“Obamacare, ” the Affordable Care Act, will not be “repealed or fundamentally changed” by the next U.S. Congress.
That’s what Robert Laszewski of Health Care Policy and Marketplace Review and one of our favorite insurance and healthcare reform experts says after Republicans took over the U.S. Senate in midterm elections on November 4, 2014. He’s admittedly not a fan of Obamacare, but offers statistics and non-partisan insight to explain the insurance implications of the law.
Laszewski penned a commentary on November 5, to offer his views of what will happen to Obamacare now that the Republicans took over the U.S. Senate and increased their majority in the U.S. House of Representatives.
Here is what Laszewski had to say:
Obamacare: Death by a Thousand Votes?
We didn’t see a Republican tide on election night.
We saw a Republican tsunami.
A year after Obamacare went into effect and Democrats said people would come to support it voters gave one Republican candidate after another, who made Obamacare a big part of each of their campaigns, one victory after another.
So, how will the Republicans use their convincing result on Obamacare?
Republicans will not have the votes to override any presidential vetoes nor will they have the 60 Senate votes needed for full repeal. But the Republican Senate can now pass lots of anti-Obamacare legislation using budget rules. Remember, the Supreme Court said the individual mandate penalty is a “tax.” The health insurance company “3Rs” reinsurance provisions are revenue related. The Obama administration’s recently using regulation to take the caps off the reinsurance program is clearly a spending item. The medical device tax could well be a bipartisan target, as would the employer mandate. And, so on.
The even bigger House majority will be happy to go along with the Senate’s forcing Democrats to vote on one unpopular piece of Obamacare after another—and then forcing Obama to veto them.
Obamacare will not be repealed or fundamentally changed in the next Congress.
But the Republicans now have the opportunity to prepare the table for 2017—so long as they don’t overplay their hand.
What this election result has guaranteed us is that the Obamacare debate is not over.
Odds of Device Tax Repeal
The big issue for device manufacturers still remains the medical device tax
Wells Fargo analyst Larry Biegelsen wrote on Election Day that his Washington, D.C. consultant still believes the likelihood of a full repeal of the device tax is only between 30%-50% with Republicans in control of the Senate. The consultant says the best path forward for the repeal of the device tax would be as a stand-alone bill, or as part of a small package of bills that would win bipartisan support.
The “Offset” Hurdle
“The issue of whether or not repealing the tax needs to be offset [with cuts to other federal spending] is a significant hurdle. It is possible that the medical device industry could face a choice between a compromise that is helpful to only some companies and nothing. The bottom line is we see the likelihood of the device tax being repealed as still lower than 50% even with a Republican-controlled Senate, ” wrote Biegelsen.
One thing we know for sure about politicians in Washington is that they are rarely predictable about policy. They’re only predictable about doing what is necessary to keep their seats and majorities in Congress.
