Friday, January 14, 2011

The Logic of the Repeal Vote

I've been saying that the ACA repeal vote now scheduled in the House for next week is basically a symbolic payoff to Tea Partiers and other core Republicans, who the leadership hopes can be bought off with symbols since their real goal -- full repeal of ACA -- is unrealistic in the current Congress.

Note that there was another track Republicans could have taken. Rather than go for a full repeal that will be dead on arrival in the Senate, Republicans could have targeted the least popular provisions of the ACA and attempted to force them through by attaching them to must-pass bills, thus forcing Democrats in the Senate to either sign off on them or face a damaging fight. 

Now, Republicans could still do that. It's actually not a bad way to unravel ACA; most of the unpopular parts are needed to pay for direct benefits, or to make an overall popular scheme (such as helping those with pre-existing conditions get insurance) work.

But as Aaron Carroll notes today, there's a very good reason for Republicans to avoid that path: GOP-aligned interest groups, and independent groups that support many Republicans, like things the way they are. Read the post for details.

What interests me here is that this is sort of the flip side of the much-noted passage of ACA with only Democratic votes. Many, at the time, claimed that strict partisanship in passing major legislation is highly unusual, and speculated that the result would be that the bill would be more vulnerable in the future.  This story suggests that not only was it important in an age of partisan polarization to buy off various important groups in order to get the bill passed, but that very same process may also protect the bill after passage. 

We shall see, of course, how it works out in practice.  Republicans certainly didn't hesitate to oppose the bill in 2009-2010 despite the support from several groups who are normally GOP-aligned or at least GOP-friendly. Will they fight against the interests of those groups now? Will they, if they win full control of Congress and perhaps the White House in the near future? I don't know.  What I do know, or at least suspect, is that industry lobbyists aren't really going to care one way or another about purely symbolic votes on the floor of the House. If that's all it takes to satisfy GOP activists, well, that's a deal that the lobbyists will be very happy to make.


  1. I've been going over the same questions in my head for months, in a much less organized and less articulate way.

    What if the insurance mandate does get repealed (either by Congress or the Supreme Court), but the American people demand to keep the popular parts of the law? That seems to be the American way, sometimes.

    There was some poll I glanced at recently about government spending. People oppose raising the debt ceiling by a huge percentage, AND oppose cutting spending on any of the high-price services we enjoy. If I remember correctly, the only places where people supported cutting spending was to foreign aid and to the IRS.

  2. Write your post in a word processor, and then use the find and replace function to replace any string of two spaces with one space.

  3. What if these groups only supported ACA because they read the tea leaves to say that the status quo was going to change, so they might as well try to negotiate what the new policy would be?

    I don't seem to recall health insurers pushing for the individual mandate in the absence of other changes; I seem to recall their argument to be that IF you make changes, you need to give us the mandate for us to afford it. Not that they had an unreasonable argument, but in 6-ish years of GOP control, I don't recall anyone seriously proposing the individual mandate alone.

  4. I guess I just have to wonder if you can trust the Republicans to take a longer, more complicated route like that (or like a gradual de-funding of it through the appropriations process). I kinda feel like if those were the Republicans' actual plans, they'd be laying more groundwork for it publicly instead of setting up this vote as the be-all-to-end-all. And plus, I can just never trust politicians to take arduous, substantive action when a flashy, symbolic one is on the table. Seems like next Wednesday is a perfect out for them- protest ACA, but then never really have to fight it down.

  5. personally,

    I would prefer to see the Republicans set this for a non-binding referendum in November.

    Ask the American people, not in a poll, but straight up.
    Repeal or don't repeal.

    It will get the same claims of just showmanship ... EXCEPT

    Can you seriously see a congressperson or Senator from EITHER party telling their constituents during the campaign of 2012 ...

    "Yes I know how you wanted me to vote. Shut up. I didn't have to listen to you then, I don't now, and I won't in the future. Now will you please re-elect me so I can continue to vote how I want and ignore your wishes."

    Even President Obama wouldn't be able to run for re-election if he ignored the non-binding referendum and vetoed the bill.

    Hell, they couldn't even really vote no on having the referendum in the first place.
    No one wants to go on record as saying "We do not CARE what the voter wants or does not want. The voter gets what WE say they deserve!"

    10 months. Make your best case. Live with the consent of the governed.

  6. Meh, we have a representative democracy, we have it for several good reasons, and I'd just as soon not compromise that, even through such "backdoor" methods.

  7. Here's what liberals could do to thwart a non-binding referendum: ignore it. As it stands, the Senate can table it and the President can veto it. Even if it unaccountably passes through the House and the Senate, an organized boycott would make the referendum rack up Saddam Hussein-esque numbers, making it clear that the so-called "referendum" (which would attract only those angry enough to take time out of work to register their disapproval) was a Republican ploy.

    There's no universe in which this would work.

  8. Without an extreme makeover, the GOP won't get serious about repealing ObamaCare in 2012, whether they control the White House or not.

  9. Anyone who has actually thought clearly about "Obamacare" has realized long ago that this is a corporatist scheme by insurance companies and Wall Street to increase their looting of America. Different packaging of the rationale for this corporatist looting is played to appease the prejudices of both left and right. For the left its all about compassion for suffering and right to die a dignified death. For the right its smaller government, lower taxes, and the right to "prosperity." Both roads lead to the same dead end...The problem with America's voting public is a lack of courage to unshackle oneself from the self imposed ideological blinders of such left versus right hogwash. Just as in Jonathan Swift's fable of the Liliputian wars over which side to crack one's egg, this ideology has been manufactured as a means of controlling the "debate." All the while the "too big to fail" criminal speculators laugh all the way to their bailouts.

  10. RightKlik- I dunno, I think if the Republicans have the trifecta in 2012, they'll repeal it. Their base wants it, they probably don't honestly care about it, and it wouldn't really cost them much, so why not? Of course, getting the trifecta, that's the tricky part...

    "this is a corporatist scheme by insurance companies and Wall Street to increase their looting of America. "

    Yes, that must be why the insurance companies and Wall Street spent tens of millions of dollars to block the bill, and then tens of millions more to defeat the people who voted for it. I mean, "anyone who has actually thought clearly" is language just weasly enough that I'm sure you'll find a way to exclude anyone who disagrees with you, but the list of health care experts and policy wonks who seriously studied the bill and came out in favor of it is a much longer and more distinguished list than the one of people who claim ideological debates in this country are scams.

  11. >I think if the Republicans have the trifecta in 2012, they'll repeal it.

    Not unless they gain 14 seats in the Senate and keep all of them on board.

  12. oooh, good point, probably right. However, it doesn't tax my imagination very much to see that the next party to win the trifecta will seriously curtail the filibuster.

    (That being said, if the Republicans get the trifecta in 2016, I'm not so certain the repeal health care. Even if the system isn't popular by then- and it could be- the campaign will almost certainly turn on other issues. A high profile repeal effort might seem frivolous, and the Party will almost certainly have other priorities).

  13. Repeal in 2016 will be almost impossible, because by then it'll be law. They'd be taking away benefits that already exist. That's why they're so desperate to repeal it in the next few years: they know they're fighting a clock.

  14. Try this as to the funding of the pro Obamacare propaganda. The AARP was a major source of TV commercials promoting it. Again its connection and sponsorship by United Health Group is very much uncontested. None are so blind as those that will not see.

  15. Honestly, I hate to pick on typos or anything, but I cannot tell what you're trying to say through that poor syntax.

    Nonetheless, I can say that the reference to AARP is kinda silly. AARP is not-for-profit. And while the ACA provides big advantages to the AARP's constituents- seniors will see the "donut hole" in prescription drug coverage close- the AARP itself will actually take a hit, because its funding under Medicare Advantage is going to dry up (ending the Medicare Advantage give-away to private insurers is one of the primary ways to pay for the ACA, as well as one of the primary things Republicans attacked it for). Nonetheless, the AARP did support the ACA.

    AHIP, of course, didn't. And AHIP is the official political advocacy arm of the vast majority of for-profit health insurers, with a president and CEO (Karen Ignagni) widely known to be the voice of the health care industry, and derided by reformers as the "Protector of Profits".

    So, yeah, I guess it's possible. But it's not a very good "corporatist scheme" when the for-profit corporations opposed it, and the organization you cite as supporting it is NOT a for-profit corporation, NOT located on Wall Street, and supported it IN SPITE of the fact that it stood to lose funding from it.


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