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Flanking Maneuvers

The GOP is trying a new tactic for bringing down Obamacare and I while I don't think it will actually get Obamacare repealed in the forthcoming Congress, it might be a useful exercise.  Medicare is set to cut reimbursements to health care providers by 25 percent.  If the cut goes through, it might be tougher for many old people to continue seeing the same providers. The GOP is looking to pass a "Doc Fix" which would keep Medicare reimbursements at the current level.  This would of course cost more money, but the money to pay for the Doc Fix would come from shifting money from Obamacare to Medicare.  I especially like Douglas Holtz-Eakin's idea of trying to take money from the future Obamacare subsidies to finance the Doc Fix.

It's a neat trick that won't work, but might do some good.  As Jonathan Chait points out, the Senate will probably not pass and Obama would in any case veto a bill that shifted funds out of Obamacare.  So what?  The fight would dramatize that Obamacare took money out of an already underfunded Medicare program to create an expensive new subsidy that won't even exist until years from now - if ever. 

So I'm for this tactic, but only tepidly.  Most old people already know that Obamacare robbed Medicare and dramatizing this could have real, but only limited benefits.  I'm not even sure how many Americans will even hear of (never mind understand) the controversy.  Even one concrete state-level initiative to significantly increase the availability and usage of consumer-driven health insurance policies (and the attendant controversies with the HHS bureaucracy and with congressional Republicans cheering the state government on) would do more good in eroding the policy and political basis for Obamacare - though it isn't an either/or matter. 

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Discussions - 2 Comments

The GOP doesn't need to do anything. Obama's Administration has already issued 222 waivers for Obamacare since its inception. Humpty Dumpty is getting ready to fall and all the King's horses and all the King's men ain't gonna be able to put it back together again. Period. End of Discussion.

cowgirl, sorry to be late getting back to you but I was out of town yesterday. I don't care if HHS gives out a thousand one year waivers this year (well I do care, but not in the sense of thinking this spells Obamacare's doom.) Obamacare is going to raise premiums and cause employers to drop coverage. Obamacare will do this even if (and it is a HUGE if) the Supreme Court strikes down the individual purchase mandate. In fact, striking down the individual purchase mandate will actually speed up the rise in premiums and dropping of employer provided coverage. Under these circumstances, where premiums are higher and many have lost their employer-provided coverage, a simple return to the pre-Obamacare status quo will seem terrifying. A regime of price controls followed by a single-payer system might well seem like the least worst option under those circumstances. Conservatives will have to be ready with a set of non-scary policies that the public is broadly familiar with and will need the placement of people in Congress, the state legislatures, and the governors mansions who will be able to implement those policies as well as a broad social movement to put pressure on the state and HHS bureaucracies.

The GOP will have (does have) plenty to do if the GOP wants to prevent government-run health care. Assuming this thing is won is not helpful. We can win but we are not winning.

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