The Latest Game Change

Today’s Courier Herald Column:

Sometime between today and next week, the Supreme Court will issue its decision on Health Care Reform and Arizona’s immigration reform, along with 8 or so other cases.  While not overtly interjecting themselves into the national campaigns, the decisions are certain to help frame the debate for President and likely be an issue in Congressional races as well.

The fact that the ruling is likely to bring health care back into the realm of major issues is easier to predict than to decide who has the advantage if the law is struck down.  An Associated Press-GfK poll shows that just one third of Americans now support the legislation.  The same poll, however, shows that more than three out of four voters want some form of replacement bill should the law be struck down.

Republicans would surely use the rebuke by the court as the failure of the President’s signature legislative accomplishment.  Health Care reform and the President’s stimulus bill used most of President Obama’s early political capital to get passed.  The stimulus bill failed to keep unemployment under 8% as promised.  Without a health care bill in place, the list of accomplishments from the President’s first term grows significantly smaller.

However, voters are just as likely to look forward as to what will replace the law when deciding who they want representing their interests on the next attempt at Health Care Reform.  Republicans should be careful cheering the fall of the law should it happen, lest they be reminded that they did nothing on the subject when they held majorities in Congress and simultaneously held the presidency.

Independent voters are the ones most likely to base their November vote on health care.  Currently, only one in five independent voters approve of the bill, a new low for AP polling on the subject.  Cost savings have not materialized.  In fact, it is clear now that long term costs under this approach will increase above the rate of inflation.  This despite new taxes imposed within the bill and significant costs transferred to state governments by moving many to Medicaid rolls.

Yet the subject of no exclusions for pre-existing conditions and portability of coverage continue to be popular, but not free.  The Republican solution for private sector and markets to prevail does not account for the growing number of people who cannot buy health insurance at any price because of an ever expanding number of prior medical incidents that render the consumer ineligible. 

Telling a small businessman with chronic medical issues or someone who was separated from their long time employer a few years shy of Medicare eligibility to rely on the private market is folly.  While this response has been the traditional fallback of Republicans, a growing percentage of the general public are quite aware there is no market for these individuals under current rules.  Hearing Congressmen who have spent their entire careers with government provided healthcare lecture individuals who have no healthcare available for purchase that they shouldn’t be relying on the government for a solution is what drives many who would otherwise vote Republican to consider Democrats who offer a solution, even if it is not the one that  is most desired.

In a discussion with Congressman Phil Gingrey during the Supreme Court’s oral arguments for the case, the Congressman was quick to point out that Republicans understand there must be a “replace” option on the table if the law is struck down, and quickly.  He went so far as to say “shame on us” for not implementing real reforms when Republicans were last in charge, and said that the common ground items such as coverage for pre-existing conditions could be handled in a bi-partisan manner extremely quickly.

It is the speed of that response, and how quickly Democrats are willing to go along with a limited reform package, that would determine how long this remains an issue for the fall elections.  Unfortunately, this being an election year, any issue that the public wants passed can usually be held hostage by ideologues of both parties to make a point, which is often preferred to making law.

In a political environment, nothing can be expected to occur quickly.  Thus, if the Supreme Court strikes down health care reform, it is likely to become an issue equal to the country’s economic future as a focal point in this election.

8 comments

  1. Bill Dawers says:

    Excellent column. When I read more about this poll, I was surprised to see that 48 percent of Americans approve of Obama’s handling of health care, despite the much lower approval of the law itself. There are some difficult political realities here. If the vast majority of the law is upheld as Constitutional, as I suspect it will be, then I hope Republicans will get to work to try to make it better — whether Obama or Romney is president. If it’s struck down entirely, then we’ll be back at square one.

  2. Scott65 says:

    The other problem for Republicans is that if you poll on the individual components of the healthcare bill, people are very much for them. I chuckle at all of this because “Obamacare” is a republican idea from the Heritage Foundation no less. The simple fact is they have no plan because the only way to not blow the costs to the moon is the mandate, and there is no way they oppose the pre-existing exemptions, keeping kids on policies till they are 26…these are all very popular, and Republicans right now have no clue how they are going to replace them with anything cost effective. Healthcare costs are the problem…not insurance

    • John Konop says:

      The sad part is if we had just done what John McCain proposed, allowing seniors to buy drugs with VA pricing we could of fixed a major part of the problem. A big issoue is special interest spends huge money spinning bs and buying politicians while tax payers get left holding an empty bag. The only reason I am somewhat optimistic is we are running out of money for special interest and if our office holders do not wake up on this issue it will get ugly.

  3. saltycracker says:

    Now we are getting to the heart of the issue. Obamacare will drive costs thru the roof and the current approach will too and break the back of the paying participants supporting a larger legion of non-participants.

    Even under Obamacare millions of people will not be under the umbrella, from the ranks of the poor, the illegal and the “not for me’s”.

    Universal healthcare has a possibility of working only with everyone with some skin in the game – Obamacare does not do that and his individual mandate is just wordplay. If the court goes with Obama’s individual mandate or rejects it, then fiscal responsibility to the taxpayers & health care providers should involve a right to refuse service. Yes, they will be at charity’s doorstep, by choice. BTW, the Feds do that now with medicare folks out of the country.

    Universal healthcare is fiscal chaos if it rejects an open, competitive private healthcare market in favor of a government bureaucratic and corrupt mess as medicare/medicaid is today.

    These are not times the two parties can sit down and do what is right. Don’t expect the Republicans to put what is needed on the table. We will be picking out our own annointed winners.

  4. Dave Bearse says:

    “Republicans should be careful cheering the fall of the law should it happen, lest they be reminded that they did nothing on the subject when they held majorities in Congress and simultaneously held the presidency.”

    What about Medicare Part D, the unfunded drug entitlement for seniors , a group that already had massive government support of their healthcare? Fiscal conservaitves ought to remember it was determined within months of its 2003-2004 enactment that it would cost $100’s of billions more than the estimate that accompanied the legislation to the floor.

    That actually is a tad worse than nothing.

    • John Konop says:

      The sad part if we had just done what John McCain proposed, allowing seniors to buy drugs with VA pricing we could of fixed a major part of the problem. A big issoue is special interest spends huge money spinning bs and buying politicians while tax payers get left holding an empty bag. The only reason I am somewhat optimistic is we are running out of money for special interest and if our office holders do not wake up on this issue it will get ugly.

      • saltycracker says:

        Exactly – and big pharma is set to do very well under Obamacare..
        Millions of seniors had some prescription coverage from their retirement companies until
        Plan D. Like A & B , the Feds broke it and they now own it.

        The only direction left is to lower costs by opening competitive private doors and allowing providers the right of refusal to the uninsured. If that isn’t acceptable then everyone must get some skin in the game.

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