A strange twist of fate placed the beginning of enrollment for the Affordable Care Act and the first day of the new fiscal year on the same date: October 1. That coincidence gave Republicans an opportunity — or what they thought was an opportunity — to try and halt the start of Obamacare.
On Friday, Republicans in the House of Representatives pushed through stopgap bill by a party-line vote of 230 to 189 that would fund the federal government for the upcoming fiscal year only if discretionary spending for the Affordable Care Act is eliminated.
Both President Obama and Democrats in the Senate, where the party has a majority, have made clear that legislation would not progress any further than the House of Representatives, which of course makes a government shutdown likely unless someone gives up. Without that resolution, significant parts of the government could shut down on October 1, and within several weeks, the United States could default on its federal debt for the first time in history.
Naturally, the Republicans are blaming the Democrats for this round of brinkmanship politics, and vice versa.
But what policy experts want to remind Republicans pushing for the defunding of Obamacare is that a government shutdown would not stop funding for the implementation of the health care reform. “A shutdown per se doesn’t stop the Affordable Care Act,” Doug Holtz-Eakin, a former director of the Congressional Budget Office who now leads the American Action Forum, an advocacy group opposed to the health care law, told Bloomberg.
The Affordable Care Act relies primarily on mandatory spending, not appropriations, meaning government inaction will not prevent the exchanges from being operational — the massive computer system will still connect federal agencies to determine whether customers are eligible for coverage and if they qualify for federal subsidies to make coverage more affordable. “None of these agencies will in their entirety shut down, and their computer infrastructure is a pretty essential thing,” Holtz-Eakin said in his interview with Bloomberg.
Exchanges are the key provision of Obamacare. They are designed to allow consumers to comparison-shop for health insurance policies in online marketplaces where their collective bargaining power will theoretically foster competition and drive down prices. Except for the provision that mandated each state expand Medicaid, the Supreme Court upheld the constitutionality of the law and the exchanges in a July 2012 decision.
As Michael Horowitz, who was general counsel for President Ronald Reagan’s budget office during a during a short government shutdown, told The New York Times, the White House has room to maneuver: It can decide which workers should be furloughed, which agencies to close entirely, and which systems are deemed vital. In such situations, many government functions continue — Social Security checks would still be sent out, and Medicare would still pay doctors and hospitals.
“For Congress to ask for a shutdown when the opposite political party is in charge of the White House is my definition of insanity,” Horowitz said to the Times.
Republican opposition of the Affordable Care Act has become a standard party position. The argument central to the opposition of the Affordable Care Act is that the health care reform is unworkable; to many, the delays to the employer insurance mandate and the income verification provision have proved as much. Sen. Ted Cruz of Texas has argued that the law is a job killer because the added labor costs are not only discouraging businesses from hiring, but are pushing full-time workers to part-time employment.
Others have said the Founding Fathers would not approve it. Sen. Orrin Hatch (R-Utah) wrote in The Hill that that to come to “any other conclusion” than that the mandate is unconstitutional “requires treating the Constitution as the servant, rather than the master, of Congress.” The reform — which will cost about $1.8 trillion over the next decade — is also seen as an unneeded expansion of entitlement programs, one that would not improve health care but hurt it by decreasing competition and increasing premiums.
Speaking to the conservative news outlet Breitbart in late August, Sen. Marco Rubio of Florida outlined an entire laundry list of reasons why Obamacare should be defunded: small businesses fear the uncertainty of new health care costs, “all 17 states” that are setting up their own exchanges are behind schedule, unions are outraged they will not be able to keep their same plans, the success of the exchanges are dependent on the enrollment young people who will most likely choose to pay the tax penalty over the prohibitively expensive premiums, and insurers will shrink health provider networks, trading quality for affordability.
Beyond the particular problems of the Obama administration’s health reform law, there is also the principle of the matter: Rubio thinks the government should “not be in the business of taking over” one-sixth of the economy — health care costs currently account for about 18 percent of gross domestic product.
To be accurate, 16 states plus the District of Columbia have chosen to set up their own exchanges, while seven partnered with the federal government to operate their exchanges and 27 states defaulted to federally facilitated exchanges.
However, Rubio does not agree that defunding Obamacare should be pursued at the expense of the government. “The American people support defunding Obamacare and oppose shutting down the government,” he said in September 20 press release. “The House voted today to follow the will of the American people and the Senate should now follow suit.”
And he is right. The Kaiser Family Foundation, a health policy think tank, found in several surveys that Americans do not approve of shutting down the government. In the August health tracking poll, 57 percent of respondents said they disapprove of cutting off funding for the implementation of the health care reform, and of those that believed defunding is not the right option, 69 percent said it was because “using the budget process to stop a law is not the way our government should work,” while 56 percent said defunding would cripple the law, which is not good for supporters or opponents.
Given the current political rhetoric, it might seem surprising that Rubio opposes both funding Obamacare and shutting down the government, but he has argued that the only person threatening a government shutdown is the president. “What he’s saying is if you don’t fund Obamacare, I won’t fund the government,” Rubio said of Obama, meaning the president is the one with the ultimate responsibility because he signs the budget.
As for Obama, responding to the House of Representative’s Friday vote, he told autoworkers at a Ford plant in Liberty, Missouri, that the defund-Obamacare Republicans are only focused on politics. “They’re focused on trying to mess with me; they’re not focused on you,” he said.
On NBC’s “Meet the Press” on Sunday, four members of Congress — two from each party — were asked if there would be a shutdown. All four answered no. Yet the Brookings Institution’s Tom Mann told the Associated Press that there is a good chance of a government shutdown. While he believes it is more likely that both parties will come to an eleventh-hour agreement, he said to the AP on September 20 that House Republicans they “feel the need to go through the effort first.” Still, Mann said he thinks “there is a good chance of [the government shutdown] happening.”
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