Published December 22, 2010
The outgoing Congress, which began with a bailout-and-stimulus bang, ends with a Tea Party-inflicted whimper, bruised by a series of post-election "shellackings" on taxes, spending and pork.
Meanwhile, a new Congress is charging toward the Hill like the U.S Cavalry, reinforced with scores of Tea Party-backed candidates and committed to a new day in Washington.
We believe big things are possible these next two years – on everything from taxes to budgets to spending – because the big-government left is on the defensive and the left’s leader, President Obama, wants to be reelected.
And nowhere is this sea-change in political fortunes more evident than on health care.
Contrary to the conventional wisdom, we believe the president’s signature accomplishment is vulnerable to repeal.
Indeed, we believe repeal is not only achievable, but may happen sooner than many expect, for five basic reasons:
1. Support for repeal has gone up since the election. The share of people supporting full or partial repeal has risen from 49 percent in last month’s Kaiser health tracking poll to 59 percent in the Dec. 13, Washington Post poll. And Rasmussen finds that “Belief in the likelihood of repeal has now edged to its highest level to date” -- 47 percent, up 1 point from the election. Voters want, and expect, repeal.
2. The law’s structure makes it vulnerable. Democrats will have trouble maintaining their current “mend it, don’t end it” stance, because they can’t persuasively explain how they’d mend it. Obamacare’s core elements -- the mandates, exchanges, and subsidies (including the massive Medicaid expansion) -- are all interconnected. This makes the law vulnerable to “effective repeal” through surgical amendment.
Like the Death Star, the law has one critical weakness: the individual mandate, which requires all individuals to purchase government-controlled health insurance. Repeal just this section, and the rest of the law comes apart. In the absence of the mandate, people who lack job-based coverage will wait until they’re sick to seek coverage through their local government exchange, and premiums will soar there, driving people away.
The system will become unsustainable.
Only 27 percent of Americans support the mandate; 68 percent oppose it. And eliminating the mandate would save taxpayers $202 billion (2014-19).
3. Fiscal realities make the law an irresistible piggy bank. Obamacare is the world’s biggest deficit-reduction piggy bank. Its $900 billion in subsidies (2014-19) offer a rich fund out of which to pay for higher priorities, for example, to provide Alternative Minimum Tax relief, a Medicare physician payment “doc fix” or a budget-neutral increase in the debt ceiling.
The Medicaid expansion will cost $434 billion; its exchange premium subsidies, $464 billion; its discretionary authorizations for new programs, $19 billion; those for existing programs, $86 billion. Eliminating all of this new spending would save more than a trillion dollars. This is one piggy bank you can be sure Congress will break open.
4. Three-fifths of the states are challenging the law, and the Supreme Court could find it unconstitutional. Most states oppose the new law, because it shifts control of insurance regulation to Washington, but even more because its massive Medicaid expansion will bankrupt them. Twenty-one states have filed suits challenging the law’s constitutionality. Another nine have filed friendly briefs.
The Dec. 13 ruling by Federal District Judge Henry E. Hudson in Virginia v. Sebelius found the individual mandate to be an unconstitutional exercise of congressional power.
Higher courts will now have to answer: Is the mandate constitutional (and therefore there are no limits on federal power)? Or is the mandate unconstitutional (and therefore Congress acted wrongly in ramming the bill through)? Voters deserve to know the answers before November 2012. That’s why FreedomWorks has launched a grassroots effort to push for expedited Supreme Court review of these cases.
5. A majority of lawmakers in the new House and a near-majority in the new Senate ran on full repeal. Therefore, after an initial “full repeal” vote in January, House leaders should bring up at least four “effective repeal” bills: (1) repeal the individual mandate; (2) repeal the IRS Form 1099 paperwork nightmare; (3) let people with private insurance “keep what they have;” and (4) let states opt out of the exchanges and Medicaid expansion. We believe each of these bills can pass both Houses of Congress with bipartisan support.
In sum, we can preserve the world’s best health care system. Repeal is achievable because the American people clearly want and expect repeal, the law is vulnerable to effective repeal and a majority of the new Congress ran on repeal.
The clock is running. Obamacare begins in earnest three years from now.
With the right combination of legislative savvy and grassroots pressure, we can -- and will -- stop that day from coming.
Matt Kibbe is president of FreedomWorks and co-author of "Give Us Liberty: A Tea Party Manifesto."