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Monday, March 18, 2024
March 18, 2024

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GOP errs on Obamacare

After high court's ruling, party must finally give up this fight

The Columbian
Published:

Displaying unanimous views and questionable political judgment, Republican presidential candidates greeted the Supreme Court’s latest ruling upholding Obamacare with yet another vow to “repeal and replace” President Barack Obama’s signature achievement.

Similarly undeterred, GOP congressional leaders promised to keep pushing measures to scrap the universal health law, rather than try to fix it. “I just don’t think this law is fixable,” Rep. Paul Ryan, R-Wis., said Sunday on CBS’ Face the Nation, predicting it “is going to collapse under its own weight.”

Such comments might please the GOP electorate. But Republican presidential hopefuls risk antagonizing crucial independents and underscoring their party’s reputation for negativism by making Obamacare repeal a centerpiece of their 2016 effort to regain the White House.

To be sure, public opinion on Obamacare has not changed as dramatically as on gay marriage, where most GOP hopefuls seemed content to issue statements denouncing the Supreme Court ruling, rather than vowing to press efforts to overturn it.

But a recent CBS-New York Times poll showed a 3-to-2 margin in favor of making changes in the health law, rather than repealing it. And time is making it increasingly difficult for repeal to get traction as Obamacare gains more of a foothold in the nation’s health system.

Already, it has reduced the number of uninsured Americans by 40 percent and slowed the relentless increase in health care costs. It is beginning to dent other problems, reducing Medicare hospital readmissions and making payments more dependent on the actual value received by patients.

Now that the law has survived what likely was its last serious legal challenge and the gridlocked political climate will forestall any serious legislative challenge until at least 2017, the emphasis ought to be on improving and expanding it.

Action is long overdue in the 20 states that refused to join the federally funded Medicaid expansion, something the nonpartisan Commonwealth Fund says could cover 60 percent of the 25 million people who still don’t have health insurance (many of the rest are undocumented workers).

That includes nearly 2 million in Texas and Florida who don’t qualify for the federal subsidies ruled constitutional by the high court — but who would be eligible for coverage under the Medicaid expansion. Besides, hospitals in those states are losing billions of dollars in potential federal reimbursements for health care costs.

If the court ruling gave ACA important legal support, November’s Kentucky gubernatorial election could provide a political boost. Republican nominee Matt Bevin has made Obamacare repeal a campaign issue, promising to try to eliminate Kentucky’s state exchange and its participation in expanded Medicaid.

But under outgoing Democratic Gov. Steve Beshear, Kentucky became one of Obamacare’s success stories, reducing the state’s uninsured rate by more than any state but Arkansas. Still, a GOP victory would encourage Republicans to press the issue in 2016, while a victory for his Democratic rival, state Attorney General Jack Conway, would signal anew this fight should end.

Meanwhile, rather than continuing futile repeal efforts, Congress ought to consider measures fixing problems in what even proponents acknowledge was a sloppily drafted law, including a provision excluding some family members from certain employer plans and strict requirements for health coverage by smaller businesses.

Even GOP talk of replacing the law in 2017 is something of a pipe dream.

Not only have Republicans failed to agree on viable replacements, but Democrats will likely keep enough votes in the Senate — however the election turns out — to block repeal. Any effort by a new Republican administration to spend valuable time and capital refighting this battle could disrupt the health system more than Republicans say results from Obamacare and create a major political backlash.

It’s time to move past this fight. Last week’s Supreme Court decision provided the means to do so.

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