Ezra Klein took a shot at John Boehner and the Republicans for pretending that they can still repeal Obamacare through the congressional oversight process. As ridiculous as that assertion is, that doesn't mean they're not going to do their best to
November 23, 2012

Ezra Klein took a shot at John Boehner and the Republicans for pretending that they can still repeal Obamacare through the congressional oversight process. As ridiculous as that assertion is, that doesn't mean they're not going to do their best to still attempt to chip away at it where possible, but at this point, pretending that they can use the oversight process to somehow repeal the law, is just ludicrous.

After seeming to come to his senses and admitting that "Obamacare is the law of the land" Boehner quickly changed course and penned an op-ed for the Cincinnati Enquirer, arguing that the law "should be on the table for cuts in a deficit reduction deal." The White House shot that down pretty quickly, but as Klein's fellow contributor at The Washington Post wrote this week, you could still see tweaks to the law which the Democrats might go along with.

And as Klein noted, Boehner is up against the insurers and pharmaceutical companies who are now working with liberal advocacy groups, who both want to see as many Americans insured as possible for varying reasons. One wants more customers and the other wants to see as many people as possible have access to affordable health care.

Rough transcript below the fold.

KLEIN: Presidential campaigns, they usually focus on, well, you might say hope and change. The candidates promise big grand new policies and how everything's going to be different and then they get elected and they go to Congress and Congress usually just says no.

This time, though, this time is different. Candidate Obama in 2008 promised universal health care. And shockingly, unlike the many, many presidents who had run for office and been elected promising that before him, President Obama was pretty much able to get it passed into law. But though the Affordable Care Act became law in 2010, it wasn't scheduled to actually begin until 2014. And that right there, that is the single most important fact about the election we have just been through.

You might have heard the old saw that elections have consequences. This election had real, completely life changing consequences for the 30 million uninsured people and maybe millions more who will get health care coverage because president Obama is re-elected and that means the Affordable Care Act will take effect. That is not just change you can believe in or change you can hope for. It is change that is actually happening. It is happening even as we speak right now. It doesn't need another vote in Congress or to clear another challenge before the Supreme Court. It is law and even John Boehner knows it.


SAWYER: You had said next year that you would repeal the health care vote. That still your mission?

BOEHNER: Well, I think the election changes that. It is pretty clear that the president was re-elected and Obama care is the law of the land.


KLEIN: That was Boehner less than two weeks ago. It was pretty clear that mission repeal Obamacare had failed. The voters had spoken and Obamacare, as Speaker Boehner said is the law of the land. Republicans weren't super happy about that message. They thought Boehner was getting a little squishy, and was giving up a fight.

That election we just had, the one where voters re-elected the Obamacare guy, the one that had Obama right there in his name, that was but a flesh wound. Today Boehner wrote an op-ed to the Cincinnati Inquirer which begins with “President Obama has won re-election but... as was the case before the election, Obamacare has to go.” But, if you read on in his op-ed, then things get a little strange.

Boehner went on to share the big plan which is “Over the past couple of years I have noted there are essentially three major routes to repeal of the president's law: the courts, the presidential election process and the congressional oversight process. With two of those three routes having come up short, the third and final one becomes more important than ever. Vigorous oversight of the health care law by the House can be expected and, in fact, is already under way.”

One of these things is not like the other. The courts and the presidential election process, they can actually stop Obamacare from happening. You get supreme court ruling against it, the President works to repeal it, that can matter. Congressional oversight hearings? That is not an accepted avenue for repeal. It is actually a little pathetic. If you think John Boehner has any chance of repealing the health care law through “vigorous oversight” from the House's oversight committees, what have they been doing for the past two years? Why isn't the health care law gone now?

Boehner is a realist. This is not wishful thinking on his part. It is lazy comforting. It is here, Republicans, don't you worry, it is all part of the plan, we're on track, but there is no plan. The country is moving forward. It is moving forward regardless of the House Republicans. On Tuesday the Department of Health and Human Services issued new regulations that explained the health care law in practical terms, like what will a deductible actually be able to go up to, and can your insurer jack up the price when you hit your 30th birthday or your 50th birthday? And this one is for you, John Boehner. What is the policy for smokers anyway?

The answers there just so you know are in order, a deductible can in the cheapest plans be $2,000 or even more in some cases. Insurers can't hit you with a huge new bill when you hit a new decade. Increases due to your age have to be gradual and smokers can be charged 1.5 times as much as non-smokers but not if they enter a program to help them quit smoking.

And as the nation's near universal health care system is being defined in Washington there is a campaign right now to make sure people around the country actually know about it, understand it and become part of it. And if this campaign succeeds, it could make the Affordable Care Act bigger and better than we thought.

You've probably heard that the law will cover 30 million people. What you probably don't know is what is behind that guesstimate. Roughly 49 million people in the United States currently don't have health insurance. The Congressional Budget Office estimates that 30 million of them will gain coverage under the Affordable Care Act. That leaves 19 million uninsured. About 5 million of that 19 million are illegal immigrants who are not eligible for the law's subsidies. The CBO projects that another 2 million of those folks live in states that will opt out of the Medicaid expansion.

That leaves 12 million people. The CBO estimates at least 6 million of them are actually going to be eligible for Medicaid. They just won't sign up. They won't know about it. Even more will be eligible for private insurance. The CBO is in effect assuming a lot of people won't participate in the bill, not because it wouldn't help them but because all government programs have a serious non- participation rate. A lot of people don't know about them.

A recent poll found that 83 percent of people likely to qualify for the Medicaid expansion in the law are completely unaware of it. They have no idea they can suddenly get health care. Some who do know about it are so beaten down by the current system they don't believe it. My Washington Post colleague Sarah Kliff visited a focus group where the uninsured were asked about the health care bill and it was searing. One woman in a genuinely heartbreaking moment of honesty said “...if it was doable” by that meaning giving people like her health care, “it would have been done by now... I just don't think it is possible.”

Think about that. If you could get to 100 percent participation or even just near to it, this bill could easily cover 40 million people a full 33 percent more than we were expecting and you don't need to pass a new law to get the people on the books. You just need to tell people this bill is there and convince them it can actually help them. And right now a ban of very strange bed fellows has teamed up to do just that, to run a public education campaign that will get these people the information they need to sign up.

The big health care players, insurers and pharmaceutical companies are now working with liberal health care advocacy groups to make sure people know about and understand the health care law and what they can get from it. They're going to spend millions of dollars to tell people about the law. The insurers and the drug makers, they want to do it because more people in the system means more profit for them. The health care advocates, because more people being covered means well, more people with health care coverage and you don't have to go through the dangerous experience of being uninsured.

And while all of this is happening, while we're hammering out regulations and trying to tell people who are depressed and discouraged with the health care system now that finally at long last we have some kind of answer for them and we can help them; as we're moving forward and changing health care in this country entirely, the Republicans are going to be chasing their tails in oversight hearings, pretending they can repeal the bill.

Come on, guys. The campaign is over. The election is over. It is now time to govern. Obamacare is the law of the land. And it is the law by the way that could have been different had Republicans chosen to participate in its construction, chosen to trade their votes for more of a say in the final policy, but they didn't. They made an all-in bet on killing the bill and then an all-in bet on repealing the bill and now both of those bets have gone bad. It is over. Health care reform is happening. The only question is whether Republicans will choose to be part of it.

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