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Tuesday, September 17, 2013

Obamacare: The Play Should Be Delay

Between now and the end of the calendar year, congressional Republicans and the Obama White House will engage in a protracted struggle over fiscal matters. The pile-up of must-do budgetary items now on the agenda makes that certain, starting with the need for stop-gap funding before October 1 to keep the government open and running. From there, Congress will need to increase the debt limit by November (according to the Obama administration’s projections) to allow the U.S. Treasury to continue financing the large deficits that no conceivable budget plan will eliminate in the short-term. And before January, Congress will again be pushed to eliminate the nearly 30 percent cut in Medicare physician fees required next year under current law—just as it has done every year for the past decade—and to pay for these added Medicare costs with offsetting spending cuts.

Such must-do budgetary items present a prime opportunity for Republicans. Legislation addressing these matters cannot get to the president’s desk without going through the Republican-controlled House. Moreover, the Obama administration cannot effectively run the executive branch using stop-gap funding measures. Such measures don’t provide enough certainty for agencies to make significant spending decisions, which means chaos for governance. At some point, therefore, the president will want to cut a deal with House and Senate Republican leaders to take budget uncertainty off the table for at least one year.

So the question is, when that time comes—probably in the days leading up to the holiday season in December—what should be the top priority of the GOP? Both for substantive and political reasons, Republicans should make it clear that their main objective is to delay as much of Obamacare as possible. 

Conservatives want to preserve the spending restraints secured in the last round of budget negotiations (although most would prefer that the brunt of them not be borne by the military). But the importance of those cuts pales in comparison to Obamacare. Obamacare is a massive, trillion-dollar entitlement program that will shift nearly total control over the health sector to the federal government. It will undermine our long-term fiscal solvency, our health-care system, and our liberty. There is simply no other policy concern that approaches Obamacare in importance. Anything that can be done to roll back or delay it, therefore, is far more important than preserving spending restraints that squeeze but don’t fundamentally alter the size or scope of the federal leviathan.

Fortunately, there are new signs that GOP leaders and rank-and-file members are coalescing around the view that Obamacare should be their primary target—and that delaying it should be their principal short-term goal. 

This is a very welcome development. For the past month, Republicans have been engaged in an intramural squabble over whether or not a defund—rather than a delay—strategy would work. Defunding Obamacare would achieve essentially the same result as delaying it, as each would temporarily prevent the overhaul from going into effect. 

But there are big differences between the two strategies from a political perspective. For starters, the president has already unilaterally and lawlessly delayed major parts of the law. In July, he delayed the law’s employer mandate for a year because the cost of enforcing it was prohibitive and because its definition of full-time work (more than 30 hours per week) is pushing millions of workers into part-time status. The president also delayed its mandated caps on out-of-pocket health costs and postponed the ability of small businesses to offer multiple insurance options to their workers in the “exchanges.” Moreover, the administration has announced that some of the basic information needed to test eligibility for subsidies on the exchanges will be based on the “honor system.” 

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