Tuesday, November 15, 2016

Repealing Obamacare?

This is a tough one.  Obamacare is fully in effect.  Several million people are getting either tax subsidies to buy private health insurance, or Medicaid.  Repealing Obamacare would cut some people's tax rates and insurance rates, but take away health insurance entirely from millions more.  That is politically dangerous.

A year ago, I would have said that if Republicans got full control of the Presidency, House and Senate, they would have done the following.  First, they would have asserted that Obamacare is a cancer that has metastasized to the point that it can no longer be repealed with a chainsaw.  It must be done carefully and surgically.  First step:  repeal the employer, but not the individual mandate.  The difference is obscure to some, but important, symbolically to some, economically to few.  After all, most employers with more than 50 people voluntarily provide health insurance anyway.  It is mostly about either symbolism or thresholds.  But, Republicans could claim it as a big win.  Then, repeal the medical device tax.  After that, it gets tricky.  Every month or two, repeal some tiny, obscure provision, make a big deal of it, and then let it fade away, saying that they are getting deep into the weeds and counting on the press and the populace to have the memories of goldfish.

Now?  The thing about a Trump victory is that it says to Republicans that they can get away with grabbing 'em by the pussy.  When you're the President, they let you do that.

In 2009, Democrats took control of the House, Senate and Presidency for the first time since 1993-4.  That was the first time for them since Carter.  This time around, Trump was predicted to lose by most analysts.  And if he is the disaster that he could well be, that could spell long-term trouble for the Republicans.  Opportunities for major policy change are rare.  Democrats took the opportunity to pass Obamacare in 2010, recognizing the rarity of the opportunity.  They paid a heavy electoral price.

So, there are two ways to think of this.  First, Trump's victory, combined with the fact that Democrats paid a heavy price to pass Obamacare might mean Republicans can actually repeal it with fewer electoral costs than one might have expected.  Just be brazen.  Alternatively, Republicans may be screwed anyway, particularly if Trump is a disaster in other ways, so they may as well take their last opportunity to get rid of Obamacare along the way.  Either way, these opportunities are few and far between, so repeal it now.  Put another way, what's the point of campaigning if they just twiddle their thumbs and diddle their interns rather than actually passing legislation?

So, will Republicans actually repeal Obamacare?  A year ago, I would have said no way.  Now?  Haven't I been burned before with that kind of blanket prediction?

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