After surviving a year-long battle in Congress, a Supreme Court challenge, and the presidential election, Obamacare is here to stay. Just yesterday, GOP House Speaker John Boehner admitted yesterday that Obamacare is, in fact, “the law of the land.”
But Boehner was quick to walk back his comments via Twitter, reasserting that the GOP’s wish is still to fully repeal or severely dismantle the law. Since the Senate and the presidency remains solidly in Democratic hands, the GOP has their work cut out for them. But that doesn’t mean they won’t try their best to beat back, sue, and defund Obamacare provisions in an effort to neuter the law at the cost of Americans’ health and financial security. Here are three ways that the GOP will likely attempt to attack and undermine Obamacare provisions:
1) Denying federal insurance subsidies to Americans under health exchanges. If states can’t make a decision by November 16th about whether to set up health insurance exchanges, the federal government will set up one for them. But House Republicans may try to throw a wrench into those plans. Republicans are claiming that a minor technicality in the health reform legislation restricts its health insurance subsidies to Americans living in states that set up their own exchanges, and doesn’t extend to the Americans in states where the federal government sets up an exchange. This is obviously not what the health reform law intends, and IRS Commissioner Doug Shumlin has already issued an IRS-rule setting aside subsidies for Americans in all states. But Republican leaders may pursue this line of obstruction for insurance subsidies, essentially leaving sick and needy Americans to fend for themselves by denying them the subsidies that would make it possible for them to afford health coverage.
2) Resisting the Medicaid expansion. ThinkProgress has consistently reported on how Obamacare’s Medicaid expansion will significantly lower state health care costs while extending insurance to as many as 30 million low-income Americans — but only if the states agree to take part in the expansion, which the Supreme Court ruled optional. Even after President Obama’s re-election, GOP governors in states such as Florida are digging in their heels against reform. Sadly, many of the expansion’s GOP detractors lead states with extremely large uninsured populations, and their refusals to implement Medicaid reform might leave millions of low-wage workers without the health coverage they depend on.
3) Undermining the medical device tax and Independent Payment Advisory Board (IPAB). The device tax and IPAB are ways that Obamacare raises revenue for its vast coverage expansion and controls the rate of Medicare spending. Republicans are already eyeing the 2.3 percent medical device tax, calling it a burden on American businesses. But repealing the device tax risks grossly under-funding Obamacare’s insurance subsidies to Americans, meaning that Republicans are seeking to lower big manufacturers’ costs by shifting the burden onto Americans’ subsidized insurance premiums in 2014. Similarly, the independent, 15-member IPAB looks to keep American health spending at sustainable levels by finding ways to control Medicare spending growth without compromising on quality or benefits. While some of these cuts may be painful at first for hospitals and some physicians, the savings accrued will act as a firewall against seniors’ rising premiums and assure that providers, rather than everyday Americans, are bearing the burden of lowering medical spending.
Americans can expect continued battles over the proper funding and implementation of Obamacare in the coming months — for example, employer groups are almost certain to challenge the law’s provisions requiring that all large employers offer their workers health benefits. But now that the uncertainty over Obamacare’s future no longer exists, it isn’t too difficult to see what attempts to weaken the law really are: giveaways to large corporations, providers, and partisan politicking at the expense of real Americans’ health care and financial security.