If your household was anything like mine, your phone was ringing off the hook with politicians vowing to “stop the government takeover of health care” or “end Obamacare.” In true campaign fashion, this country worked itself into a tizzy.
It seems that everyone from Kansas Governor-Elect Sam Brownback to Assumed Speaker of the U.S. House John Boehner joined in a chorus of “repeal and replace.”
What are the actual chances that Congress will “repeal and replace” federal health reform?
In my estimation, not good. Republicans do not have enough seats to repeal health reform, let alone overcome a Presidential veto of repeal legislation. Aside from this political calculus, I see three major reasons that the full repeal of health reform will not happen…
• Many of the bill’s provisions are popular, especially those that are already in effect. In a poll of the Kansas City area, 64% of respondents supported provisions to keep children up to age 26 on their parents’ insurance. A whopping 67% supported insurance reforms that prohibit denials based on pre-existing conditions, something already in effect for children.
• The health reform bill is already in effect. One of the most powerful forces in American politics is vested constituencies. There are people who are already benefiting from reform and they will mobilize against repeal attempts. Parents of sick kids, small businesses, and people in high risk pools have all tasted the benefits of reform.
• I believe that this election was really about the economy. A post-election poll by the Kaiser Family Foundation asked respondents to name what influenced their vote. Health care was fourth, behind the economy, party preference, and the views of individual candidates.
Here’s what I think will happen. Republicans in Congress will attempt to use the appropriations process to undermine the implementation of health reform. Republican governors will also seek opportunities to weaken health reform as it is implemented. And, finally, legal challenges may indeed be successful if conservative judges feel empowered by the recent election.
Will health reform be repealed and replaced? Nope.
Will it be slowly and steadily chipped away? Probably.
That’s where you and I come in. We know that reform was necessary. It may not be perfect, but it’s all we’ve got. Join me in my chant of “implement and improve.”