Tuesday, October 14, 2014

What Happens if Senate Flips

Things which you don’t want to happen happen more frequently than things you do hope happen.

Plautus (254 BC – 184 BC)

What happens if GOP wins the Senate?

The short answer is: we don’t know. The long answer is: we know what GOP hopes to happen.

The GOP hopes ObamaCare is repealed.

And to that end, Republicans will hold one or more symbolic votes to repeal. But those repeals will be vetoed, and the GOP will not have the 60 votes to overturn a veto.

The GOP then hopes to offer an alternative plan which will contain these elements.

• Allowing shopping across state lines.

• Allowing small businesses to band together to reduce premiums.

• Strengthening Health Savings Accounts and Patient-Centered Health Advantage Plans.

• Leveling the tax-reform field by allowing individuals and small groups health spending deductions, in other words, making tax credits universal.

• Enacting legal and malpractice reforms to discourage defensive medicine.

• Allowing more free market and state-based decision making, particularly for Medicaid.

The Republicans will then to try to passing bills they think have a decent chance of passing.

These bills will include.

• Repealing the medical-device tax, which will have bipartisan support, even in blue states like Minnesota and Massachusetts and California.

• Taking a stab at repealing, defunding, or otherwise hobbling the individual and employer mandates, which are unpopular among the public and which have made the part-time workweek without health benefits the rule rather than the exception of full-time employment.

• Concentrating on those improper subsidies on federal health exchanges, which the law said could only be offered on state exchanges.

• Pointing out that only 67% of physicians accept Medicaid patients, the acceptance rate which could be increased by upping Medicaid pay and cutting regulations for physicians.

All of these hopes, in my opinion, will rest on the margins, if any, of the GOP Senate victory. With a small Senate margin, say 51 to 49, or a 50/50 tie partisan paralysis is likely. With a large margin, three to four or 54-46 or 55 to 45, other things are possible.

ObamaCare will be very difficult to reverse because three more health exchange signups are scheduled before Obama’s second term ends. How things pan out will depend on how many sign up, how smooth the healthcare.gov enrollment process is, how the public’s judges Obama’s competence , how steep premium increases and deductibles become, and how foreign affairs defeats or triumphs work out.

In any event, it will be difficult to reverse ObamaCare if as many as 15 to 20 million of America's 30 to 40 million uninsured receive benefits under the provisions of the health care law.

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