The Republican Dilemma Over Funding of Obamacare

August 21, 2013

Republicans are between a rock and a hard place over the funding of Obamacare.

 On the one hand, defunding the Affordable Care Act (ACA) through current federal budget negotiations could be the last chance to starve the monstrous law of the finances needed for implementation. Of the $1.76 trillion total cost of the law, 4 to 6 percent goes to the administration of the ACA and the remainder goes to the expansion of Medicaid and to taxpayer subsidies for people to buy health insurance in the exchanges. The Medicaid expansion and the exchanges don't begin until next year, 2014. Consequently, Republicans could put up a budget fight, provide funds for critical services (military, etc.) and established entitlements (existing Medicaid, Social Security, etc.), and eliminate funds for Obamacare.

The history of America strongly suggests that once a government entitlement such as Obamacare begins, it is very difficult to eliminate that program or do a meaningful reform. Once people become dependant on the government for services, those programs grow, regardless of their popularity.

Of course, a budget fight now would potentially run the risk of a second sequester, or complete shut down of the federal government. This would put the Republicans in a politically unpopular position for the 2014 elections when they need to retain the U.S. House and retake the U.S. Senate. 

A middle ground would be to delay the implementation of Obamacare as much as possible. The Administration has already missed one half of the deadlines set in the law, so even the strongest proponents of the ACA can't comply with the timeline. Dragging out the Medicaid expansion and making the exchange as inefficient as possible could get the country to the 2016 election cycle without too much damage to our health care system from Obamacare. Republicans would then have another chance of taking control of the White House and the U.S. Senate and reforming or repealing the ACA.

Even the most vocal proponents of the ACA now have doubts. The President recently said, "people will like the law IF it works." Delay and reform of Obamacare may be the country's greatest hope for putting patients back in charge or their health care.

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