A lesson in the challenges of governing

Obamacare supporters react to the  U.S. Supreme Court decision to uphold President Obama's health care law, on June 28, 2012 in Washington, D.C.
Obamacare supporters react to the U.S. Supreme Court decision to uphold President Obama’s health care law, on June 28, 2012 in Washington, D.C.
Photo by Mark Wilson/Getty Images
When congressional Republicans talk about health care policy in any depth, it’s quite common for them to struggle. GOP policymakers tend to find it easy to blast “Obamacare” with poll-tested soundbites, but when it comes to real substance, the party’s record in recent years can charitably be described as woeful.
 
And at a certain level, it’s tempting to be forgiving. After all, this is an exceedingly complicated issue. There’s a reason we’ve come to celebrate the media health care wonks who help bring clarity to our health care questions – they understand what many find mystifying.
 
The trouble, though, is that congressional Republicans don’t understand what they don’t understand. They seem convinced that they’re fully aware of the nuances of health care policy, but their confidence is sorely misplaced, based more on confidence than knowledge.
 
Take Rep. Todd Young (R-Ind.), for example, who came up with the “Save American Workers Act,” which has 208 co-sponsors and is set for a House vote next week. The bill seeks to “fix” the Affordable Care Act by changing the definition of a full-time work week from 30 hours to 40 hours.
 
But when it comes to a complex health care system, a policy change in one area often has unexpected consequences in another area.
An analysis of the bill, released Tuesday by the nonpartisan Congressional Budget Office and Joint Committee on Taxation, found that it would cause 1 million people to lose their employer-based insurance coverage. The report projected that more than 500,000 of them would end up getting coverage through Medicaid, the Children’s Health Care Program or the Obamacare exchanges. The rest, CBO and JCT said, would become uninsured.
 
The legislation would also lower the amount the federal government collects in penalties from businesses who don’t abide by the employer mandate. As a result, the report found, the deficit would go up by $74 billion over 10 years.
Oops.
 
What we have, in other words, is a Republican bill that would have the opposite of its intended effect. The entirety of the CBO report is online here (pdf) and for its proponents, the results aren’t pretty – the “Save American Workers Act” would likely lead to more Americans seeing their hours cut and more Americans losing their coverage, all while adding to the deficit that GOP lawmakers occasionally say they’re worried about.
 
Jonathan Cohn’s analysis rings true: “The Congressional Budget Office just taught the Republican Party a lesson. Governing is hard…. [T]hat’s the reality Obamacare’s critics are never willing to confront. They’re great at attacking Obamacare. But they’re lousy at coming up with alternatives that look better by comparison. There’s a reason for that. The downsides of Obamacare are real, but, in many cases, they make possible the upsides. Take away the former and the latter go away, too.”
 
From time to time, GOP officials will pretend health care is actually easy. They’ll just repeal “Obamacare”; throw together some free-market ideas; wave a magic wand; and presto – problem solved. And because the party is lacking in credible wonks who know better, there aren’t many Republicans around to set them straight. But the next time you hear their bravado on health care, remember the “Save American Workers Act.”
 
Of course, the next question is whether Republicans will bother to change their minds about the bill, or whether they’ll just move forward on it anyway. Since the legislation has more to do with politics than policy – a common problem in the GOP-led House – it wouldn’t come as a huge surprise if the bill reaches the floor next week and its proponents pretend yesterday’s revelations never happened.
 

Affordable Care Act, Health Care, Health Care Policy and Obamacare

A lesson in the challenges of governing