Commentary Magazine


Topic: insurance rules

Bad Policy, Worse Politics

James Capretta and Yuval Levin make a key point about the health-care bill snaking its way through Congress:

This timeline of tax and spending implementation corresponds rather awkwardly to the political calendar confronting the Democrats. The new entitlement, insurance rules, and other elements of the plan will not go into effect until well after the 2010 congressional elections and even the next presidential election, but some serious tax hikes will take place by then.

Meanwhile, again to make for a palatable CBO score, the bill envisions radical cuts in Medicare beginning quite soon. For instance, steep cuts in Medicare Advantage start in 2011, which means millions of seniors will begin hearing the bad news in 2010 as their plans withdraw from the program, cut their benefits, or raise their premiums.

So how exactly does this play out in the 2010 elections? Republicans will be holding up the Medicare cuts and urging seniors to run to the polls and vote the Democrats out. The Democrats will either savage their own bill by undoing the cuts or defend it as is, while explaining that other voters should be happy because by 2014 they will get subsidized health care. (“Essentially all of the spending provisions and insurance reforms–including the individual mandate to purchase health insurance, the employer mandate to provide it, the state insurance exchanges, the federal subsidies for coverage, and the Medicaid expansion–would only go into operation in 2014.”) Gosh, who has the better argument?

Then let’s break that down on a race-by-race level. In states where voters overwhelmingly oppose ObamaCare, Republicans running against incumbents like Byron Dorgan, Blanche Lincoln, and Harry Reid will run against the taxes, mandates, fees, and corruption. Republicans running in Blue states like California will question why someone like Barbara Boxer didn’t do a “better job” and allowed Nebraska or Iowa to get Medicare carve-outs, leaving their seniors to scrounge for doctors (who won’t make ends meet on Medicare’s reduced fees) and to live without their much-loved Medicare Advantage benefits. What exactly are the Democrats going to say to voters in an off-year election who are generally older, more conservative, and more politically savvy than the masses who turn out for a presidential election? I’m sure aggrieved voters will be delighted to hear that the bill is “historic.” But that means nothing to most of them, who have insurance and whose benefits and taxes are going to be impacted in a huge government power grab.

So if the bill makes no sense on the merits, it makes even less sense politically. The only question remains whether nervous incumbents figure this out and grudgingly agree to return to the drawing board. If not, they better figure out how they are going to defend this in front of enraged voters.

James Capretta and Yuval Levin make a key point about the health-care bill snaking its way through Congress:

This timeline of tax and spending implementation corresponds rather awkwardly to the political calendar confronting the Democrats. The new entitlement, insurance rules, and other elements of the plan will not go into effect until well after the 2010 congressional elections and even the next presidential election, but some serious tax hikes will take place by then.

Meanwhile, again to make for a palatable CBO score, the bill envisions radical cuts in Medicare beginning quite soon. For instance, steep cuts in Medicare Advantage start in 2011, which means millions of seniors will begin hearing the bad news in 2010 as their plans withdraw from the program, cut their benefits, or raise their premiums.

So how exactly does this play out in the 2010 elections? Republicans will be holding up the Medicare cuts and urging seniors to run to the polls and vote the Democrats out. The Democrats will either savage their own bill by undoing the cuts or defend it as is, while explaining that other voters should be happy because by 2014 they will get subsidized health care. (“Essentially all of the spending provisions and insurance reforms–including the individual mandate to purchase health insurance, the employer mandate to provide it, the state insurance exchanges, the federal subsidies for coverage, and the Medicaid expansion–would only go into operation in 2014.”) Gosh, who has the better argument?

Then let’s break that down on a race-by-race level. In states where voters overwhelmingly oppose ObamaCare, Republicans running against incumbents like Byron Dorgan, Blanche Lincoln, and Harry Reid will run against the taxes, mandates, fees, and corruption. Republicans running in Blue states like California will question why someone like Barbara Boxer didn’t do a “better job” and allowed Nebraska or Iowa to get Medicare carve-outs, leaving their seniors to scrounge for doctors (who won’t make ends meet on Medicare’s reduced fees) and to live without their much-loved Medicare Advantage benefits. What exactly are the Democrats going to say to voters in an off-year election who are generally older, more conservative, and more politically savvy than the masses who turn out for a presidential election? I’m sure aggrieved voters will be delighted to hear that the bill is “historic.” But that means nothing to most of them, who have insurance and whose benefits and taxes are going to be impacted in a huge government power grab.

So if the bill makes no sense on the merits, it makes even less sense politically. The only question remains whether nervous incumbents figure this out and grudgingly agree to return to the drawing board. If not, they better figure out how they are going to defend this in front of enraged voters.

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