Delaying The Implementation Of Health Reform Is A Bad Idea

Rep. Michael Burgess (R-TX) tells Inside Health Policy’s Sahil Kapur that he is considering introducing legislation to delay the implementation of the Affordable Care Act for two years or more until the Supreme Court rules on the constitutionality of the mandate and the economy is in better shape to handle the upfront costs of the measure:

In an interview Tuesday afternoon (Aug. 16), Burgess said delaying the law’s spending measures that begin 2014 would save money, though like other Republicans he would like total repeal of the law.

Burgess said the health law poses long-term financial concerns. “We’ve got the other looming problem in 2014, when the spending really accelerates out of the Affordable Care Act that’s really going to be disruptive to the budget,” he told Inside Health Policy. “On a larger scale, if we really wanted to control spending, we could look at postponing the 2014 start date and move that out by — fill in the blank — 2 years was my suggestion, but I’m willing to listen to other arguments.” […]

“Clearly it’s all building up to a point where the Supreme Court is eventually going to rule,” Burgess said. “All I would ask is, can we postpone the expense of implementation until we see which way this thing is going.” Burgess said the federal government is spending tens of billions every year to implement the law — money that, he argued, may end up being spent for no good purpose if the Supreme Court decrees some or all of the measure unconstitutional. “So if we could just agree to put a hold on the spending until we see the direction that this thing is going to go.”

This is very hard to take seriously. First, it’s true that the Affordable Care Act requires an upfront investment to establish a structure for universal coverage that reduces the deficit (and the rate of growth of health care expenditures) over a 10-year window. But since health care costs rise annually, delaying implementation not only postpones benefits, it also increases government expenditures. Everything is more expensive in the future and the longer we wait, the more the government will have to spend on premium subsidies, out of pocket cost sharing, etc.

The other point to make is that Burgess is going about this the wrong way. If he’s interested in balancing the budget, he should raise some taxes. If he wants to lower health care spending, then he should be offering a strong public option, a federal exchange, speeding up the delivery reforms, and a host of other cost containment initiatives that would actually save the government some money. Delaying implementation isn’t fixing anything. It’s only kicking the health can down the road.