Neil King and Janet Adamy offer us the Republican plan of attack on the Affordable Care Act:
Republican congressional aides and advisers say their focus would including blocking funding to hire new Internal Revenue Service agents, who are needed to enforce the law’s tax increases. They also would consider barring spending for a new board that approves Medicare payment cuts as well as on research that compares the effectiveness of medical procedures.
Other potential targets include funds to pay for a long-term care insurance program and money to help states set up insurance exchanges where consumers will be able to use tax credits beginning in 2014.
There are a bunch of different ideas here. And since they’re all framed as reductions in spending, it’s easy to overlook the fact that virtually all of these measures would increase the budget deficit. Failure to hire new IRS agents would increase the deficit by reducing revenue. Failure to finance IMAC would increase the deficit by increasing overall spending. Failing to take in CLASS Act revenue would increase the deficit by reducing revenue.
And there’s more!
Republicans would also bring to a vote measures that attack the law’s least popular parts, including the requirement that most Americans carry health insurance and cuts to payments for privately run Medicare plans.
Eliminating the individual mandate will increase the deficit by increasing outlays on exchange subsidies. Eliminating the “Medicare Advantage” cuts will increase the deficit by increasing spending on Medicare advantage.
The IMAC thing seems particularly noteworthy since one of the most common critiques I’ve heard made of the Affordable Care Act is the idea that many of its deficit-reducing provisions are likely to be repealed in the future. Whether history proves that true or not is something that only time will tell. But it doesn’t make much sense to simultaneously complain about ACA’s impact on the deficit while working to repeal its deficit-reducing elements.