Mike Capuano’s op-ed in today’s Globe re ACA implementation:
Outright repeal is one way to sabotage health care reform, but most opponents recognize they don’t have the votes for that, let alone enough to override a certain presidential veto. Of course, this has not prevented House Republicans from voting three dozen times to repeal health care reform. A 37th attempt took place earlier this month. All of this represents nothing more than political grandstanding. Since they haven’t been able to achieve an outright repeal, Republicans are also working to thwart implementation.
Over the last three years, the Obama administration and leaders in many states have been preparing for the full implementation of health care reform. At every step, the Republican majority in the House, their committed counterparts in the Senate, and their allies in many state houses across the country have sought to delay, obstruct, and undermine these efforts. Rather than fix the parts of the law that need to be fixed, they plot new ways to kill it by a thousand cuts.
Republicans have denied funding for essential preparations and made it plain they will resist confirmation of presidential nominees needed to administer it. Moreover, the Republican-led House has voted to defund the law and targeted specific aspects of it. They have voted to withhold salaries for employees who will set up health care exchanges, the marketplace where consumers will go to choose a plan. They have voted to repeal funding for school-based health care centers and voted numerous times to eliminate the Prevention Trust Fund. You don’t have to be a doctor to recognize that preventing illness is cheaper than treating it. Eliminating funding for programs like this will result in higher health care costs.
The evidence is overwhelming that Republicans are undermining health care reform whenever possible so that it will either be delayed, incredibly messy, or impossible to administer responsibly. Then, in the run-up to the next national election, they will simply blame Obama and Democrats for passing a bad law while denying they did anything to sabotage it.
Their national echo chamber will magnify those accusations, trying to provide them with the appearance of credibility. If the American public buys into their scheme and elects more Republicans, they may gain enough seats to win outright repeal.
When Medicare drug expansion coverage became law in 2003, Republicans overwhelmingly supported it and Democrats opposed it, including the late Senator Ted Kennedy, the champion of Medicare. The proposal added hundreds of billions of dollars of cost without any money to fund it increase. The outcome of a massive expansion without additional revenue is collapse — bankruptcy through the back door.
A similar path will likely be taken when it comes to some of the more popular aspects of health care reform, such as mandatory coverage for pre-existing conditions. No one will stand up in public to object to the goal, but Republicans will deny all funding needed to actually pay for it, with the same inevitable result: bankruptcy and collapse.
The Massachusetts delegation is vigorously fighting to protect health care reform, but Democrats do not hold the majority in the House, and therefore do not control the agenda.
It’s still too early to be confident that health care reform is safe and implementation will proceed smoothly. There are still too many opportunities for mischief and deceit. The death-by-a-thousand-cuts approach could lead to the collapse of health care reform just as surely as repeal of the law. Those of us who actually believe in basic affordable health care for all Americans must remain diligent, honest, and above all, prepared to continue this struggle for America.
It’s worth noting that early evidence suggests that Obamacare is actually working pretty well – to the extent that it’s been implemented. (Which, admittedly, is more than I expected. One of the benefits of being a pessimist is that sometimes you’re pleasantly surprised.)
More on Republican efforts to make government not work in an op-ed in yesteday’s NY Times, “The Wisdom of Bob Dole” (emphasis added is mine):
Bob Dole no longer recognizes the Republican Party that he helped lead for years. Speaking over the weekend on “Fox News Sunday,” he said his party should hang a “closed for repairs” sign on its doors until it comes up with a few positive ideas, because neither he nor Ronald Reagan would now feel comfortable in its membership.
“It seems to be almost unreal that we can’t get together on a budget or legislation,” said Mr. Dole, the former Senate majority leader and presidential candidate. “I mean, we weren’t perfect by a long shot, but at least we got our work done.”…
The difference between the current crop of Tea Party lawmakers and Mr. Dole’s generation is not simply one of ideology. While the Tea Partiers are undoubtedly more extreme, Mr. Dole spent years pushing big tax cuts, railing at regulations and blocking international treaties. His party actively courted the religious right in the 1980s and relied on racial innuendo to win elections. But when the time came to actually govern, Republicans used to set aside their grandstanding, recognize that a two-party system requires compromise and make deals to keep the government working on the people’s behalf.
The current generation refuses to do that. Its members want to dismantle government, using whatever crowbar happens to be handy, and they don’t particularly care what traditions of mutual respect get smashed at the same time…
At long last, this is finally drawing the rancor of Mr. Dole’s heirs in the responsible wing of the party. Senator Bob Corker of Tennessee said that negotiating on a budget was an “issue of integrity.” Roy Blunt, Lamar Alexander and many others have encouraged talks, and Mr. McCain (who was not above veering to the far right when he was running for president in 2008) now says the Tea Partiers are “absolutely out of line” and setting a bad precedent.
“We’re here to vote, not here to block things,” he said last week. “We’re here to articulate our positions on the issues and do what we can for the good of the country and the let the process move forward.”
More here on the conflict between old-school Republicans and Tea Partiers in the Senate.