The GOP seems determined to reinforce its reputation as “the stupid party.” Senate Majority Leader Mitch McConnell and other prominent Republicans plan to co-sponsor a piece of legislation introduced by Wisconsin Senator Ron Johnson that, as he recently admitted in the Wall Street Journal, would allow Obamacare subsidies issued through federal exchanges to continue for two more years — even if the Supreme Court declares them illegal. This will not only mask the negative consequences of the sloppily written law, it will antagonize the voters who reinstated the GOP congressional majority last November and provide yet more time for Obamacare to metastasize.
Senator Johnson and his co-sponsors have evidently fallen for the counterintuitive Democrat talking point, relentlessly repeated in the media, that a Supreme Court ruling against the Obama administration in King v. Burwell will harm the GOP. King is, of course, the lawsuit whose plaintiffs hold that Obamacare subsidies can’t be legally issued though federal exchanges. PPACA stipulates that all premium assistance must emanate from state exchanges, but most states refused to establish such “marketplaces,” forcing HHS to create three dozen federal exchanges. The IRS has been issuing subsidies through these entities, which prompted the lawsuit SCOTUS will soon decide.
It is eminently possible that the Court will rule against the Obama administration, and this will leave millions of Obamacare enrollees in the lurch. It is, however, far less likely that the wrath of these Obamacare victims will be directed at Republicans, assuming the GOP handles itself with intestinal fortitude and intelligence. This problem was created by incompetent Democrat lawmakers, compounded by the illegal distribution of subsidies by an out-of-control IRS, and complicated even further by the refusal of the Obama administration to warn vulnerable enrollees of their peril. Republicans should not rush in to prevent the victims of this skullduggery from feeling the resultant pain.
Instead, they should initiate a public relations campaign that makes it obvious to the affected enrollees that the cause of their discomfiture is Obamacare itself and its disingenuous Democrat authors. The subsidy issue could be tied to the disastrous rollout of Healthcare.gov. After all, the enrollees adversely affected by a SCOTUS ruling will have been enrolled through that comically clunky website, and it would be neither difficult nor deceptive to represent the premium assistance problem as another predictable result of government ineptitude. Knowing how badly Healthcare.gov was bungled, few will have trouble believing that Beltway bureaucrats are also responsible for the subsidy mess.
Another reason Senator Johnson’s bill is a bad idea involves the voters who went to the polls in November, many with fingers clamped tightly over their noses, and provided the GOP with its congressional majority. As Michael Barone pointed out after the midterms, Obamacare was a crucial motivating factor for the voters who put the Republicans in control of the Senate. These people didn’t give power to the Republicans so they could make nice with Democrats. They want Obamacare repealed and replaced, and they are not going to be pleased to see the GOP producing a “bipartisan subsidy fix” that lets the Obama administration off the hook if the Supreme Court hands it a defeat.
In fact, as I pointed out in this space last month, a recent survey conducted in the states that refused to set up exchanges shows that the voters most likely to feel the effects of the Supreme Court ruling are already disposed to blame the subsidy mess on a “poorly written law.” A majority of these voters want Congress to re-open the law, and not merely to amend it so premium assistance can be legally doled out through federally created exchanges: “Voters want more than just minor tweaks that only affect individuals currently receiving subsidies.” In other words, the real people who would allegedly benefit from Senator Johnson’s proposal have already said, “No, thanks.”
Beyond masking the pain already inflicted by Obamacare, and damaging Republican credibility, the Johnson bill would allow the “reform” law to continue wrapping its regulatory tentacles around U.S. health care. The abomination whose supporters still call the “Affordable Care Act” is already doing immeasurable damage to our medical delivery system. Its technology mandates and Soviet-style price controls are causing rural hospitals to shut their doors at the rate of one a month, and driving community hospitals into the arms of ever more powerful corporate monopolies. This bilious combination is reducing access for patients, and increasing the cost for those who are able to get care.
Meanwhile, Obamacare is also killing what was once the foundation of American health care — the independent medical practice. Propaganda relating to the recently passed “Doc Fix” notwithstanding, PPACA has fundamentally transformed the independent MD into a dinosaur. As Dr. Scott Gottlieb writes in Forbes, “Obamacare required a consolidation of doctors into salaried roles, mostly as employees of hospitals and hospital owned health systems … This is supposed to give doctors an economic incentive to constrain their use of medical services.” In reality, it eliminates physician autonomy as well as competition. The result? “Doctors and patients will be the big losers.”
But Obamacare was never really about doctors or patients. Like all big government initiatives, it is about money and power. The voters instinctively understand this, and gave control of Congress to the Republicans in the hope that they would put a stop to this crime against democracy. If they follow the lead of Senator Johnson, and collude with the Democrats to keep illegal subsidies flowing, the GOP’s credibility will be destroyed. If, on the other hand, they allow the voters to experience firsthand the painful consequences of the latest Obamacare debacle, the Democrats may be damaged enough to lose the 2016 presidential election. Then, Obamacare can finally be repealed.