The Myths of ’Obamacare’ in GOP Campaign
To hear some Republican presidential candidates tell it, the president’s pen is a magic wand that can make "Obamacare" vanish in one day and sweep in cheaper health care, economic growth and lots of jobs in businesses freed from the health care law’s heavy hand.
But there is no such fairy dust in Washington.
Across the board, the contenders pledge to repeal the health law they denigrate as "Obamacare." In doing so, some are more realistic than others about what they can achieve and how fast.
The Republican case against the law comes with a dose of myth-making that may raise false hopes among voters who wish it could, in fact, simply go "poof." If the overhaul is to fall, it won’t happen overnight with a new GOP administration. Any dismantling promises to be just as much of a slog as was its creation.
Mitt Romney has been the most persistent in claiming that as president, he would free states from the law’s requirements with an executive order on his first day in charge, even though he would have no authority to do so. Rick Perry has held out the prospect of lower health insurance premiums once the law is gone, citing research that actually tells a mostly different story.
Herman Cain would like to turn repeal into a birthday present of sorts. He says if Congress moves fast enough he’d sign the repeal March 23, 2013 - his son’s birthday and the third anniversary of the law’s signing.
All place the law’s repeal as a chief component of their plans to grow the economy and jobs, rightly noting the overhaul’s myriad regulations but overselling the ability of one act of legislative subtraction to lift all boats.
A look at some of the claims in the Republican campaign and how they compare with the facts:
ROMNEY: "One thing I’d do on Day One if I’m elected president is direct my secretary of health and human services to put an executive order granting a waiver from Obamacare to all 50 states. It is bad law. It will not work. And I’ll get that done on Day One." - Claim in Sept. 7 debate, which he echoed in most other debates.
PERRY: "And I’ll promise you, on Day One, as the president of the United States, that executive order will be signed and Obamacare will be wiped out as much as it can be." - Sept. 7 debate.
CAIN: "I’m going to un-pass it on my son’s birthday." - Nov. 2 forum with the GOP’s Congressional Health Care Caucus.
MICHELE BACHMANN: "With all due respect ... issuing an executive order will not overturn this massive law." - Sept. 7 debate.
THE FACTS: Bachmann is right, and it’s not the first time she corrected her rivals on the matter.
A president cannot overturn a law with an executive order. Moreover, the health law lays out an onerous process for letting individual states off the hook from its requirements; that process cannot begin until 2017.
For a state to be granted a waiver, it must show that it will provide coverage that is at least as comprehensive and affordable as under the federal law. Also, a state has to insure a comparable number of its residents, and its plan must not add to the federal deficit by shifting costs to Washington. Finally, a state has to enact its own health law setting up the system envisioned in its waiver request.
Romney’s assertion also implies that all states would want to get out of the health care law. That’s a doubtful proposition for Democratic-leaning states.
Cain recognizes that for the law to be repealed, Congress must act. But presidents don’t set the congressional calendar, and even if Republicans can secure a 60-vote majority that gives them control of the Senate, the train of legislation seldom runs on schedule.
ROMNEY: "On Day One, granting a waiver to all 50 states doesn’t stop in its tracks entirely Obamacare. That’s why I also say we have to repeal Obamacare, and I will do that on Day Two with a reconciliation bill, because, as you know, it was passed by reconciliation, 51 votes. We can get rid of it with 51 votes." - Oct. 11 debate.
THE FACTS: This is a strategy to undermine the law by starving it of money. Its only real chance is if Republicans win congressional majorities as well as the presidency or at the very least a rash of improbable Democratic defections in Congress.
Although not a single-day project, it represents one threat to Obama’s law, if one with political risk and tough odds. Some core parts of the law are not dependent on annual budgeting.
Going beyond the budget process to repeal the law in full is an even steeper climb. It would require a larger Republican congressional majority to move forward and to clinch 60 votes in the Senate - all this as the law increasingly takes root in the nation’s medical and insurance system.
The law extends coverage to uninsured citizens and legal immigrants by providing tax credits to help middle-class households buy a policy and by expanding Medicaid for low-income people. It would require almost all people to carry health insurance, either through an employer, a government program or by individual purchase. It would set up health insurance markets in every state to make it easier for individuals and small business to buy coverage. It’s financed through tax increases and Medicare cuts.
PERRY: "According to CBO’s own calculations, repealing Obamacare will reduce the cost of health insurance premiums and reduce federal spending on health care." - His economic plan.
THE FACTS: No one can be sure what would happen with premiums absent the health care law, but Perry’s use of a Congressional Budget Office analysis was selective, at best.
The nonpartisan congressional accountants forecast that repeal of the law would raise premiums for people who get coverage from large-employer plans, not lower them, and that premiums could go either way for small-employer plans. About half the population is covered by such work-based insurance.
The CBO says repeal of the law probably would result in lower premiums in the individual insurance market, which covers about 4 percent of the population.
But there are important caveats. Many policyholders would probably end up paying more because they would not get the insurance subsidies provided under the law, the analysis says.
Individual insurance policies on average would provide fewer benefits, and cover less of an enrollee’s health care expenses, than will be provided by the insurance exchanges coming into effect under the law.
The analysis also projected that repealing the law would increase the federal deficit.