The Obamacare (Affordable
Care Act, ACA) controversy has been
rolled into reforming entitlements as
part of the dealing with the White House on raising the debt ceiling.and
deficit reduction. However, the GOP’s rationale
for defunding, repealing, delaying or sabotaging the ACA because it would increase the deficit is bogus. In fact, the GOP proposals would add to the deficit .
The GOP House of
Representatives has reduced their conditions
to ending the shutdown or raising the debt ceiling from defunding the ACA to delaying it a year to
just removing the tax on medical
devices, or removing the penalty on individuals who fail to sign
up for insurance by March 31. Rep. Paul Ryan did not even mention the ACA in an
op-ed in the New York Times as he tried to move the GOP goal to reforming all entitlements as a debt ceiling and deficit reducing bargaining chip.
Tea Party die hards still want to include the ACA in the
entitlement discussion. . To tie the ACA
to deficit negotiations is nonsensical. The Congressional Budget Office said the
ACA would decrease the deficit by $109 billion over ten years and that
the ACA added 12 years to the life of Medicare. The ACA has a “pay for” built in through a
variety of mechanisms: reducing the
overpayment to insurers for coverage and holding them to no more than 20% of
premiums for overhead; reducing payments to hospitals because they no longer
have to absorb the costs of treating uninsured patients who could not pay their
bills. The previously uninsured now have affordable access to insurance. Competition within the marketplace exchanges
are resulting in premiums which are even 16% lower than
original predictions. Unnecessary but
expensive subsidies to Medicare Advantage private insurer administrators have
ended. Some taxes and penalties will
also produce revenue.
Some fear that
increasing the debt limit is a go ahead to go into debt more in the future.
Lifting the debt limit does not approve more expenditures than Congress has already
approved. There are those that contend
that if the debt limit increase is not approved, nothing will happen.. There is no one in the business community or
Wall Street or the prime funders of the Tea Party movement,
the Koch Brothers, who agree with that.
What the GOP advocates could make the deficit worse. For example, removing the tax on medical
devices could add to the
deficit by at least $29 billion in lost revenue over 10
years. Another “pay for” should be
included in any deal to maintain the ACA’s contribution to deficit reduction..
Some deal is likely since the President
says it is not a “core” part of the ACA.
Another GOP proposal, to
delay the penalties associated with the mandate for young people to sign up is a
“core” attack on the ACA. Not bringing the younger and healthy into the
insurance pool would sabotage the affordability of covering pre-existing conditions because that
is what makes that part of the ACA affordable.
The GOP argues the
President let large businesses off the hook for a year from being fined for not
having health insurance for their employees. The difference is the impact on
the cost of the ACA. Only a very small percent of large businesses do not
already provide employee insurance.
Using
computer glitches in the federal web site as a reason to delay is a weak argument since computer software can be fixed and administrators have until March 31, 2014 . Fourteen states
like Colorado that opted to run their own systems have better results than the states who relied on the federal system. .
Sign up by computer Is not the only method to enroll.. Marketplace exchanges provide telephone and in
person enrollment as alternatives to on line sign ups.
