Republicans Split Over Plan to Repurpose ObamaCare Funding


Photo credit: Gage Skidmore / Foter.com / CC BY-SA

There's an interesting split developing between foes of ObamaCare right now. On the one hand, there are folks who want to work within the boundaries of the Affordable Care Act, at least for now, and attempt to pass legislative tweaks that might improve the law. On the other hand are those who will settle for nothing less than full repeal.

You can see this split today in the back and forth over the Helping Sick Americans Now Act. The bill, which is scheduled for a House vote today, would take about $4 billion from ObamaCare's prevention fund and put it toward the law's high risk pools—the Preexisting Condition Insurance Plan (PCIP).

There are a couple of goals here. One is to put money towards the law's high-risk pools, which earlier this year were shuttered to new entrants due to a lack of funding. Republicans are generally more sympathetic to the concept of publicly subsidized high-risk pools than to other types of health reforms, although it's not clear that many are particularly big fans of the specific high-risk pools built into ObamaCare. (A number of Republican governors, for example, declined to participate in the program, deeming it a potential budget liability.)

Another is to take money away from the prevention fund, which is widely seen as a slush fund for funneling money to liberal causes—as well for potentially funding the implementation of the law's health insurance exchanges. So the argument for the bill is that it would shift money from something Republicans don't like to something they do like—or at least dislike less.

And in the process, some Republicans think they can perhaps embarrass President Obama by asking him to approve a funding shift that would help provide health insurance to as many as 40,000 additional people. If he says no, then what does that say about his commitment to helping people get health insurance? GOP members of the House Energy and Commerce Committee have already written a letter to the White House to this effect.

The bill's opponents basically argue that it does little more than rearrange deck chairs on a sinking ship. "We're shifting money from one part of Obamacare we don't support to another part of Obamacare we don't support," Rep. Justin Amash (R-Michigan) said today, according to NRO's Katrina Trinko. "That's a non-starter for me."

Conservative critics of the bill are worried that it will allow Obamacare's liberal backers to accuse them of wanting to spend more on the part of Obamacare they like. And sure enough, earlier today ThinkProgress ran an item titled "Republicans to back bill expanding ObamaCare program."

One question here is how much this sort of small-ball tweak really matters in the larger scheme of things. But what most Obamacare critics seem to be asking is whether or not it's worth the hypocrisy charges, and the inter-coalition squabbling, to try to repurpose the money to the high-risk pools. A concern is that although the high risk pools may be more amenable to the GOP sensibility than most of the rest of the law, they are still deeply flawed. Per-beneficiary costs turned out to be much higher in the program than expected—so high that despite enrollment being far lower than expected (about 100,000 versus the 300,000 initially projected) the program had to close entry early.

It's maybe not the best signal for the full-repeal crowd. And that's what worries some of them. "Our first vote on Obamacare," Indiana Rep. Tim Huelskamp told NRO, "will be an expansion of a failed part of the program that's come in drastically over cost."

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    1. NO KILL I

    2. Precisely. Complete nullification and repeal must be attained. Nothing short of that will be acceptable.

      1. By any means necessary. Kill the state exchanges. Defund. Attempt to repeal over and over again.

        And, all the while, come up with a deregulatory and de-welfaring scheme to restore something like a free market in healthcare and health insurance.

        1. Pussies, all of them.

          Well, maybe not all, but most of them.

          When the GOP took over the House, ACA shouldnt have survived the first session.

          1. …they voted to repeal it…they still have to deal with the Senate you know.

            1. I suggested they attach it to every single bill.

              Let nothing out of conference without it.

            2. Fine. Why stop? Ever? We do Obamacare, and we’re going to be fucking Europe. And not Germany, either.

              Don’t forget that the one big disadvantage we have in comparison to our European brothers [“And sisters!”]. . .and sisters is that we’ve got massive military commitments. So when we blow apart, we’ll do it much quicker.

              1. when we blow apart, we’ll do it much quicker.

                I have, sadly, come to the opinion that the only way we can kill the leviathan is total collapse and that Obamacarousel will speed this up and is therefore a good thing.

        2. That’s what I advocate in this matter — utter militancy in confrontations with the progressives.

          Obliterate them rhetorically, make heavy use of each and every trick, radicalize the states against federal enforcement — anything and everything.

          We have to draw the motherfucking line somewhere.

          1. Look, it’s not like we’re talking about some radical change. ObamaCarousel is the radical change, and it’s got shitstorm of disaster written all over it.

            If you can’t kill this travesty, then what good are you?

            1. +100.

              Trust nobody who contemplates compromise on the issue.

    3. No, fuck you, shift spending.


      The only use they have that I can think of is to prevent a meaningful and real opposition party from rising by sucking all the air out of the room.

  2. The GOP is engaging in political maneuvering as opposed to legislating or governing. Let’s see what they suck at most.

    1. See, GOP buddies? See why they can’t be trusted? Wanna bet that fucking Romney would NOT have killed ObamaCarousel? My ass he would’ve–this is the real GOP, the one that never takes significant steps to roll back Leviathan.

      I am so pissed.

      1. Too bad Tulpa isnt here to say, I dont know what, probably criticize your grammar or something.

      2. Romney was a fan of hefty, interventionistic governance. The only thing he would have accomplished is becoming a symbol of the supposed free-market failures the pinkos are railing against, despite his authoritarian ideology.

    2. I don’t mind them bidding their time if they intend on repealing or otherwise overhauling the law once they get the numbers in Congress and the presidency.

      But then again we see how they act once they get into power so I wouldn’t be surprised if they kept the popular aspects of the law. Gollum, after all, wants to keep his Precious.

      1. Please. Please fucking kill it. Please. I have children.

        1. Don’t beg ProL, progressives might be polishing their knobs with your tears as we speak. Stiff upper lip and all that.

          1. I’m not talking to those idiots.

        2. They will not kill it. It is just one more way to extract campaign support from industries that benefit from the law.

          It is now too late.

          1. The Dread Taxer Roberts did this to us.

            1. Yes, and there is pretty much nothing he can do in the future to negate the damage he has done.

            2. The Dread Taxer Roberts take no prisoners.

            3. Penaltax

              You keep using that word. I do not think it means what you think it means.

        3. They’re not going to kill it. The best we can do is let it collapse under its own weight.

          Of course the progtards will blame the evil obstructionist GOP, but imagine what a great campaign issue this will be for Amash when he runs for Senate and Rand when he runs for president.

          1. The unions with their gold-plated insurance plans are going to get fucked over pretty badly when Obamacare kicks in. We can only hope that a schism in the democratic party leads to a repeal of the worst parts of the law.

        4. Don’t worry Pro Lib. I will take care of your daughter for you.

  3. They only acceptable direction is zero cooperation with the democratic party on Obamacare. It’s a year away from utter failure, and during an election year no less. “Be the Obstruction”.

  4. “sinking shape”

    Freudian slip? Haven’t seen a picture of the Mrs. lately…

  5. AH HA! I knew you were all closet Republicans in Libertarian clothing!


  6. The bill’s opponents basically argue that it does little more than rearrange deck chairs on a sinking shape.

    What shape would that be? A circle? A square? Something more exotic like a rhombus or a dodecahedron?

    Is everything ship-shape over there at Reason?

    1. Even “a sinking ship”? Don’t they know the name of the ship? Isn’t the saying, “Rearrange the deck chairs on the Titanic“?

  7. I’m in the “legislative sabotage” camp.
    Add the following amendments:

    1. Let people avoid the penalty by buying high-deductible plans.
    2. Add more things to the list of things insurers can vary rates for (start with obesity).
    3. Eliminate the MLR provisions.

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