The No. 33, and the surprisingly bipartisan art of repeal

Today marks the 33rd vote the Republican-led Congress has taken to repeal all or part of ObamaCare. Many media outlets are using the stat du jour as sort of de facto proof of repeal’s futility. Look at these silly, extremist Republicans, tilting at government-subsidized windmills 33 times!

The fact is this is only the second vote on total repeal, the first one coming in January of 2011 after Americans elected a wave of 63 new Republicans to, you know, repeal ObamaCare. Both votes for full repeal, in 2011 and 2012, were more bipartisan than the vote to pass ObamaCare, with three and five Democrats crossing over to the Republican side, respectively. And, I know we all love when we can work together, across the aisle, to get things undone. Beyond that, many of the votes on the Washington Post’s list feature far more Democratic defectors to the anti-ObamaCare side than the other way around.

The figure 33, of course, includes all sorts of bills that were only tangentially about ObamaCare repeal, or tweaked small parts of the bill, often with Democratic endorsement and votes. It includes several bills passed with hard-fought compromise later signed by Obama, like the debt-ceiling deal, and other bills that accomplished Obama’s legislative goals, such as the payroll tax cut extension bill.

So, are the House’s machinations futile and extreme?

There’s already been bipartisan cooperation in repealing large parts of the health care law in the House— the 1099 reporting requirement and the CLASS Act.

The very first part of ObamaCare to get the knife was the 1099 reporting requirement. That extremist bit of legislation passed the Senate 87-12 and the House, 314-112, and landed on the President’s desk for signing on April 14. The 1099 reporting requirement was one of the funding fictions ObamaCare supporters used to make it look as if the President’s plan would fulfill his promise not to “add a dime to the deficit.” Post-passage it was almost universally recognized as unworkable. It would have required businesses to fill out an IRS form (1099) for every $600 of staples and printer paper they bought at Target within a calendar year. It closed a loophole, and that loophole was shopping.

When it was repealed, Obama called it “a big win for small business.”

“Small business owners are the engine of our economy and because Democrats and Republicans worked together, we can ensure they spend their time and resources creating jobs and growing their business, not filling out more paperwork,” said the noted extremist.

The CLASS Act accounted for half of the Affordable Care Act’s claims of deficit reduction, but in February of 2012, it too was repealed by the House, with more than 28 Democrats crossing over to help. Obama’s deficit commission recommended its repeal and HHS Secretary Kathleen Sebelius admitted the program could not work in a letter she sent to Congress:

For 19 months, experts inside and outside of government have examined how HHS might implement a financially sustainable, voluntary, and self-financed long-term care insurance program under the law that meets the needs of those seeking protection for the near term and those planning for the future.  The work has been groundbreaking in many ways and has taught us a great deal, much of which is captured in the attached report.  But despite our best analytical efforts, I do not see a viable path forward for CLASS implementation at this time.

Great health care writer Peter Suderman explains why this new entitlement for long-term care collapsed under its own weight:

When the Congressional Budget Office scored the budgetary effects of the law, it counted the $70 billion in premium payments expected to be collected in the program’s first decade toward the law’s alleged deficit reduction—despite the fact that those premiums were eventually supposed to pay for the program’s benefits…

[T]he most likely problem the program faces is the specter that haunts all insurance pools: the death spiral. According to researchers at Boston College’s Center for Retirement Research, it’s a problem to which CLASS is particularly susceptible. Because premiums won’t be based on health status, the program is likely to prove particularly appealing to the sick. The sicker the population, the higher the premiums required to pay for their benefits. But higher premiums will drive away healthy individuals who need benefits less, resulting in an even sicker insurance pool, on average, which in turn will mean even higher premiums. From there, the insurance merry-go-round spins further out of control: higher premiums, reduced enrollment, a sicker and sicker population, and so on and so forth until the program is composed almost entirely of very sick, very expensive individuals. Indeed, in an absurd twist, the program’s broken financing model could hasten the death spiral’s ugly cycle by scaring away healthy individuals who might otherwise have bought in.

The CLASS Act is still on the books, threatening to fall apart the moment someone tries to implement it. Democrats aren’t anxious to kill off what Sen. John Thune called a “zombie” program for fear of losing the funding fiction it supports and ceding momentum to repeal efforts.

The 1099 repeal was the culmination of an eight-month-long fight.

Nancy Pelosi once said we needed to pass the health care bill to see what was in it. Once we found out, it turned out repealing large parts of it would be a “big win for small businesses,” and save us from giant entitlements without a “viable path” forward. Republicans will and should keep trying to remove these boondoggles, and sometimes it’s gonna take quite a few tries. It always does with zombies.

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Jazz Shaw 5:31 PM on December 01, 2022