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ObamaCare As Unpopular As Ever But Administration Charges Ahead January 27, 2012

The latest tracking poll from the Kaiser Family Foundation shows that ObamaCare remains as unpopular as ever.

  • Americans overwhelmingly object to the individual mandate — most because they believe it is an over-reach of government powers and also because they believe the mandated insurance will be too expensive.
  • A majority also thinks the Supreme Court should rule the mandate unconstitutional.
  • Another interesting finding: Three in ten of those surveyed think a Court ruling against the mandate effectively will mean the end of the entire law, but a majority (55%) understands that parts of the law still will be implemented even if the Court strikes down the individual mandate.

Mitt Romney adviser Norm Coleman, a former senator from Minnesota, reinforced those fears this week when he predicted ObamaCare won’t be repealed, even if a Republican wins the White House in November.

“You will not repeal the act in its entirety, but you will see major changes, particularly if there is a Republican president,” Coleman told BioCentury This Week television in an interview that aired on Sunday. “You can’t whole-cloth throw it out. But you can substantially change what’s been done.”

Every Republican candidate — including Romney — has vowed to repeal the law. The Romney campaign quickly distanced itself from Coleman’s prediction. “With all due respect to Sen. Coleman, he’s wrong,” campaign spokeswoman Andrea Saul said. “Gov. Romney can and will repeal ObamaCare and is committed to doing so.”

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No doubt it will be difficult. Thousands of pages of regulations have been written and implemented that already are sinking deep roots into the health sector. In addition, tens of billions of ObamaCare dollars already have been spent that cannot be recovered. The repeal legislation would have to specify that the regulations that have been issued are void and acknowledge that money which already has been spent cannot be recovered, such as the $5 billion for health insurance for uninsured people with pre-existing conditions.

It will be a mess to untangle as the health sector already is reorganizing itself around the law and its many mandates. The administration is going full speed ahead in writing as many regs and implementing as many programs as fast as possible.

The biggest attack after repeal is that Republicans would take away health insurance from millions of people who otherwise would get it under ObamaCare. Republicans will have to offer a credible replace strategy, which Rep. Joe Pitts, chairman of the key health care subcommittee of the Energy and Commerce Committee, said would be offered this summer.

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Full speed ahead: Health Sec. Kathleen Sebelius said this week that even if the Court tosses out the individual mandate, her department will continue to charge ahead.

Sebelius said in an interview on The Daily Show — which she no doubt wishes she hadn’t done — that she’s confident the Supreme Court will uphold the mandate, but that there are alternatives if it doesn’t.

“I think we keep going,” she said. “We find ways to encourage people to become enrolled and become insured. And the mandate’s the fastest way to do it, and it just says, basically, everybody’s got some responsibility. But there are other ways to encourage people to come in.”

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And about last night’s debate: I wrote a piece recently for The American Spectator which takes apart the many inconsistent statements and positions that Gov. Romney has taken regarding RomneyCare and ObamaCare, including claims he made again during last night’s debate in Jacksonville, FL.

Romney is stubbornly defensive about his law, even as Republican voters see it as the platform for ObamaCare. John McDonough, who helped design both RomneyCare and then ObamaCare, said the federal law is, “Massachusetts with three more zeros.”

Romney’s statements are just not selling with Republican voters. For example:

  • Individual mandate affects “only 8%”: Romney has called the individual mandate requiring all residents to have health insurance “the ultimate conservative idea” because it takes care of “free riders.”Romney claims: “Our bill dealt with eight percent of our population, the people who aren’t insured and said to them, if you can pay, don’t count on the government. Take personal responsibility.”But the mandate applies to everyone, not just to the eight percent who were uninsured.
  • Repeal and Replace — with RomneyCare? In the October 11, 2011 debate, Romney said: “…we all agree about repeal and replace. And I’m proud of the fact that I’ve put together a plan that says what I’m going to replace it with.” He says he wants to repeal and replace ObamaCare, but then he says what he would replace it with is RomneyCare! Does he really mean that he wants to use Massachusetts as a model for his “replacement” plan? No wonder voters are worried.
  • Medicare cuts. Romney also boasts, accurately, “We didn’t cut Medicare.” This is a bogus boast, however, since states have no authority over spending in the federal Medicare program, and cutting Medicare therefore never was an option with RomneyCare.
  • Waivers for the states. Romney has said repeatedly that one of his first acts as president would be to “put out an executive order granting a waiver from ObamaCare to all 50 states.”But Romney can’t use an executive order to wipe out the law’s massive new federal entitlement program and its huge taxpayer subsidies for health insurance, its vast expansion of Medicaid coverage, the Medicare rationing board, $550 billion in new and higher taxes, $575 billion in cuts to Medicare, and federal mandates on individuals, businesses, and the states to comply with the law. These are all part of the federal health overhaul law and simply cannot be waived by executive order.The Congressional Research Service sent a letter to Sen. Coburn in November confirming this. “A President would not appear to be able to issue an executive order halting statutorily-required programs or mandatory appropriations…(or blocking) an agency from promulgating a rule that is statutorily required by PPACA,” the CRS concluded.So Romney’s campaign slogan is calling for an action that simply would not be legal. Waivers are not a solution and, in fact, might well detract from the ultimate goal of repealing ObamaCare and replacing it with a genuine free market alternative.
  • Mimicking Obama. When Romney says he wants to give states more discretion in implementing ObamaCare, there is very little daylight between his position and President Obama’s.The president has said Congress should pass legislation to accelerate the provision in the law that would allow states more flexibility in implementing the health law starting in 2017, arguing Congress should move the date forward to 2014. That is precisely Romney’s position. Not much room for debate there.
  • RomneyCare and taxes. He also defends RomneyCare by saying that Massachusetts didn’t raise taxes to finance his plan. That’s because Massachusetts simply passed a big share of its costs along to federal taxpayers. Massachusetts relied on previously-enacted health insurance taxes and an infusion of federal Medicaid money to finance its coverage expansion.Washington didn’t have any higher government authority to draw from so it had to raise taxes to finance ObamaCare. The fact that a significant part of Massachusetts’ coverage expansion relied on federal Medicaid money defies Romney’s position that the Bay State’s reform was a state solution.
  • The speed of repeal. Romney pledges to pursue the ultimate goal of repealing ObamaCare and replacing it with “free-market reforms that promote competition and lower health-care costs. But since an outright repeal would take time, an executive order is the first step in returning power to the states,” he wrote earlier this year.Actually, it wouldn’t. Romney’s cautious step-by-step approach overlooks the fact that the Republican House passed a repeal bill within a few weeks of taking power. If there were a majority in the Senate supporting repeal, then a new president could have a repeal bill to sign on his desk within a month or two of taking office.Why on earth would a President Mitt Romney want to send states on a wild chase to start implementing ObamaCare in a different way when, as he himself observes, the ultimate goal must be total repeal?

I offer suggestions for how Romney can adjust his position in my Spectator piece. Unless he takes steps to remedy his position, he will have trouble convincing Republican voters he is serious about repeal and will have an even harder time mapping a clear plan on health reform should he be elected president.

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CLIP OF THE WEEK

Beyond the Individual Mandate: Why ObamaCare Must Be Repealed

Grace-Marie Turner of the Galen Institute, Sally Pipes of the Pacific Research Institute, and Michael Tanner of the Cato Institute examine the continuing debate on ObamaCare, the impact and consequences of these policies, and an alternative path to improve health care for America.

HEALTH REFORM

A Supreme ObamaCare test
George F. Will, The Washington Post, 01/20/12

ObamaCare and Religious Freedom
Archbishop Timothy M. Dolan, The Wall Street Journal, 01/25/12

What We Give Up for Health Care
Ezekiel J. Emanuel, The New York Times: Opinionator, 01/21/12

Inside the ObamaCare Spin Zone
James C. Capretta, National Review Online, 01/23/12

How Health Care Dropped Out Of The Presidential Conversation
Julie Rovner, NPR: Shots, 01/26/12

Kaiser Health Tracking Poll
Kaiser Family Foundation, 01/12

Is ‘ObamaCare’ receding as a GOP cause?
Sally C. Pipes, Philadelphia Inquirer, 01/20/12

American Soldiers Deserve Cutting-Edge Health Care
Sally C. Pipes, Forbes.com, 01/24/12

MEDICARE AND MEDICAID

The Wyden-Ryan proposal — a foundation for realistic Medicare reform
Joseph Antos, The New England Journal of Medicine, 01/26/12

Medicare Advantage Chronic Special Needs Plan Boosted Primary Care, Reduced Hospital Use Among Diabetes Patients
Robb Cohen, Jeff Lemieux, Jeff Schoenborn, and Teresa Mulligan, Health Affairs, 01/12

ObamaCare: Obama Ends Medicare As We Know It
The Heritage Foundation, 01/25/12

STATE ISSUES

Massachusetts Health Reforms: Uninsurance Remains Low, Self-Reported Health Status Improves As State Prepares To Tackle Costs
Sharon K. Long, Karen Stockley, and Heather Dahlen, Health Affairs, 01/25/12

‘Tiered’ Insurance Confounds Consumers, Docs In Mass.
Martha Bebinger, Kaiser Health News, 01/17/12

EVENTS

Health Plan Innovations: Caring for Medicare and Medicaid Patients with Chronic Illnesses
America’s Health Insurance Plans
Friday, January 27, 2012
12:00pm – 1:30pm
Washington, DC

If You Like What You Have, Can You Keep It? PPACA and Employer-Sponsored Insurance
e21 Event
Tuesday, January 31, 2012
3:00pm – 4:00pm
Washington, DC

Health Care Reform: A Different Path – Current Federal Plan May Be Bad For Your Health
Orange County Forum
Thursday, February 2, 2012
11:30am – 1:00pm
Irvine, CA

Hatton W. Sumners Distinguished Lecture Series with Jeb Bush
National Center for Policy Analysis Event
Thursday, February 23, 2012
12:00pm – 1:15pm
Dallas, TX