Repeal ACA? Make my day!

This is not a winning issue for the Republicans this year.

Marco Rubio wants to repeal the Affordable Care Act: except for that little bit about not denying coverage for pre-existing conditions. But of course if you require insurance companies to cover everyone, you set up an incentive for people to stay uninsured until they get sick and the whole insurance structure crumbles. So you have to penalize people who don’t buy insurance. And – at American health care costs – you can’t mandate insurance purchase without providing subsidies for people who otherwise couldn’t afford it. And if you’re going to do all of that, you’d better try to put in some cost-containment measures. The whole thing actually does fit together.

Rubio’s position is that he loves the penthouse and wants to keep it; he’d just like to get rid of the building underneath. And remember, this is the Tea Party candidate.

With support for ACA continuing to rise gradually in the polls, Republicans who think they’re going to run on getting rid of it are going to find that the status quo bias that was their friend when ACA was just a proposal is their enemy now that it’s the law.

So I wish the best of luck to the discharge petition for the repeal of ACA. In fact, if I were the Speaker I’d ask the CBO to “score” ACA repeal – it will come in as adding something like a trillion dollars to the deficits – and then bring it to a vote even without the discharge.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact:

4 thoughts on “Repeal ACA? Make my day!”

  1. To make the Tea Party pay for its lack of basic common sense, you need to make that metaphor stick: to create a meme to the effect that "He likes the building but hates the foundation." This would certainly work in a world in which old fashioned horse sense still plays a role.

  2. Except that, here, the foundation IS rotten and unstable — as the original post points out, at the very beginning, the crucial decision came to not address the cancer but, rather, to try a band-aid in the form of pumping even more money through the private insurance parasites, in hopes that more access to health care would result. Like a badly tied tourniquet, the "fix" will soon cause as much damage as the underlying injury — starting with the idea that there is ANY limit on what the federal government can require people to do if you invent a Commerce Clause argument for it.

    We know Medicare is constitutional, and we know it is far more efficient than the private parasites, and we know that the people who have it will not trade it for anything, especially not the parasite lottery we call private health insurance. If we had a Democrat in the White House and Democratic control of the House and Senate — coming on the heels of an epochal economic collapse — we could have expected an FDR-level approach, bringing Medicare to all Americans as a birthright. Instead, we have Rube Goldberg's device, brought to us by the moral midgets who have managed to continue the worst of Bush's policies and to implement none better in field after field.

  3. A trillion dollars now? This is so stupid it's hard to even know where to begin.

  4. Speaking of the above post's reference to the public's "feeling of being ruled by huge actors whose actions they can’t affect.", have you considered that relying on the people coming around to liking this polic or that has dangerous long term implications? Even if it works?

    Suppose you suggested that I'd like caviar, and I vehemently insisted that I didn't want to eat fish eggs. You then tie me down, pry my mouth open, and force feed me some.

    After a fit of gagging, I might eventually come around to thinking that this caviar stuff wasn't so bad after all. But I'd also come to the conclusion that you were a dangerous lunatic who didn't give a damn about what I wanted. And once you got those ropes off me, you'd better look out.

    The public might, just might, decide that it likes the ACA. But keep shoving things down their throat, and they'll also decide that they'd rather not be ruled with an iron fist by people who have nothing but contempt for the opinions of the people they rule.

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