Michael G. Franc and Gary Andres
Waging War on Obamacare
Obama and his allies won the first battle. Market-oriented reformers can still win the war.
The cloud of Obamacare has a faint silver lining. Both the substance of the bill and the way it was passed have boosted the electoral prospects for right-leaning candidates in November. That’s a critical first step toward repealing the most consequential expansion of government’s role in our daily lives in many decades.
Let’s be clear, however: To repeal or even defang Obamacare will require a combination of skill, luck, and the right political environment. And it will require conservative reformers in both parties (yes, both parties — the only bipartisanship on display this past year, it is worth recalling, has been bipartisan opposition to Obamacare). It’s doable, but it won’t be easy.
As long as President Obama is in the White House, his veto pen can stop any reform bill. A veto override requires two-thirds supermajorities in both House and Senate — a wholly unrealistic prospect unless Republicans make unprecedented electoral gains and scores of politically queasy moderate Democrats openly rebel against their party leaders.
But each day seems to bring news that should make moderates queasier and liberals less cocky. Less than a week after passage of the bill, major U.S. companies like AT&T, Caterpillar, and John Deere announced billions of dollars in writedowns to account for the new law’s financial impact. And thousands of Americans eager to sign up for their “free health coverage” learned they’d have to wait four years before Washington would start delivering on that promise.
More negative news is on the way. A long list of new tax burdens and regulations will create additional unintended consequences. The CEO of Medtronic Inc., for example, believes the new 2.3 percent excise tax on medical devices will force his firm to eliminate a thousand jobs. The CFO of Massachusetts-based Zoll Medical Corp. warns that his company may have to relocate 650 Bay State jobs overseas.
This fall, millions of seniors enrolled in Medicare Advantage plans will receive notices of benefit cutbacks or even the termination of their plans, thanks to Obamacare’s $200-billion cuts in the popular program.
With these developments looming on the horizon, President Obama and his Hill allies hope to focus attention elsewhere: on jobs and the economy. If Republicans, the conservative grassroots, and the media become preoccupied with other concerns, they hope, the voters will soon calm down.
Center-right America should not let itself be distracted.
A coalition of Republicans and a few courageous Democrats can jettison Obamacare if they gain the trust of voters on health-policy issues. That’s already starting.
Obamacare has not won the people’s hearts and minds. Despite wildly positive media coverage and the triumphant White House signing ceremony, surveys find public support for the new law dropping like a stone. Support in the most recent CBS poll has fallen to a dismal 32 percent, with opposition up to a new high of 53 percent. The same trend was apparent in polls conducted by Fox News and Rasmussen. Nearly six of every ten voters now support outright repeal, according to the most recent Rasmussen survey.
The polls reveal that frustration is particularly acute among political independents. Over half of the independents in the CBS poll, for example, thought the new law would increase their health-care costs; only 13 percent thought their costs would come down. Similarly, 42 percent expect Obamacare to deliver lower-quality care; only 13 percent expect it to deliver better care. By six to one (67–11 percent) they dismiss outright the claims by the president and Hill leaders that the new law will cut federal deficits.
Such intense animosity offers an opening for lawmakers who want to build voter enthusiasm for a market-oriented approach to health-care reform, which would be far less costly and would give Americans far greater freedom.
Democrats used to have an advantage in public opinion on this issue. Over the past two decades, however, Gallup surveys that have asked voters which party they trust to handle the health-care issue found that the gap between Republicans and Democrats narrowed whenever the GOP actively promoted its market-oriented alternative view.
The gap shrank in 1993 (after Republicans fought the Clinton health-care bill). It narrowed again in 1997–98 (when the GOP promoted a balanced budget, including provisions to slow the growth of health-care entitlements). Now, after a year of debate on Obamacare, the gap has closed once again.
A recent Rasmussen survey echoes the Gallup findings. It found that likely voters give Republicans a significant edge over Democrats (53 to 37 percent) on health care, a sea change compared with a year ago. The same poll shows that the GOP enjoys an even larger advantage among independents (58 to 22 percent), also a considerable improvement compared with November 2008.
In the past, lawmakers espousing free-market ideas on health care would abandon the playing field to liberals once the media ceased focusing on health care. Like a scrum of six-year-old boys following the soccer ball, they would pursue the next hot issue while liberals kept plugging away, adding new layers to Medicaid and transforming what once was a relatively modest program for children’s health insurance into a mushrooming entitlement that now covers childless adults with middle-class lifestyles.
This time must be different. Republicans and the moderate Democrats who opposed Obamacare must remain on the playing field. They must keep highlighting the many problems with this legislation and work tirelessly to convert nascent voter trust into a more permanent attachment. Only then will we have a realistic shot at replacing Obamacare with a better, market-oriented alternative.
The best way to do this is to broaden that playing field. Obamacare, after all, will not just lower the quality and increase the cost of our health care. It will also wreak havoc in many other areas of our lives. Federal and state budgets will explode; new tax burdens on investors and medical-device innovators will stifle job creation; tomorrow’s students and young workers will have to shoulder even greater fiscal burdens. And so on.
Specifically, reformers must:
Understand that the repeal effort should be waged at the state level as well as in D.C. Work closely with governors and other state officials in both parties to highlight the negative budgetary consequences and likely unconstitutionality of Obamacare. Recall that Tennessee governor Phil Bredesen, a Democrat, was the first governor to openly criticize Obamacare’s impact on his state Medicaid program;
Educate younger voters on how the new insurance regulations will increase their costs and dim their prospects for upward mobility;
Draw in the 9 million or so seniors who will bear the brunt of the Left’s crusade to destroy the only competitive corner of Medicare: Medicare Advantage;
Give platforms to entrepreneurs in the health-care sector to explain how the regulatory spawn of Obamacare will impede the development of next-generation medical breakthroughs;
Ditto for employers, who, as they encounter the harsh realities of Obamacare, will opt to scale back their workforce, farm out operations overseas, or simply leave their employees to the tender mercies of the Obama health exchange; and, finally
Give a voice to the tens of thousands of practicing physicians who see how Obamacare will eviscerate the doctor-patient relationship, robbing millions of patients of the quality care they deserve.
It’s hard to keep public attention focused on an issue once Congress acts. But history demonstrates that lawmakers who tout commonsense solutions to difficult problems gain credibility and trust when they persevere.
When it comes to health care, the GOP and like-minded Democrats must stay engaged and active, or else Democratic progressives will press ahead with implementing Obamacare, in the process exploding state and federal budgets and hindering upward mobility, while making health care more expensive and reducing quality for everyone.
— Michael G. Franc is vice president of government relations for the Heritage Foundation. Gary Andres is vice chairman of research for Dutko Worldwide.
April 12, 2010 4:00 A.M.
Putting Obamacare on Trial
Health reform will be at the center of the upcoming Supreme Court hearings.
The retirement of Justice John Paul Stevens means that in coming months we’ll have another hearing on a Supreme Court nominee. But it’s not likely to be the sort of hearing we got used to in the two decades after Edward Kennedy declared war on Robert Bork in 1987.
Nomination fights in those years centered on the issue of abortion. Many Republicans hoped and most Democrats feared that Republican nominees would vote to overturn Roe v. Wade. Democrats launched ferocious and often unfair attacks on nominees such as Bork, Clarence Thomas, and Samuel Alito. Republicans defended them warily, but refrained from launching similar attacks on Democratic nominees Ruth Bader Ginsberg and Stephen Breyer.
These were arguments over a political issue of little practical impact but great moral content.
A reversal of Roe v. Wade would have allowed states to criminalize abortion, but only a few — Utah, South Dakota, Louisiana, Guam (a U.S. territory) — would have done so; abortion would have remained widely available. But the feminist Left and the religious right believed that important moral principles were at stake.
This was a period when the demographic variable that most highly correlated with voting behavior was religion, or degree of religiosity, and the issue that seemed to be most critical to voting choices was abortion. Given the court’s activism in deciding abortion cases, it was inevitable that nominations would be hard fought over the abortion issue.
Those days are over. We didn’t hear much about abortion when Barack Obama appointed Sonia Sotomayor last year, and not just because the president was replacing one pro-Roe justice with another.
More important, the public’s issue focus has changed. And while the issue of whether to criminalize abortion tended to favor Democrats, the political issues that now raise constitutional questions tend to favor Republicans.
Those are issues raised by the big-government programs of the Obama administration and Democratic congressional leaders, in particular by the health-care legislation they jammed through Congress despite huge public opposition last month.
One is the constitutionality of the health-care bill’s mandate to purchase private health insurance. The federal government has never before commanded citizens to buy a commercial product. Could the government command you to buy breakfast cereal?
Some 14 state attorneys general are trying to raise the issue in court, and pending state laws outlawing mandates could raise the question, as well. Those state laws are obviously invalid under the supremacy clause unless the federal law is unconstitutional. Is it?
I would expect an Obama nominee to decline to answer. But Republicans may not take such a response as meekly as they did when Ginsberg declined to answer dozens of questions back in 1993. They might press harder, as they did in 2009 when they prompted Sotomayor to declare, to the dismay of some liberal law professors, that she would only interpret the Constitution and the law, not make new law. Just raising the health-care-mandate issue helps Republicans given the great and apparently growing unpopularity of the Democrats’ legislation.
Another set of questions could prove embarrassing for Democrats who have lauded Griswold v. Connecticut and Roe v. Wade for creating a right to privacy that includes contraception and abortion. “How can the freedom to make such choices with your doctor be protected and not freedom to choose a hip replacement or a Caesarean section?” asks former New York lieutenant governor Betsy McCaughey in the Wall Street Journal. “Either your body is protected from government interference or it’s not.”
McCaughey also notes that in 2006, the Supreme Court in Gonzales v. Oregon ruled that the federal government couldn’t set standards for doctors to administer lethal drugs to terminally ill patients under Oregon’s death-with-dignity act. So does the Constitution empower the feds to regulate non-lethal drugs in contravention of other state laws?
Such questions may not persuade an Obama nominee to rule that Obamacare is unconstitutional. But they can raise politically damaging issues in a high-visibility forum at a time when Democrats would like to move beyond health care and talk about jobs and financial regulation. Stevens apparently timed his retirement to secure the confirmation of a congenial successor — but some Democrats probably wish that he had quit a year ago, when they had more Senate votes and fewer unpopular policies.
— Michael Barone is senior political analyst for the Washington Examiner. Copyright 2010 the Washington Examiner. Distributed by Creators.com.
One interesting point in all this is that, contra Graham's days of rage on this board, the individual mandate to purchase health insurance that has long been central to Obamacare still exists (which is why so many state governments are preparing to go to court against it) even though the Democrats excluded a clear enforcement mechanism at the 11th hour. How then will such a "mandate" be enforced?
Look for amendments to the present bill in the future, as well as the IRS riding shotgun on any enforcement on its own imitative.