I’m in agreement with Matt Yglesias and Aaron Carroll that chances of health reform being repealed are exceedingly slim. But that doesn’t mean it can’t be watered down to a far less ambitious scale. As I wrote before, money attracts a crowd, and there’s a lot of money in health reform that some would like to use for other purposes.
What I think is more likely than repeal, though by no means certain or even highly probable, is an erosion of the low-income subsidies in real terms, perhaps tied to a change in the minimum level of coverage required. A Republican congress and president might pass such changes along with a tax cut. It is very likely that Republican candidates will campaign on it.
I could see the whole thing being spun as middle class assistance: options for cheaper insurance and a lower tax bill, albeit with subsidies for the poor that don’t keep up. Since the poor aren’t a big constituency this strikes me as at least plausible.
Another wrinkle that could make this work is a weaker mandate that includes exemptions when the premium-to-income ratio is above a threshold. Put it all together and you’ve got a gradual erosion of health reform: worse insurance, less low-income assistance, fewer individuals covered, a weaker mandate. That’s not repeal, but it would make a mockery of the hard-won reforms. Watch for it.
by JP1954 on December 29th, 2009 at 13:46
Republicans may decide that the individual mandate is an easy target, but they’ll have a powerful adversary should they try to weaken or abolish it: The Heath Insurers. Without the mandate, insurers can’t cover pre-existing conditions or chronic illnesses. Moreover, Republicans will be hard-pressed to respond to charges that they intend to reward “free riders” who want to avoid having to pay for insurance until they actually get sick or injured.
Naturally, I expect Republicans to take the bait anyway. They can’t help themselves.
by KJ on December 31st, 2009 at 09:58
The GOP actually cutting spending in conjunction with enacting a tax cut? I’ll believe that when I see it.