After several dozen pointless repeal votes, congressional Republicans haven't exactly been subtle about their intentions towards the Affordable Care Act. In fact, with a major Supreme Court case pending, GOP lawmakers are once again considering new plans to try to "repeal Obamacare" all over again.
But everyone involved in the debate should be clear about the consequences. The effects on millions of families would obviously be brutal, but CNBC reports today on the fiscal impact on the nation.
The nonpartisan Congressional Budget Office said Friday that a repeal of the Affordable Care Act would over the next decade "probably increase budget deficits with or without considering the effects of macroeconomic feedback." Depending on those economic considerations, the federal deficit could increase up to $353 billion over the next 10 years as a result of a repeal of Obamacare, the CBO said.
The part about the "with or without considering the effects of macroeconomic feedback" is interesting because it gets at the root of Republican rhetoric. To hear GOP lawmakers tell it, the evidence may suggest that repeal would cost hundreds of billions of dollars, but this fails to take into consideration the economic boom that the right believes would occur after Republicans tear down the existing American health care system.
This defies common sense -- 2014 was the first full year for ACA implementation and it was the best year for American job creation since the '90s -- but the Congressional Budget Office concluded it defies budget arithmetic, too, whether officials rely on actual math or the kind of math conservatives prefer.
The same CBO report, available online here, found that if Republicans succeeded in scrapping the law, 19 million Americans would join the ranks of the uninsured by 2016. The total would grow by several million in the years that follow soon after.
To be sure, Republicans insist they'll eventually come up with a reform plan of their own that might help some of these people, but this plan has been in the works for five years and it doesn't currently exist in any tangible form.
As a political matter, GOP lawmakers and candidates take a degree of pride in their unhealthy obsession with repealing the Affordable Care Act, but in a more sensible climate, this repeal agenda would be considered scandalous -- Republicans are effectively bragging about their plan to add hundreds of billions of dollars to the deficit while destroying the health security of tens of millions of Americans.
I don't mean to sound picky, but this isn't an agenda worthy of boasts.
But stepping back, there's also the inconvenient fact that so much of the Republican agenda increases the deficit. We talked in April about the common fiscal thread that ties together so much of the GOP's policy agenda: so much of what Republicans want increases the deficit the party sometimes pretends to care about.
On tax policy:
The bill would make permanent a tax break for research and experimentation that would increase the deficit by $177 billion over 10 years and also make permanent the deduction for state and local sales taxes, at a cost of $42 billion. The tax break for charitable giving would cost $14 billion. Despite Republicans’ frequent fearmongering about the deficit, they propose no spending or revenue offsets.
And abortion:
The official budget scorekeeper of Congress says the Pain-Capable Unborn Child Protection Act, which would ban abortions after 20 weeks, would increase Medicaid costs by as much as $400 million…. CBO officially estimates that the bill increases federal deficits by $75 million between 2014 and 2018, and $225 million between 2014 and 2023.
And immigration:
Senate Democrats threatened Thursday to block action on legislation funding the Homeland Security Department until Republicans jettison House-passed provisions that reverse President Barack Obama’s key immigration policies…. The Congressional Budget Office estimates that the measure would increase the federal deficit by $7.5 billion over a decade.
As Danny Vinik put it a while back, “Republicans shouldn’t be allowed to get away with this two-faced policymaking. If they care about the deficit, they have to care about it in all contexts. If not, then they shouldn’t justify their opposition to Obama’s policies on grounds that they increase the deficit.”
This is especially true on ACA repeal. Whenever GOP officials vow to pursue this, the first question should always be, "How would you pay for it?"