and implementation. There will also be piecemeal repeal votes of various sections, a few of which could become law (such as the ridiculous provision requiring IRS notification of all business payments of $650 or more).
Why is this happening? Hubris of the Obamacare architects and supporters. A huge legal change of the size and scope of Obamacare requires bipartisanship to be accepted as the people’s democratic will. But the Republicans had no voice in the legislative drafting. Had they been consulted and truly compromised with, it would have resulted in a less grandiose vision of reform. Alas, Obamacare architects not only wanted to improve the system–they also wanted to seize control of it. And so compromise was never seriously considered.
In the first two years, Obamacare supporters clearly lost the political debate but were able to barely pass the mess known as the Affordable Healthcare Act into law because of huge Democratic majorities. (Supporters never needed one Republican vote. Their problem was opposition by many Blue Dog Democrats, who, for example, killed the public option.) Through a series of corrupt deals and special political payoffs, Obamacare became law. Partially as a consequence, Nancy Pelosi is no longer Speaker of the House.
Obamacare Repeal will also include action in the courts. A whopping 25 states have now sued to declare the individual purchase mandate unconstitutional, and attack the unfunded extra Medicaid requirements. I don’t recall any law so rebelled against by the states. My educated estimate is that the Supreme Court, if it remains as currently constituted, will invalidate the purchase mandate. Keeping Obamacare would then bankrupt the insurance companies–which it will do anyway–and we will be on the way to repeal and replacement if we are wise, or single payer if we are not.
Liberal columnist E. J. Dionne today lectures Republicans to be civil in the debate–for example not use the term “death panel”–even trying to bring in the Tucson tragedy, which won’t work, the guy was a Bush hater and “truther” according to the NYT. (Dionne says the term refers to end of life counseling. As I have repeatedly pointed out here, it actually refers to potential rationing boards. Palin got it wrong the first time, but corrected herself later.)
As usual when trying to limit the arguments of the opposition, it is a case of the pot calling the kettle black. Remember Representative Grayson and his slander that Republicans want sick people to die? And the NYT called him “colorful” in a good-bye story after he lost re-election. That’s the kind of arguing I think we can expect from defenders of the law for the next two years. But, maybe I will be surprised.
In any event, we will discuss Obamacare Repeal often here at SHS. And we will be civil.