Can the Obamacare Power Grab Be Stopped? How?

Elsewhere last week, I reported on an Obamacare rundown I recently received from a prominent Washington insider:

[There has been] tremendous gloom among Capitol Hill Republicans and conservatives about Obamacare in recent days.

The just-announced full-year postponement in implementing the employer mandate was not an admission of failure, I was told, but an application of strategic delay. The idea was to put off some of the most objectionable parts of the law while aggressively signing people up. Remember, this insider went on, most of the people Obamacare targets have health insurance now. By luring them into the program, the administration gets them to surrender their current coverage. That way, when, after the 2014 midterm elections, the employer mandate starts to bite and calls for repeal become more urgent, these millions will be locked into the president’s system without a safety net.  They will become a core constituency for blocking repeal.  There is nothing that can be done to stop this….

But it turns out that there is another view circulating in conservative circles.  It is that, instead of shying away from Obamacare as an issue, Republicans should be doubling down on it.  The big GOP failure in the last presidential campaign, these advocates argue, was that we had a presidential candidate who could not argue in any coherent fashion against Obamacare at all.  Since November, where our candidates have sounded a clear trumpet of opposition, they have won.  Where their trumpet has been uncertain or silent, they have lost…

I share this second view. The GOP should make repeal of Obamacare a cornerstone of the next two election cycles.  

I would campaign to replace the Rube Goldbergesque monument to the hubris of the administrative state with, yes, expanded health savings accounts, as well as with a federal law making it legal to sell in all states any health insurance policy approved in one state.  And I would remove laws designed to preserve medical-service monopolies. Of these last, some are intended to protect hospitals from competing facilities that focus on particular conditions, procedures, or diseases, usually at an enormous quality and price advantage. Others protect doctors offices from multi-office competitors, including national ones. In short, I’d stop government from regulating the business of healthcare, which has become an admission room for rent seekers.

That is what I’d do. What would you do? Or are the Washington Insiders right? Is there nothing that can be done?

  1. BrentB67

    Clark you are hitting on what must be done.

    Running around screaming Repeal! at the top of our lungs is a losing strategy just as Not Obama is a losing strategy in elections.

    Conservatives will win the day when they formulate and articulate an alternative. There are 2 reasons ObamaCare got through: our healthcare system was already failing so there was an opening to do something different and D majority in both houses of Congress.

    If Republicans want to repeal ObamaCare they need a plan because the previous status quo was only a slightly smaller mess.

    I think republicans should be bold: break the employer grip on the market, restore consumer choice, re-establish the link between choice and payer, and not be afraid to explain that we will have the healthcare we can afford and/or choose to pay for.

    Additionally, Paul Ryan’s Medicare reform should be in the discussion.

  2. Paul A. Rahe
    C

    Someone in the Republican caucus should go to court, sue Sebellius, and get a court order requiring that the Obamacare law be enforced as written. This Republican should trumpet his opposition to the bill and trumpet his commitment to the rule of law.

  3. KC Mulville

    I certainly favor the piecemeal approach.

    The problem we see, consistently, with these broad bills is that (amazingly!) people don’t respond as lawmakers expect them to respond.

    Obviously, the biggest immediate problem with ObamaCare is that it has a 50-employee “full time” barrier, which means that anyone with more than 49 full time employees must provide “full” coverage. We’re now seeing how businesses respond: they cut hours. And in turn, the government trumpets how many people are working, as opposed to how many hours they’re working (and whether they’re making a competitive wage).

    Human beings are like water; they will find, erode, and exploit any openings they can possibly find. (That is, by the way, a good thing.)

    I’d much rather see one step at a time, observe the change in behavior, and then move onto another step … but only after the situation is stable.

  4. Nick Stuart
    The big GOP failure in the last presidential campaign, these advocates argue, was that we had a presidential candidate who could not argue in any coherent fashion against Obamacare at all.  

    The thought that ran through my head immediately:

    “The big GOP failure in the last presidential campaign, these advocates argue, was that we had a presidential candidate who could not argue in any coherent fashion against anything at all.”

    2014 & 2016. No more Mr. Nice Guy and Ms. Nice Gal. If the House GOP would drop the hearings schtick (hearings are not results, results are firings and prosecutions), fiddling with student loan rates, working on their tan, etc., and fight for something it would be a big step in the right direction. This would be a good place to start.

  5. BrentB67
    Paul A. Rahe: Someone in the Republican caucus should go to court, sue Sebellius, and get a court order requiring that the Obamacare law be enforced as written. This Republican should trumpet his opposition to the bill and trumpet his commitment to the rule of law. · 13 minutes ago

    I think that makes a nice show, but not much substance. How many court orders are there regarding the recess appointments to NLRB? Courts can order anything they like and the Obama admin will do what they want.

  6. Paul A. Rahe
    C
    BrentB67

    Paul A. Rahe: Someone in the Republican caucus should go to court, sue Sebellius, and get a court order requiring that the Obamacare law be enforced as written. This Republican should trumpet his opposition to the bill and trumpet his commitment to the rule of law. · 13 minutes ago

    I think that makes a nice show, but not much substance. How many court orders are there regarding the recess appointments to NLRB? Courts can order anything they like and the Obama admin will do what they want. · 4 minutes ago

    I disagree. The NLRB decrees will all be nullified, and this case would go through the courts quickly.

  7. BrentB67
    Paul A. Rahe

    BrentB67

    Paul A. Rahe: Someone in the Republican caucus should go to court, sue Sebellius, and get a court order requiring that the Obamacare law be enforced as written. This Republican should trumpet his opposition to the bill and trumpet his commitment to the rule of law. · 13 minutes ago

    I think that makes a nice show, but not much substance. How many court orders are there regarding the recess appointments to NLRB? Courts can order anything they like and the Obama admin will do what they want. · 4 minutes ago

    I disagree. The NLRB decrees will all be nullified, and this case would go through the courts quickly. · 2 minutes ago

    I will trust you are correct about the long term nullification, but when does that take place? 2016+? and what do we do about the damage from the one sided decisions handed down before then? Who reimburses those fighting the NLRB in court?

    I trust and hope you are correct, but as long as there is a rogue administration the courts are a weak sauce.

  8. Nealfred

    Is there nothing that can be done? Has the sound of a victim . There is plenty that can be done. I wish to make the single point here: employers and individuals should sue the administration on the grounds that this hideous piece of junk (APCA or whatever!) is unconstitutional require resignations in the highest offices meaning Roberts, Obama, Sebellius et alStay pissed! These peeps don’t represent us. The worst case scenario should be ok so you got your messed up “Law” now enforce it ! JERKS

  9. Merina Smith

    Here’s a cogent article on why Obama’s tactics are likely to backfire.  

    http://online.wsj.com/article/SB10001424127887323368704578596360026187772.html

    The wheels are obviously coming off the Obamacare bus for all the reasons Republicans opposed it in the first place.  Surely there must be a way to make political hay out of this. But I agree that viable alternatives must be presented.  

  10. Duane Oyen
    BrentB67

    Paul A. Rahe

    BrentB67

    Paul A. Rahe: Someone in the Republican caucus should go to court, sue Sebellius, and get a court order requiring that the Obamacare law be enforced as written. This Republican should trumpet his opposition to the bill and trumpet his commitment to the rule of law. · 13 minutes ago

    ……………….

    I disagree. The NLRB decrees will all be nullified, and this case would go through the courts quickly. · 2 minutes ago

    I will trust you are correct about the long term nullification, but when does that take place? 2016+? and what do we do about the damage from the one sided decisions handed down before then? Who reimburses those fighting the NLRB in court?

    I trust and hope you are correct, but as long as there is a rogue administration the courts are a weak sauce. · 44 minutes ago

    This would be great, but there is an historic separation of powers/standing issue regarding mandamus.  There have been few successes in persuading courts to step in between the other two branches of government.

    Someone ask John Yoo to expand on this.  Blue Yeti! C’mere!

  11. Duane Oyen

    Clark, look into the spectacular lack of success we have had in the across-state-lines insurance situation; Federalism, bolstered by the McCarran-Ferguson Act, would require that the latter be partially repealed.  And there is no lobby as effective as the NAIC in preserving their authority.  Talk to some of the AEI health care experts- in fact, Capretta could probably give you an earful on that.  This is going to require a more creative and dedicated approach.

    My concern with using such a strategy is that the strongest, loudest, and currently most influential voices on our side have spent the last 25 years pretending that there is no need to address the issue of health care, and what attention has been paid at all has been to yell “NO!” at every opportunity instead of seriously engaging the public on an issue that has seen every major country implement something.  As we have protested, we have left the door open for there Left to own the issue using tops-down approaches. 

    The public (correctly) does not trust us on the issue of entitlements- because they read Ricochet and infer that our plan is to get power and kill everything.

  12. FlyoverThinker

    Key piece that hasn’t been brought up yet:  disconnect the purchase of health care from employers.  This is a remnant of wage/price controls that limits portability and discourages creative insurance products.

  13. BrentB67
    Duane Oyen: . 

    The public (correctly) does not trust us on the issue of entitlements- because they read Ricochet and infer that our plan is to get power and kill everything. · 28 minutes ago

    You had me until this last paragraph, but we just disagree about these things.

    If you feel motivated I think a post about the lack of action by republicans to seriously reform this mess would be great. It looks like you have some very good insight on inter-state insurance issues, etc. I would benefit a great deal from hearing more about this subject.

  14. BrentB67

    Duane – looking forward to hearing your thoughts.

  15. Adam Brandes
    Nick Stuart

    The big GOP failure in the last presidential campaign, these advocates argue, was that we had a presidential candidate who could not argue in any coherent fashion against Obamacare at all.  

    The thought that ran through my head immediately:

    “The big GOP failure in the last presidential campaign, these advocates argue, was that we had a presidential candidate who could not argue in any coherent fashion againstanythingat all.”

    2014 & 2016. No more Mr. Nice Guy and Ms. Nice Gal. If the House GOP would drop the hearings schtick (hearings are not results, results are firings and prosecutions), fiddling with student loan rates, working on their tan, etc., and fight for something it would be a big step in the right direction. This would be a good place to start. · 8 hours ago

    “2014 & 2016. No more Mr. Nice Guy and Ms. Nice Gal.”  -says an incurable optimist. 

  16. Devereaux

    Interesting discussion here.

    Seems there are basically 2 ways to change all this. First is to bend the system slowly but carefully into something that might actually work, and second is to wrench it into a different system.

    The first is clearly the more gradual, and so less intrusive, method. But it requires a multi-generational plan and commitment, and I see no one or group so dedicated, nor any such plan. The Left has had such ideas and plans, and has implemented them. None of this happened last week, nor will it be changed next week in this approach.

    The second way is to wrench the system onto a totally different road. Such an approach requires some relatively significant event to destroy some part of the system – as Katrina destroyed the physical plant of schools in NO.

    Perhaps the Emanuel way of letting no crisis go to waste isn’t such a bad idea.

  17. Duane Oyen
    BrentB67

    Duane Oyen: . 

    The public (correctly) does not trust us on the issue of entitlements- because they read Ricochet and infer that our plan is to get power and kill everything. · 28 minutes ago

    You had me until this last paragraph, but we just disagree about these things.

    If you feel motivated I think a post about the lack of action by republicans to seriously reform this mess would be great. It looks like you have some very good insight on inter-state insurance issues, etc. I would benefit a great deal from hearing more about this subject. · 7 minutes ago

    Brent, notice that I didn’t say that was our plan- I said that the public perceives that that is our desire.  And I do indeed plan to write such a post- but be warned that it requires some of what appears on the surface to be added Federal involvement to unwind the mess we have right now.  But the ultimate objective is a solid market system.

  18. Umbra Fractus

    Thank you for linking that old thread, Duane. I’ve been trying to say this:

    Duane Oyen: You are not trusted to reform something if your continuously trumpeted opinion is that it shouldn’t exist. 

    1) The public will believe you, and infer from your words that if you were charged with reforming, you would instead kill it.

    2) The public, by large majorities, perceives a need for a program.

    3) Ergo, the public will never trust you to reform it.

    4) The other side is determined to preserve an untenable structure, due to wishful thinking and love of centralized power over the ignorant masses.

    5) Therefore reform does not occur until you hit the edge of the cliff.

    6)Reform is often done wrong (see the last 2 SS “fixes”).

    7) The fact thatithas to get that bad is our own faultbecause we ignore #2.

    …for a while now, but less articulately.