The news is that the House will vote on a measure to repeal the new health reform law on January 12.* “The repeal legislation will be a brief document that simply revokes the law,” writes Paul Kane (Washington Post, 1/3/11). But we all know that this route to repeal is itself dead on arrival:
In a Monday letter to Boehner signaling that they have no intention to consider the repeal, Senate Democrats cited the “doughnut-hole fix” as a key provision that must be allowed to take effect. “This proposal deserves a chance to work. It is too important to be treated as collateral damage in a partisan mission to repeal health care,”Majority Leader Harry M. Reid (D-Nev.) and other Senate Democratic leaders wrote.
And yet, those of us paying attention know the ACA was just a first step, that much more reform to our health system is needed. The new law is unlikely to do enough on cost or quality. In this, I agree with Don Taylor:
It is good news that we will revisit health care reform. I have written consistently that the ACA was a good step, in large part because it was a step. The law that was passed has the chance to begin to address health care costs if implemented, and substantially expands coverage, but we know that we will have to do more in the future to get a handle on health care costs. And we must do more soon because our long term deficit problem is fundamentally a health care cost problem.
But a House vote on repeal is not revisiting health care reform. It’s dodging it. The way forward is to either build on the ACA or at least be clear about what might replace it. What’s the “better way”? And by “better” I mean “can pass both houses of Congress, be signed by the president, increase insurance coverage at least as much as the ACA will, cost no more, and further improve quality.” Do the Republicans have a plan that can do all that? Don Taylor invites them to show it to us:
[Republicans] owe it to the country to provide clarity in the direction they would take the nation on health care reform. They have to shift from defense to offense. There is no evidence they have an offense.
Now is their chance to prove me wrong: they control the House of Representatives, and all the committees. They need to move beyond slogans and sound bites and write a bill. If it is so simple to address costs and 50 Million uninsured persons, the bill will be short and everyone can read it and get to know it well. Then have hearings on their bill. Mark it in a committee(s). Have the CBO score the bill. Let the country talk about it, and how it compares to the ACA. Debate the best way forward. And then put it to a vote in the full House of Representatives. The Republicans not only owe specificity to the country, they owe it to themselves if they want to be taken seriously on matters of health policy.
The only thing I oppose is debate without substance. If anyone wants to be taken seriously on health care (or anything) they’ve got to do the work, all of it. Democrats did so and they got a law passed and enacted. It’s not perfect, but it is an improvement over the status quo. Can Republicans make it better? It takes more than repeal.
*By the way, I think the January 12 scheduling is telling. It significantly ahead of the State of the Union address (Jan. 25 or so, I believe). That means that it’ll be old news by the time Obama gets to reset the message. What’s likely going on is that Boehner, knowing that repeal won’t go anywhere, that it is a symbolic vote, wants to send a signal to the GOP base without really getting in the way of more important business. In a sense, the schedule suggests to me that Boehner knows that the repeal vote is not itself very serious. If he wanted to make a bigger show of it, why not schedule it for a day or two before the State of the Union? Why not do it the day of the speech itself? That would be very confrontational.