This evening, Rep. Steve King (R-IA) explained that he opposed a provision in the Affordable Care Act that would allow children to stay on their parents’ insurance until age 26 because it could permit some younger members of Congress to “still be on mommy and daddy’s health insurance policy” when they’re elected*. King explained that all members should take responsibility for their own government-sponsored health insurance plans:
KING: What a lot of people don’t know in this country is that there are at least two members of this Congress that were elected before age 26 and had Obamacare been implemented before they had been elected to office, they would have, could have, been on their parents health insurance plan. Now isn’t that a nice thing when you wean them off of their parents’ health insurance plan and you transfer them over and put a pin on their lapel and say, ‘now run the country!’ They haven’t had a single minute of their own health insurance coverage until they get here and actually we have a responsibility for it here.
Later in the speech, King inadvertently made the case for the individual mandate when he defended the right of insurance companies to “discriminate” against individuals with pre-existing conditions. King argued that insurers should be able to ban individuals who waited to purchase coverage after becoming sick because property and casualty insurers can disqualify individuals who purchase a policy just as their houses catch on fire. Watch that HERE.
The individual mandate, however, would prevent this kind of gaming of the system by encouraging Americans to purchase insurance before they become sick.
* It’s unclear who King was referring to, however, since it appears that everyone in this Congress was over 26 years of age when elected. I have asked his office to clarify.
Moments ago, during a hearing in the Rules Committee, another Republican who supports repealing the Affordable Care Act announced that he would forgo the Federal Employers’ Health Benefits Plan (FEHBP) — the exchange that offers coverage at reduced rates to federal employees. Rep. Richard Nugent’s (R-FL) decision now brings the total number of Republicans who are staying out of Congressional coverage to seven, or just 3% of all the Republicans in the House:
NUGENT: I will tell you this, what I will pay for insurance to get through my employer, not through the House, will be almost — will costs me $9,000 more a year. But I wan to remain with that, because I think it’s the right thing to do. Because I think that when you have Americans that are struggling, why should I get a cost saving because I just got elected to the United States House of Representatives?
Yesterday, Republicans voted down a proposal offered by Rep. Joseph Crowley (D-NY) that would have required members to disclose the source of their insurance coverage. A spokesperson for House Speaker John Boehner (R-OH) dismissed the measure as “junk food” political rhetoric, suggesting that it has nothing to do with the Affordable Care Act. Under the health reform bill, the exchanges that become operational in 2014 are largely based on the FEHBP program and members would have to enroll in the new market place and face the same kinds of choices as their constituents.
Nugent joins Reps. Sandy Adams (FL), Bill Johnson (OH), Mike Kelly (PA), Bobby Schilling (IL), Joe Walsh (IL) and Daniel Webster (FL), and Rep. Frank Guinta (R-NH) in opting out of the program.
This morning, at a press availability at the U.S. Capitol Visitor Center, House Speaker John Boehner (R-OH) dismissed the Congressional Budget Office’s (CBO) estimate that repealing the Affordable Care Act would add $230 billion to the deficit over 10 years and would not commit to pursuing universal coverage that prohibits insurers from discriminating against individuals with pre-existing conditions if the measure is ultimately repealed. “I do not believe that repealing the job-killing health care law will increase the deficit,” Boehner said of the score. “CBO is entitled to their opinion, but they’re locked within constrains of the 1974 Budget Act”:
ON THE CBO: CBO can only provide a score based on the assumptions that are given to them. And if you go back and look at the health care bill and the assumption that were given to them, you see all of the double counting that went on, you’ll see the fact that the doc fix wasn’t even part of the bill.
WILL REPLACEMENT INCLUDE CONSUMER PROTECTIONS: We’ll deal with a resolution next week instructing the committees of jurisdiction to decide what those replacements would look like….We’ll let the committees do their work on how we will replace this…we’ll see what they come back with.
Boehner’s argument does not hold up on close scrutiny, particularly if you look at the actual meat of his criticism. He’s arguing that the Democrats artificially lowered the cost of reform by purposely excluding certain provisions — in this case the doc fix — that were part of an earlier draft of the bill or somehow manipulating the 10-year budget window. But the first charge is a marker of fiscal responsibility, not access: Democrats built their bill to ensure that it lowered the deficit and kept out pieces that it could not pay for. Consequently, the CBO found that the measure reduced the deficit by $143 billion over 10 years and — partly because the cost controls don’t kick in until late in that budget window — estimates that it “will reduce federal deficits during the decade beyond the 10-year budget window relative to those projected under current law—with a total effect in a broad range around one-half percent of GDP.”
But it’s not that Boehner has a problem with the CBO. He has a problem with this particular score because it would force him to admit that he’s kicking off his speakership by passing legislation that would explode the deficit. Recall that he praised the agency as a “nonpartisan Congressional score-keeper” when it served his political ends:
- “When it comes to reforming health care, controlling skyrocketing costs is the American peoples’ top priority. Now CBO has confirmed that the Republican plan will lower health care costs for American families, and that’s good news for everyone struggling in today’s economy. The choice now could not be clearer: Speaker Pelosi’s plan raises costs. Our plan lowers them.” [Boehner, 11/04/2009]
- “Democrats’ opposition to lawsuit abuse reform continues even now, after the non-partisan Congressional Budget Office found that these proposals, if implemented, would achieve significant savings for taxpayers.” [Boehner, 10/13/2009]
- “The Obama administration’s own scorekeeper at the Centers for Medicare and Medicaid Services says overall health spending will go up by more than $200 billion under the Democrats’ bill. The nonpartisan Congressional Budget Office (CBO) also says federal health spending will rise.” [Bohener/McConnell op-ed, 3/16/2010]
At the presser, Boehner dismissed questions about why Republicans refused to allow Democrats to offer amendments to the repeal provision that would retain some of the more popular consumer protections, saying, “I promised a more open process. I didn’t promise that every single bill was going to be an open bill.” He also made no commitment to adding the protections to the Republican replacement legislation or prioritizing reform in the new Congress.
A central component of the GOP’s argument for repealing the Affordable Care Act and replacing it with some yet-to-be-determined alternative is that some of the new requirements and regulations in the law will eliminate jobs and hurt small businesses. “What we believe is that Obamacare has been a job killer,” House Majority Leader Eric Cantor (R-VA) explained this morning on MSNBC’s ‘Morning Joe.’ “If you look at what’s going on in the regulatory arena in this town, the agencies have followed up the passage of that bill by implementing some real job killing regulations,” he added:
CANTOR: Where we’re putting our energy, as you said Mika, is jobs. And the one thing we keep hearing from small businesses and large is the Obamacare bill is chalk full of rules and regulations in the agencies that have now provided big disincentives for hiring. That’s part of what’s going on in this economy, is folks’ uncertainty where Washington is going next in the health care arena. That’s why we’re going to see a health care repeal bill come across the floor next week in the House.
But none of this makes a whole lot of sense. Since President Obama signed health care reform into law on March 23, 2010, the economy created 117,000 jobs per month, leading to a total of 935,000 new jobs in the private sector and economists estimate that the savings from health care reform could add even more. That’s because employers respond to rising costs by reducing benefits and lowering wages. But, since firms can’t significantly lower wages for employees at or near minimum wage or workers who are in fixed contracts, rising health care costs also lead to job losses. One study found that every 10% increase in health costs that are above GDP growth leads to 120,000 fewer jobs. Economists predict that reform will lower health care spending (CBO says that reform will reduce average premiums for employers with more than 50 employees by between 0 and 3%) and estimate that it has the potential of creating somewhere between 250,000 and 400,000 jobs — positions which will never be available if the measure is repealed.
This isn’t to say that businesses aren’t anxious about rising health care costs or the impact of the various health care provisions on the bottom line. But thus far, HHS has been quite flexible in how it implements the measure, granting businesses that can’t meet the new requirements temporary waivers and exemptions that would allow employers to change gradually and prevent immediate cost hikes. In the interim, a growing number of employers have taken advantage of the tax credit that allows businesses with fewer than 25 workers and average wages under $50,000 to deduct up to 35% of the cost of the premiums they provide for their employees and many are receiving money from the law’s reinsurance program, which assists employers with retiree health costs. The law also invests in Community Health Centers, which could create an additional 300,000 jobs in the neighborhoods that need them most and in 2014, small businesses can take advantage of the new health insurance exchanges to pool resources and lower costs by covering their workers through a larger risk pool. All this would free up dollars that could then be used for job creation.
So the burden of proof is on the GOP — since reform has been enacted, which jobs have been “killed”?
Moments ago, the Congressional Budget Office released its cost estimate for the GOP’s health care repeal bill — H.R. 2, the Repealing the Job-Killing Health Care Law Act, introduced yesterday in the House by the new Republican majority:
- 32 million Americans will lose coverage compared to current law: “Under H.R. 2, about 32 million fewer nonelderly people would have health insurance in 2019, leaving a total of about 54 million nonelderly people uninsured. The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, compared with a projected share of 94 percent under current law (and 83 percent currently).” (p. 8-9)
- Increases deficit by $230 billion over 10 years: “Consequently, over the 2012–2021 period, the effect of H.R. 2 on federal deficits as a result of changes in direct spending and revenues is likely to be an increase in the vicinity of $230 billion, plus or minus the effects of technical and economic changes to CBO’s and JCT’s projections for that period.” (p. 5)
- Huge deficit increases over next decade: “Correspondingly, CBO estimates that enacting H.R. 2 would increase federal deficits in the decade after 2019 by an amount that is in a broad range around one-half percent of GDP, plus or minus the effects of technical and economic changes that CBO and JCT will include in the forthcoming estimate. For the decade beginning after 2021, the effect of H.R. 2 on federal deficits as a share of the economy would probably be somewhat larger.” (p. 7)
- Individuals would pay more for health insurance: “Although premiums in the individual market would be lower, on average, under H.R. 2 than under current law, many people would end up paying more for health insurance— because under current law, the majority of enrollees purchasing coverage in that market would receive subsidies via the insurance exchanges, and H.R. 2 would eliminate those subsidies.” (p. 9-10)
- Average health care benefits would be worse: “In particular, if H.R. 2 was enacted… the average insurance policy in this market would cover a smaller share of enrollees’ costs for health care and a slightly narrower range of benefits.” (p.9)
- Premiums for employer-sponsored insurance would increase: “Premiums for employment-based coverage obtained through large employers would be slightly higher under H.R. 2 than under current law, reflecting the net impact of many relatively small changes.” (p. 10)
The GOP is excluding the vote from its new cut-go rule — under which increases in mandatory spending would have to be paid for but tax cuts would not — and dismissing the CBO’s estimates of savings in the health law by claiming that the initial savings from reform are largely imaginary. But this now places the new majority at odds with the ‘gods’ at the CBO — who they’ve routinely cited to bolster their own proposals — and its repeated pledges to lower spending in the new Congress.
In June 2009, the Congressional Budget Office scored an incomplete Democratic health care proposal, issuing an unhelpful analysis with little practical value. At the time, Eric Cantor (R-Va.) not only accepted the CBO numbers as gospel, but called the analysis “the turning point in the healthcare debate.” (Dems crafted a more complete bill, and soon received a better score.)
,Republicans come back with their expected response — Democrats fooled the CBO into thinking health care reform saved money:
I just asked Boehner spokesman Michael Steel for a statement on the CBO letter. “There is no one that believes the Washington Democrats’ job-killing healthcare law will lower costs, because it won’t,” Steel responded. “That’s why we pledged to repeal it, and replace it with common-sense reforms that will actually work.