The Political Economy of Affordable Care Act Repeal

I think we should view this story about John Boehner’s new lobbyist-turned-political-director to be a good map to what will and will not be serious issues in efforts to repeal the Affordable Care Act:

Brett Loper, senior executive vice president at the Advanced Medical Technology Association, was deeply involved in the health care debate and fought against the fees Democrats ultimately assessed the industry to help pay for reform.

“I’m very pleased Brett will be joining our team,” Boehner said in a statement. “There are few people who are better equipped to help our new majority change the way the House works and advance a new governing agenda that reflects the will of the people we serve.”

Ask yourself what the Advanced Medical Technology Association likes and doesn’t like about the Affordable Care Act. Do they want to see subsidies for low-income people to purchase health insurance go away? Of course not, subsidized insurance means more insurance means more treatment means more purchases of AMTA. But how about the pay-fors? Well, as the article says AMTA fought against some of the taxes that are used to pay for the bill. Presumably AMTA also doesn’t like the idea of reducing wasteful Medicare spending. Conversely if you think about what liberals in Congress really care about, there’s much more concern with preserving low-income families’ access to health care than there is in preserving specific parts of the pay-for package.


During the actual negotiations over the bill, the White House — led by Peter Orszag at OMB — was fairly fanatical about making sure the increased health spending implied by expanding coverage was counterbalanced by cost control measures. But Orszag’s not at OMB anymore, he’s going to be a Vice President at Citigroup.