HHS Secretary Kathleen Sebelius questioned the GOP’s promise to repeal the health care law, arguing that the party has no alternative for coving the 50 million Americans who went uninsured in 2009 or the ability to make up for the deficit reductions achieved by the law. Speaking this morning at a National Journal event to commemorate the six months since President Obama signed the reform bill, Sebelius also predicted that repealing the law will become less popular, as “millions of Americans” “will be receiving direct benefits from the passage of the law”:
SEBELIUS: By January there will be millions of Americans who will be receiving direct benefits from the passage of the law…I think the question is, and go back to what? Leaving 50+ millions Americans with no health care coverage, with rates continue to dramatically increase year-in and year-out with no safety net system. With no focus on the future. And with frankly an increase in the deficit that according to the Congressional Budget Office the implementation of this bill will reduce the deficit by $100 billion in the first 10 years and by close to a trillion in the second 10 years. [...]
What is the alternative? …There was never really an alternative put forward…but no strategy about what to do about the now 50 million Americans that are uninsured. No real strategies about cost control and containment. No strategies about how to go after fraud. All of the ideas that were put on the table were essentially incorporated. So I think there has got to be a realism about this debate.
To be fair, the GOP did offer and vote on a reform alternative that would have covered just 3 million people and actually lead to an increase in the number of uninsured. But Sebelius touches on an important reality. While the GOP may find some ways to defund certain parts of the health care law, they won’t be able to repeal it outright: they won’t have the votes, the offsets to pay for the deficit savings, or the public support. Consider this: according to the latest CBS News/NYT poll, 40% of Americans say they support repealing the health care law. But when told that repeal would allow insurance companies to exclude people with pre-existing conditions, support fell to just 19%.
As the benefits set in, reform will grow less popular and the GOP will have to stand up to its base. After all, it’s one thing to speak exclusively to conservative activists in a midst of a political campaign, but once the GOP is in charge, they will have to govern for the entire country. And telling millions of Americans that they will be taking away the law’s consumer protections and pre-existing conditions exclusions is not a good way to retain power. As Collin Powell put it yesterday, once you’re in power, “You can’t just say ‘no’ to everything. You can’t just sit around beating up the President.”
Of course, that’s not to say that the law won’t need to be amended or improved. At today’s event Sebelius predicted that the law will likely evolve, just like Medicare did after 1965. “Will the bill need fixing along the way? You bet,” she said. “You know, Medicare today looks little like it did when my dad in 1965 was a member of Congress and voted for Medicare. … It doesn’t work exactly like it did in 1965. It’s changed and developed along the way and I think that’s the framework possibility that we have.”