The Politics of Health Care Policy

Even before the November 2, 2010 elections catapulted them back into power in the U.S. House of Representatives, members of the Republican leadership were already announcing their intention to repeal “Obamacare” – the health care reform legislation enacted by Congress only eight months earlier – as one of their first legislative goals.

True to their word, House GOP leaders introduced legislation to repeal the new health care law on January 5, 2011, the first day of the 112th Congress. It was the second piece of legislation introduced, preceded only by a bill setting out the rules for conducting legislative business in the new Congress. In a move that exemplifies the political rancor that has characterized the debate over health care reform for more than the past year and throughout the recent elections, H.R. 2 is known officially as “Repealing the Job-Killing Health Care Law Act.”

Specifically, H.R. 2 would repeal the Patient Protection and Affordable Care Act (Public Law 111-148) and the provisions of the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) that are related to health care. Both laws were enacted in March 2010.

Yet according to the non-partisan Congressional Budget Office (CBO), repealing the new health care law would add hundreds of billions of dollars to the national debt, and deprive health insurance to 32 million Americans.

In what it referred to as a "preliminary analysis," CBO said that repealing the new law would add $145 billion to the national debt by 2019 due to projected cost savings that would not be realized. This figure would grow to $230 billion by 2021. After that the amount added to the debt would continue to grow, as the impact of eliminating a range of money-saving and revenue-raising provisions of the new law would begin to be felt.

The 32 million uninsured Americans refers to the number of people that were estimated to gain coverage under the law.

House Speaker John A. Boehner (R-Ohio) rejected the report’s conclusions, saying that "CBO is entitled to their opinion" and adding that the agency was working without all the necessary information when it did its analysis: “CBO can only provide a score based on the assumptions that are given to them.”

Meanwhile, House Republicans fired back with a report containing their analysis of the financial effects of keeping the law intact. The report, which draws on H.R. 2 for its name, is entitled: "Obama-care: A budget-busting, job-killing health care law."

A Gallup poll released January 7 showed that Americans remain divided on repealing the legislation, with 46 percent backing repeal and 40 percent opposing it. The survey also indicated that opinion on repeal remains split along partisan lines: 78 percent of Republicans are in favor of repealing the overhaul while 64 percent of Democrats are against repeal.

Brad Dayspring, spokesperson for House Majority Leader Eric Cantor (R-VA) said, "Americans have legitimate concerns about the cost of the new health-care law and its effect on the ability to grow jobs in our country."

Yet is the impact of the new healthcare law on the debt or the number of jobs it creates really the issue? As Washington Post analyst Glenn Kessler observed, "It was a law designed to reduce the number of uninsured Americans and (with a little luck) rein in medical costs."

Kessler, who writes a column for the Post entitled "The Fact Checker" wrote a piece last week that looks closely at the accuracy of budget claims by both Democrats and Republicans. He found the assertions being made on both sides of the party line to be lacking.

Debate in the House over repeal of the new health care law is expected to take place this week, with a vote tentatively scheduled for Wednesday. Like the vote which created the law, this one is expected to break down along party lines, so passage in the GOP-led House is probable. But with the Senate and the White House still under Democratic control, actual repeal of the legislation is all but certain to fail.

So while the coming debate in the House over H.R. 2 will likely have little impact on health care policy in the United States, it is sure to make for some fine political theater.