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In government shutdown over Obamacare, who's being stubborn?

October 01, 2013|By Jon Healey
  • A mule stands firm at the site of a shipwreck near Tierra del Fuego, Argentina. Any resemblance to members of Congress is purely coincidental.
A mule stands firm at the site of a shipwreck near Tierra del Fuego, Argentina.… (Wikipedia )


The word has been uttered repeatedly during the debate about the stopgap spending bill, HJ Res. 59. House Republicans say Senate Democrats and the White House are being stubborn because they refuse to negotiate. Democrats say House Republicans are stubbornly refusing to acknowledge that the Patient Protection and Affordable Care Act, a.k.a. Obamacare, is the law of the land, having survived a Supreme Court challenge and a presidential campaign in which it was probably the main point of contention.

It's clear that the House GOP is being intransigent. If its members wanted to avoid a shutdown, as numerous House Republicans claimed Monday, they would stop attaching contentious healthcare riders to the continuing resolution. On fiscal matters -- and the CR is supposedly about appropriations -- the Senate quickly accepted the House's lower spending total. The only disagreement on spending, in fact, is whether to have the CR last until mid-December (the House position) or mid-November (the Senate's preference). That's just a minor dispute.

The more interesting question is whether Senate Democrats are being unreasonable by refusing to negotiate with the House over its riders. Isn't it unreasonable not to give an inch on the healthcare law?

It would be if House Republicans were just asking for an inch. They aren't.

Every proposal the House has offered up to this writing has included at least one provision that wasn't designed to improve the Affordable Care Act, but to kill it. They started by seeking to "defund Obamacare." Although cutting off appropriations for the measure wouldn't have affected many of its provisions, Democrats weren't about to support a proposal that billed itself (albeit misleadingly) as a way to stop the law in its tracks.

Then the House GOP switched to proposing a one-year delay in all new provisions of the healthcare law, such as the mandate to buy insurance, the premium subsidies, the Medicaid expansion and the requirement that insurers cover all applicants regardless of pre-existing conditions. It also proposed to repeal the tax on medical devices, which would have raised $30 billion (most likely, from insurers and others who paid for care) to help cover the cost of the new subsidies and new Medicaid recipients.

The point wasn't to give the federal government, states and employers more time to prepare for the new law. It was to push the start of these features and benefits past the next congressional election, when Republicans hope to regain control of the Senate -- giving them yet more leverage to try to repeal the Affordable Care Act.

The Senate rejected that offer as well, leading the House to return with yet another attempt to cripple the law -- this time in the guise of "fairness." The version the House proposed at the end of the day Monday would have delayed just the individual mandate to buy insurance, while requiring members of Congress, their staff and White House political appointees to pay more for their coverage.

House Republicans say it's only fair to push back the individual mandate, considering that the Obama administration unilaterally delayed for a year the mandate on larger employers to provide coverage to full-time workers. Yet that's a false analogy.

The point of the employer mandate is to deter companies from dropping health benefits when the federal government  offers insurance subsidies to those without coverage at work. The individual mandate serves a very different purpose. As I've explained before, guaranteeing people the ability to obtain insurance (as the Affordable Care Act does) without requiring them to do so only invites people to delay buying insurance until they're sick. That would leave insurers with a costlier group of customers, driving up premiums and leading more healthy people to forgo coverage -- in short, a vicious cycle that would wreck the individual insurance market.

There are some critics of the Affordable Care Act who predict such a cycle will happen anyway because the penalties for not obtaining coverage will be lower for many people than the cost of insurance. Maybe so, but delaying the mandate would only make that outcome more certain.

Senate Majority Leader Harry Reid (D-Nev.) is taking such a hard line, he's lending credence to the GOP charge that the Senate is being unreasonable. On the other hand, it's understandable why he doesn't want to go into conference with House members determined to hack away at the Affordable Care Act.

Here's another way of looking at it. If the House GOP succeeds in undermining the healthcare law through this temporary funding bill, it would only encourage the chamber to engineer more potential shutdowns or defaults in order to advance the policies it doesn't have the votes in the Senate to achieve. Defund the Environmental Protection Agency? Repeal the Dodd-Frank financial regulations? Eliminate capital gains taxes? Allow people to create private Social Security accounts? Where does it end?

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