The Supreme Court’s historic ruling today upholding the key provision of “Obamacare” — the individual mandate — affects politics, policy and constitutional understanding as few opinions have in U.S. history. It’s hard to think of another decision in this century or the last handed down so close to a presidential election that could be as consequential.
First the politics: Republicans and conservatives are energized by the ruling. With the same passion and enthusiasm against “Obamacare” that ushered in a Republican majority in 2010, the right now has the battle cry of “Full Repeal” heading into November. In fact, Majority Leader Eric Cantor (R-Va.) announced Thursday that the House will vote on full repeal on July 11. GOP intensity for the elections, already high, is now even higher.
The effect on Democrats is positive — for now. President Barack Obama today can claim victory for his seminal achievement. His supporters, deflated by his failure to create jobs and spur the economy, can point to his health care reform as a reason to reelect him.
Yet, after Obama and congressional Democrats repeatedly insisted in 2009 that the new health care law would not be a “tax,” the Supreme Court has now affirmed that’s what it is. Time will tell, but in an economy that faces more than a $1 trillion deficit, dismal 2 percent growth and 8.2 percent unemployment, Americans — whether Democratic or Republican — will likely grow increasingly displeased with the increased costs they are likely to shoulder thanks to “Obamacare.”
Starting today, health care has taken a close second place to jobs and the economy in the minds of the voters as both parties battle for public support in the next four months.
With this ruling, health care policy is again up for wide public debate. In calling for repeal, what should the GOP propose to replace the law?
Some timid souls will advocate that Republicans sit back, accept “Obamacare” as permanent and get started on implementing the law today. They are wrong.
It is critical that the GOP focus on the needs of the American people. Is a Big Government, high-cost, high-regulation program run by Washington bureaucrats really what we need to solve our health care problems? For the sake of our health, our health care and our economy, Republicans must take the lead on offering a positive alternative — one that provides higher-quality care at lower cost and with increased choice — for Americans to support this fall.
There are many policy proposals that Republicans have already advanced that contrast well with Obama’s plan to pull Washington deeply into the business of health care.
The GOP must advocate and advance legislation that aims to expand private sector coverage — but at an affordable price and not at the expense of quality medical care and innovation, things “Obamacare” will not do.
A plan to replace the health insurance exclusion for employees with a deduction or credit for medical insurance for both group employee and individual plans would be one strong step in the right direction.
When combined with the contrast that Republicans are drawing with the president on solutions to propel economic growth, a bold GOP health plan would further underline the urgency of this election. It will ensure that the public sees it as a referendum on the future — not just a choice between two individuals.
Republicans should also include a lead role for the states. Governors, especially Republican governors, have developed a formidable array of ideas to expand health coverage. The state health exchanges, properly defined and developed, could spur competition and innovation for consumers — if companies are allowed to really compete, not just on price but on benefit packages.
Individuals know far better than Washington the proper type and amount of coverage their families need. Republican governors also have a bevy of ideas to reform Medicaid. Now that the Supreme Court has ruled that states have the ability to opt out of the “Obamacare” forced Medicaid expansion, GOP legislators would do well to consider block grants to the states as a replacement for the current regulated fee-for-service system, which is on the verge of collapse in any case.
Today, Republicans must stay focused on the No. 1 goal: create jobs and expand the U.S. economy. Repealing and replacing “Obamacare” is a step toward achieving that goal.
Come November, Obama’s presidency will still be defined by record deficits, crony capitalism and a belief in an imperial chief executive. The effects of “Obamacare” effects will add to that. None are permanent policies. They can be changed or altered by future presidents.
The GOP’s real opportunity now is to stand up for the American people, remind the president that the “Obamacare” model of tax-and-regulate isn’t good enough and finally, define the choice this November — on health care and on the economy — as a choice between empowering government or empowering individuals.