The debate du jour within the Republican Party is not about philosophy or objectives, it is about the best strategy for defunding Obamacare. One group thinks it must be done now, before it gets ingrained in our national welfare state; the other thinks it more realistic to marshall the political resources to roll it back in 2014 or 2016. Neither adequately addresses what comes next. Some observations:
- A majority of the public believe that the new law will make the healthcare system worse, but that number is volatile. Liberals complain about a few ads encouraging people not to sign up, but future months will see a billion dollar advertisement campaign from the administration, insurance companies and other advocates.
- We are at the peak moment of dysfunction. Thirty six states have decided to let the feds run their exchanges. Several large insurance companies have decided not to participate. Polling shows that most young people will choose not to buy insurance despite the mandate. Computer glitches abound. Clerks managing subsidies will have access to previously private health records and income tax returns - and for 2014 will accept applicants claims of income without any verification. Much of this will be worked out in a year or two, if not in months.
- Even if Republicans hold the House and win the Senate in 2014, President Obama will veto any rollback. A trifecta in 2016 is far from inevitable. The surest approach is to attach a defund mandate to a bill that the Senate and the President must pass and sign - a continuing budget resolution or a debt limit increase.
- Election losses following the 1995 government shutdown are a myth - Newt Gingrich's Republicans held the House and gained Senate seats in 1996. It is the president who refuses to negotiate on the budget, the debt limit, or Obamacare. It is the president who grossly misrepresented the impact of Obamacare on the middle class in terms of taxes, change of doctors, and change of insurance carriers.
For the "marshall the resources" advocates (The Republican establishment):
- Don't worry about the law succeeding. Tens of billions in new taxes will hit the public as they prepare 2013 and 2014 tax returns. Unions and the public understand that the employer mandates are destroying the 40 hour work week and full time jobs in the service sector. Doctors are dropping Medicare while Obamacare is trying to add 30 million patients. Insurance companies will be offering inferior provider networks at mostly higher rates, higher deductibles and higher co-pays. Corporations are requiring hundreds of thousands of employees to purchase their own insurance. The individual mandate and required coverage for contraception and morning after pills remain strongly unpopular.
- Rarely does a political party face a president whose "signature accomplishment" is so unpopular and so difficult to implement. There is a golden opportunity to force Democrats in red states to take votes that will be vastly unpopular - particularly Mark Begich of Alaska, Mark Pryor of Arkansas, Mary Landrieu of Louisiana, and Kay Hagan of North Carolina who face reelection in 2014. Ted Cruz has helped to shine the spotlight. A pickup of 5 is needed for control.
Most analysts, and even firebrands such as Rand Paul, believe that the Republicans will eventually give in rather than risk giving up a winning political hand for 2014.
But this is only the prelude. Beyond "defunding Obamacare", the Republicans need a plan of their own. Elements could include tort reform, selling insurance across state lines, perhaps a base government-funded catastrophic insurance, perhaps enhanced Health Savings Accounts, something to enhance access for people with preexisting conditions, perhaps the popular requirement that kids could remain dependents until age 26. The absence of a Republican alternative creates two problems:
1. In the ongoing debate it is hard to beat something with nothing.
2. More importantly, as Obamacare becomes increasingly unpopular the Democrats have a Plan B - "single payer", perhaps in the form of Medicare for everybody, with current support from folks such as Harry Reid, unions, and other advocates for a government run national healthcare system.
In 2016 a Democratic candidate promising to simplify the system and get rid of insurance companies will have an attractive message. Republicans had best get their plan put forth while the Democrats are still concentrating on the Obamacare monstrosity.
This week's video shows President Bush at Yankee Stadium for the World Series in New York after 9/11. Exceptional.
And for those who have 10 minutes to better understand Ted Cruz, here is Cruz' father discussing Cuba and his son's upbringing.
bill bowen - 9/27/13