Repeal Cost Controls, Boost the Deficit
In the tough but essential fight against outright lying in American politics, Ezra Klein has struck an important goal in a <em>Newsweek column today. As he points out, there are elements of the new health reform law that reduce the federal budget deficit (according to the nonpartisan Congressional Budget Office) either directly by raising revenues (e.g., the tax on high-cost insurance policies) or indirectly by controlling health care costs. There are also provisions that in isolation would increase the federal budget deficit, either directly through more spending (e.g., subsidies for the purchase of private health insurance) or indirectly by boosting health care costs (requirements that people with pre-existing conditions be sold affordable policies).
Now Republicans are free to make the argument that the expensive stuff in the bill outweighs the stuff that reduces expenses, though simply asserting that against the independent expertise of CBO isn't terribly persuasive. But as Klein points out, that's really not where they seem to be going. Republicans are most focused on repealing cost controls, which generally aren't popular, and are least interested, to the point of actual opposition in some cases, in repealing the very popular new benefits:
[O]ne of the unnoticed dynamics of health-care reform was that Democrats were so desperate to pass a bill that they were willing to accept cost controls that they would've laughed at in normal circumstances. They ran over unions to begin taxing employer benefits and created a process making it harder to protect Medicare from future cost-cutting reforms. Republicans could've used the opportunity to strengthen the sort of cost controls they've long said they wanted, while focusing their repeal efforts on the bill's spending.
But they're doing the opposite, and there's a real risk to their strategy: if the bill's hard choices are political losers, the policies that cost money aren't. Subsidies for poor people are popular. Rules preventing insurers from discriminating based on preexisting conditions are popular. Tax credits for small businesses and closing the doughnut hole in the Medicare Prescription Drug Benefit are popular. Cost controls aren't. And Republicans, who've frequently argued that the bill is too costly, are taking direct aim at them.
If they repeal the parts but not the whole, we could end up with the bill's cost control wrecked but its spending intact. "You can't argue that you're for fiscal responsibility then argue for taking out all the fiscally responsible parts," says Maya MacGuineas, president of the Committee for a Responsible Federal Budget.
It's all the more reason that Republicans should be constantly pushed to offer their own vision for the health care system, not just attack the enacted reforms because some of them are unpopular.