Obamacare's Death by a Thousand Cuts

The way to repeal Obamacare is to hasten its ugly results.

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Congress is getting busy, starting to move legislation on everything from soup to nuts. For a columnist, this creates a target rich environment, filled with things to poke at because they go too far, don't go far enough or are just silly.

Take the Farm Bill. It's true that corn grows faster than this bill has moved, but that's because the whole thing is deceptive. Only 20 percent of the legislation deals with farmers. The rest is about the food stamp program.

In an honest world, the Farm Bill would be called the Food Stamp bill, but it isn't because farmers are more popular. And renaming it would also underscore, as former House Speaker Newt Gingrich likes to remind people, that under Barack Obama more Americans are on food stamps than ever before, making Obama "The Food Stamp President."

Then there is the immigration bill currently moving though the Senate. It weighs a reported 27 pounds and it is doubtful that most of the senators voting on it have read the entire thing. Moreover, its primary focus seems to be on keeping people out of the United States, rather than transforming a broken system to allow more people who would add value to the American economy in.

It's true that border security is important and that too much of that effort has been left unfinished by the current administration. So why not do the border security piece first? If Congress passed legislation that truly restricted the flow of illegal immigrants into the United States, actually writing rational metrics into the bill, the rest would probably be much easier to do. Unfortunately, the legislative politics involved in assembling a coalition to do immigration reform that way may just be too hard to achieve.

[Read Vince Smith: Farm Bill Unlikely to Cut Subsidies for Wealthiest Famers and Agribusiness.]

The mother of all legislative fights, however, remains health care. The Republicans are resolute in their promise to repeal it. The Democrats are just as strongly fixed on their efforts to get the new system in place, even though leading Democrat Max Baucus, the senior senator from Montana and the principle author of the bill, has called the Obama administration's efforts to implement it a "train wreck."

The new system is already causing problems. Health insurance rates in certain states are projected to double, triple or even quadruple; so much for the affordability part of the Affordable Care Act. Some companies may even be planning, as Aetna has announced it will do in California, to suspend the sale of individual policies.

Slowly but surely the existing healthcare system will start to unravel even before the new one can be put in place, giving the opponents of Obamacare a window in which they can push for full repeal. In order to get the best field position they can once that time comes, they would be wise to do two things: push for a vote in the House of Representatives on repeal of the individual mandate on which the entire program rests and force the House to vote on legislation proposed by George Republican Rep. Tom Price to cut off the funding necessary to expand the Internal Revenue Service to allow it to enforce Obamacare until the questions about its politicization by the Obama administration over the last five years are resolved.

[See a collection of political cartoons on health care.]

By taking both these steps, the Republicans can force the Democrats back to the table to craft a new healthcare plan. It won't work without the individual mandate and it won't work without the IRS to enforce that mandate, if indeed it would ever have worked at all. As all of this is going on, and it will be possible to get a vote in the Senate on both measures if certain vulnerable Democrats want to be re-elected in November 2014, the American electorate will begin to see they liked the health care they had a lot more than they health care they are getting now that Obamacare is law.

There are those in the healthcare policy community who argue, perhaps rightly, that no vote on Obamacare in Congress matters except the vote on full repeal. That may be true, but is highly unlikely. As the Democrats have done to the Republicans for decades concerning legislation they thought was bad for the country or for their agenda, the GOP must expose Obamacare to death by a thousand cuts. The objective is not so much to "fix" it, because it can't be fixed, but surgically removing key parts of the law to accelerate the arrival of the inevitable problems it will cause.

The system as designed by Congress and the current White House can't work, won't work and is unfixable as it stands. The question is whether to let people come to that understanding in 15 or 20 years or to help them understand it by experiencing the problems in the first two or three years. Then repeal will be easy, because the people will understand they bought a pig in a poke, they made a bad bet and everything is coming up snake eyes. 

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