A lot of thought goes into the naming of new legislation. Calling the health bill the Patient Protection and Affordable Care Act hits on the essential goals of health care reform—medical security and financial savings. So the GOP’s proposed law to repeal the health legislation needed an equally pithy title to rally support: “Repealing the Job-Killing Health Care Law Act” is nothing if not evocative.
With the repeal effort, the GOP is counting on bringing the focus back to the one issue that most of the country is very concerned about; unemployment. By using the words “job-killing,” the implication is that the Affordable Care Act will lead to increased expenses for employers, followed by job losses and a worsening of our country’s financial recession. House leaders have set the date for a vote on repeal (largely symbolic since the effort is sure to stall in the Senate) for January 12, although there are signs it might come even earlier.
In last year’s mid-term elections, Republicans managed to grab 63 more seats in the House, putting them in control for the first time since 2006. Plenty of Monday-morning quarterbacking went on after the sweep; the consensus being that the sputtering economy and lack of jobs were the main factors in voters’ dissatisfaction with the status quo. Repealing health reform was not high on the list. In a recent Washington Post/ABC News poll, some 52% of those surveyed said they “did not support health care changes,” but only 29% of those who indicated lack of support actually want to see the legislation repealed. In fact Americans indicate that they generally support the few provisions of the bill (adult children remaining on parent’s health plans, lower prescription drug costs for seniors, a ban on denying coverage for pre-existing conditions, for example) that have already been rolled out.
The only way to rally voters to support repeal is to link health reform to job losses. In October, Senators Tom Coburn (R-OK) and John Barrasso (R-WY), both self-described “practicing physicians,” released a report entitled “Grim Diagnosis: A check-up on the federal health law.” The report predicted that the Affordable Care Act would lead to the loss of up to 700,000 jobs—many of them in small businesses (over 50 employees) who will have to offer health benefits or pay $2,000 for each worker they fail to cover. The report charges that “the massive Medicaid expansion will ―encourage some people to work fewer hours or to withdraw from the labor market. Additionally, phasing out the subsidies to buy expensive insurance ―will effectively increase marginal tax rates, which will also discourage work.” Finally, the report predicts that the health bill will lead to job losses in the health care industry because physician-owned hospitals will be prohibited from expanding after 2014.
Today, the Center on Budget and Policy Priorities released a report that responded to–and clearly refutes–these alarmist claims. “Health reform will change the American economy in many ways over the next few decades,” write the CBPP authors, “but it will not significantly change the number of jobs or the unemployment rate. A nonpartisan economic assessment by the Congressional Budget Office (CBO) finds a variety of possible labor market effects, some positive and some negative, but nothing that justifies the inflammatory ‘job-killing’ rhetoric invoked in House Republicans’ efforts to repeal the legislation."
According to the report, the CBO indicated there could be up to half a percent net reduction in the labor supply, due “largely to the fact that the Affordable Care Act’s expansion of Medicaid and the availability of subsidized health insurance through the new exchanges could lead some people who now work mainly to obtain health insurance to retire earlier or spend more time on activities outside the workplace.” The authors continue, “That effect could be partly offset, however, by increased incentives to work for people who now lack access to employer-based coverage and lose their eligibility for Medicaid if their income rises too high but who, under health reform, will continue to have access to insurance if they work more hours and raise their income.”
Finally, Moody’s Analytics adds that “there is the potential for the new law to reduce ‘job lock,’ when workers stay in a particular job because they are afraid of losing their insurance. . . . If the bill works as planned, Americans will be more able to switch jobs and open new businesses.” This, according to the CBO, would result in greater productivity.
Back in February, Nancy Pelosi told Congress that the new health care bill could lead to 400,000 new jobs in health care and the “entrepreneurial field.” It’s hard to pin down that number, but expanding insurance coverage for many of the 50 million currently uninsured Americans will clearly require a larger health care workforce. Provisions in the Affordable Care Act will pay for more community health centers, more nurse practitioners and other health care professionals (especially in primary care) and includes funding for education in the health professions.
In short, calling the health care bill “job-killing” ignores evidence to the contrary. Still, the question remains, could repeal have a positive effect on the budget deficit—another burning issue for the GOP and American voters? Jon Cohn writes on his New Republic blog, “Democrats went to great pains–and, arguably, suffered tremendous political damage–because they were determined to produce a bill that the CBO would pronounce as deficit-reducing.”
He continues, “They succeeded, too. CBO projections suggest that the Affordable Care Act will reduce the deficit by more than $100 billion over ten years, which is not bad–indeed, not bad at all–for an initiative that will allow 30 million more people to get insurance and push the entire health care system in the direction of more efficiency.”
Today we found out that repealing the Act will do just the opposite. In a letter to House Speaker John Boehner, the CBO outlined a preliminary scoring report that predicted the impact on the economy of the proposed repeal legislation (H.R. 2). Some highlights include:
The Repeal Act will increase the federal deficit over next 7 years:
“CBO expects that enacting H.R. 2 would probably increase federal budget deficits over the 2012–2019 period by a total of roughly $145 billion”
And will worsen in coming decades:
“Correspondingly, CBO estimates that enacting H.R. 2 would increase federal deficits in the decade after 2019 by an amount that is in a broad range around one-half percent of GDP…For the decade beginning after 2021, the effect of H.R. 2 on federal deficits as a share of the economy would probably be somewhat larger”
It will leave some 17% of the non-elderly American public uninsured:
“Under H.R. 2, about 32 million fewer nonelderly people would have health insurance in 2019, leaving a total of about 54 million nonelderly people uninsured”
Premiums might be a little lower, but only for those purchasing “bare-bones” policies on the individual market:
“premiums for health insurance in the individual market would be somewhat lower than under current law, mostly because the average insurance policy in this market would cover a smaller share of enrollees’ costs for health care and a slightly narrower range of benefits”
But without subsidies, most Americans will end up paying more or going without insurance:
“Although premiums in the individual market would be lower, on average, under H.R. 2 than under current law, many people would end up paying more for health insurance—because under current law, the majority of enrollees purchasing coverage in that market would receive subsidies via the insurance exchanges, and H.R. 2 would eliminate those subsidies.”
The effort to repeal health reform legislation is nothing more than political theater. The Senate will block the bill and President Obama would surely veto it if the legislation ever made it to his desk. But it’s important to address the issues the repeal effort raises: Many Americans are only hearing that the Affordable Care Act will kill jobs, bloat the deficit and “steal $100 billion” from Medicare. The administration—and the media—need to delve deeper into these claims and provide hard evidence that these fears are partisan and unfounded.
I’m going to have my work cut out for me on my local blogs. . . .
I hate to say this, but maybe this country deserves what it votes for. In other words, maybe the dems should back away from healthcare actions and let the current system with Repub support just implode, which it surely will. There will be plenty of suffering on the way to healthcare Armageddon, but when a critical lack of healthcare mass is finally reached for the average American, then the repub emperor has no clothes strategy will finally be clear.
Rooting for failure, hmm. Where have I heard this before?
“The effort to repeal health reform legislation is nothing more than political theater. The Senate will block the bill and President Obama would surely veto it if the legislation ever made it to his desk.”
This is true. Sometimes, though, political theater serves a useful purpose. This is one of those times. This episode allows conservatives, especially many of the newly arrived tea party types, to burnish their lower spending and smaller government credentials. They will also be looking to actually achieve some cuts in domestic discretionary and maybe defense spending. The overall effort will help them to build political capital with their base and make it easier for them to cast an otherwise difficult vote to raise the debt limit as early as March. After that, the health reform repeal effort will probably fade away. The bottom line: it’s much ado about very little. So, relax.
I am fed up like many with these antics.Naomi/Maggie- admire your persistance in writing about it.
What really gets under my skin is Boehner’s repetative mantra that “ObamaCare is going to destroy the best health care system in the world”
By almost any objective measurement our US health care system falls short.
I thought sane politicians/planners all agreed we have a very broken system?
Most call it a crisis!
Dr. Rick Lippin
Southampton,Pa
Job killing is by definition the precise way to define the health “socialization” bill that is a bald attempt to socialize one sixth of the US economy.When you take capital out of the economy and put it in the federal government, it kills jobs. Obama just figured it out with the extension of the now “Obama” tax cuts.
Lastly, you should sit in on the employee benefits renewal meetings as I have and see the reactions where organizations are trying to absorb the 15% cost escalation the HR bill has caused in just its first year.
Why was the Congress taken back by the people from the liberals? The health socialization law was a big reason.
Hoyt- ObamaCare is not jobkilling at all. But our former healthcare system was surely lifekilling
BASIC health care for all US citizens is not a commodity that should be for sale. It is a moral obligation of any society that professes to be civil and fair
Dr. Rick Lippin
Southampton,Pa
Barry, Ng,
This is Naomi’s post, but
I wanted to thank you both for your comments.
Barry–
You and Naomi essetially agree: this is “political theatre” or “much ado about very little” (your words.)
You are right that Tea Party activists who are newly elected to Congress see the theatre as a way to “burnish their credentials,”, but this has nothing to do with helping the nation at a very difficult time.
I’m afraid that these tea party enthusiastis have little interst in cutting domestic spending in areas where it could be safely cut (some agricultural subsidies, defense, etc.).
They are populists; voters in rural areas and voters who favor spending large amounts on defense are an important part of their base.
Keep in mind that the conservative leadership has declared that its first priority is to make sure that President Obama is not re-elected.
Other issues–reducing unemployment, boosting the economy, reducing health care spending on futile end-of life care, repairing infrastructure,
moving away from fossil fuels–all seem a distant second on their list.
ng– Some people who I respect agree with you. They believe that most people in this country won’t be ready for true heatlh care reform until the system impolodes, and the upper-middle-class no longer has affordable access to care.
The problem is that, by then, it could be too late. The cost of reform could be too high, and I’m afraid that if we don’t have health care reform (and reform in other areas on WAll Street and in the economy) this country will be in great financial trouble– a huge deficit; a dollar that is worth far less; foreign investors unwilling to invest in our Treasuries unless we are paying them much higher interest rates; and real unemployment that remains about where it is now–if not higher.
Today’s jobs report was alarming. We are not creating enough new jobs to cover new workers entering the workforce each year (for example, new h.s. and college graduates.)
The unemployment rate is down only because the number of Americans in the workforce has shrunk. People who have been looking for work for 1 or 2 or 3 years and have given up and so the gov’t no longer counts them as “unemployed””–or as part of the workforce.
So the share of the so-called “work-force” that is unemployed is smaller. But the number of Americans who want to work and cannot find a job is rising.
These jobless Americans–and the neighbors, relatives and friends who still have jobs, but are worried about losing them–are not going to be spending. As a result, U.S. companies are not going to get the new customers needed to spur them to begin hiring .
Hoyt:
Amazing you would pick up on the removal of capital from the economy as the deletion of jobs, hence labor, when such has been happening under the present scenario going back to the eighties and with greater frequency since 2001. Productivity Gains since the eighties have been heavily skewed towards Capital Appreciation not involving Labor. Since 2001 with the heavy influx of foreign money to Wall Street and the passage of the 2001 Financial Services Act, the “buckos” have been going towards the securitization, of MBS/CDO, CDS, naked CDS which for the most part had little impact on Labor producing business. Why would one invest in Labor intensive business with a 3% return when we can achieve a much greater return holding a tranched CDO, a CDS, or even a bet with a “naked CDS?” Then there is the 30% return on credit cards made legal by SCOTUS in 1978 with Brennan deciding on Marquette versus Mutual through the outlawing of usury across state lines.
Sorry Naomi/Maggie, I am digressing a bit here. I find it a tad disingenuous for Hoyt to dwell on the job killing by healthcare reform when past actions by Wall Street and the gov (2001/2003 tax breaks) have focused money to the 1% of the taxpayers making > $500,000 in income and who invest in non-labor securities.
Healthcare reform is poised to create more jobs within those companies having fewer than 26 employees and making less than $250,000 annually by making healthcare more reasonable for them through subsidies. I believe this group of “Joe-The Plumber” type of companies are still produscing the most jobs?
What I find most interesting is that the early data (http://lat.ms/evuFij) shows small businesses are coming out in droves to provide health care to their workers.
Dean:
For small businesses of 25 or less employees get tax breaks. This probably the reason they are now getting healthcare insurance for their employees.
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“Job Killing” is the current buzz phrase of the election cycle. Anything the C of C or other business groups don’t want is now “Job Killing”.
The phrase shows up in local elections on money issues, and is being used to fight school bonds, gas taxes, minimum wage increases, public employee unions, bottle bills…just about everything that could possibly lead to even a miniscule reduction in business profits.
It would be an even better slogan if “Socialist” were added, as in “Socialist Job Killing” whatever.
While in the ultimate analysis, the challenging people that survive the challenging times achieve this due to the fact they’ve picked to react positively to their predicament. Hard instances in no way final, but hard men and women do. Tough individuals stick it out. Historical past teaches us that every predicament has a lifespan.
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Great post. You point out that “the danger that patients will lose faith in their physicians is growing.” This loss of faith is evident in other health systems, such as in the UK, where trust in the institutions of medicine and science (though not necessarily its practitioners) has been notably declining for at least 15 years, if not longer.