Since Tuesday’s elections, the leaders of the new House and Senate majorities have trumpeted their intention to repeal the Affordable Care Act, or at least cut off its funding (although they haven’t said how they’d make up the cost savings that would be lost). I must admit, the saber-rattling was getting to me.
The country does appear to be split about the ACA. An conducted by Edison Research for the AP reported that “about half – 48 percent – of voters want the health care law repealed. Another 31 percent said it should be expanded and 16 percent want it left in place as is.”
Among Florida voters, “a majority want it either expanded (30 percent) or left as it is (19 percent). About 44 percent of voters said [the health care law] should be repealed,” according to an exit poll by Edison Research for the National Election Pool.
But health care blogger Maggie Mahar looked at the issue and concluded:
[I]t is essential to realize that this [election result] was not a vote against health care reform. As [the Edison/AP exit poll] revealed, nearly two-thirds of voters identified the economy as the most important issue weighing on their minds; less than one-fifth named health care as their top concern.
Given the economy, Democrats would undoubtedly have lost their majorities regardless of what they did or didn’t do with health care reform, simply because they were the party in power. Writes Mahar:
Conservatives will continue to claim that the election was a referendum on reform. This is yet another Big Lie. If the administration had failed to pass reform legislation, the president’s party still would have been trounced at the polls, and the administration branded “impotent.” If the Obama administration had managed to push a stronger health care bill through Congress -- let’s imagine that a handful of progressives defied all odds, and passed a single-payer bill -- the majority of Americans who now are wary of reform would be totally terrified. (The fear-mongers would have made sure of that.) Progressives might have lost even more seats.
How much could the Republicans actually do? Given Obama's veto pen, any effort to repeal the entire law could not succeed. And Mahar points out that for all their threats, the Republicans may not really be able to do much about the funding:
It is unclear just how much of the reform legislation’s financing turns on Congressional approval. Reportedly, only about $100 million of the funding needed for the $1 trillion bill is subject to the Congressional appropriations process.... Moreover, as John Gever points out on MedPage Today: “The items in the ACA that require significant appropriations are either popular -- like bringing insurance to the uninsured -- or don't matter much to the electorate, like electronic health records. Killing these won't score points with the voters Republicans will need in 2012 to defeat Obama, and could actually hurt them.”
I suspect that Gevar is right when he says:
Everything you have read and heard about what the new Congress will do is posturing for 2012. It's all about the rhetoric, not the legislation. That's why you will see little actual change -- on anything -- until then.
So while I’ll be keeping an eye on what happens, I’m going to try not to let the Republicans’ threats get to me.