There is considerable discussion about how the new Republican majority can “repeal” Obamacare. Surely, Obama would veto any legislation that did so. However, Obamacare supporters have given us a roadmap to the complete frustration of their plans. It tells us exactly what we must do.
ACA opponents could deliver on another pledge: to cut off funding for implementation. Here is how such a process could work.
Customarily, substantive legislation “authorizes” spending, but the funds to be spent must be separately “appropriated.” The ACA
contains 64 specific authorizations to spend up to $105.6 billion and 51 general authorizations to spend “such sums as are necessary”
over the period between 2010 and 2019. None of these funds will flow, however, unless Congress enacts specific appropriation
bills. In addition, section 1005 of the ACA appropriated $1 billion to support the cost of implementation in the Department of Health
and Human Services (DHHS). This sum is a small fraction of the $5 billion to $10 billion that the Congressional Budget Office estimates
the federal government will require between 2010 and 2019 to implement the ACA.4 The ACA appropriated nothing for the Internal
Revenue Service, which must collect the information needed to compute subsidies and pay them. The ACA also provides unlimited funding
for grants to states to support the creation of health insurance exchanges (section 1311). But states will also incur substantially increased
administrative costs to enroll millions of newly eligible Medicaid beneficiaries. Without large additional appropriations, implementation will be
crippled. If ACA opponents gain a majority in either house of Congress, they could not only withhold needed appropriations but also bar the
use of whatever funds are appropriated for ACA implementation, including the implementation of the provisions requiring individual people to buy insurance or businesses to offer it. They could bar the use of staff time for designing rules for implementation or for paying
subsidies to support the purchase of insurance. They could even bar the DHHS from writing or issuing regulations or engaging in any other federal activity related to the creation of health insurance exchanges, even though the ACA provides funds for the DHHS to make grants to the states to set up those exchanges. That would set the stage for a high-stakes game of political “chicken.” The president could veto an appropriation bill containing such language. Congress could refuse to pass appropriation bills without such language. Failure to appropriate funds would lead to a partial government shutdown.
There it is folks. The road map to stopping Obamacare is right there, provided by its supporters. The key is that the bill passed is NOT a health plan. It is a wish list and a skeleton that needs to be completed. In their hubris, they never dreamed that they would be turned out of office with the plan unfinished.
If Obama vetoes an appropriations bill that doesn’t fund Obamacare, that does not fund it. The key is to write small bills that fund specific programs. Let’s say, we pass an appropriation bill that cuts public broadcasting by 50%. Obama vetoes it. What happens ? Public broadcasting is cut 100%. Everything else goes on undisturbed.
Newt Gingrich was too hubristic. Small is beautiful.
Tags: health care, politics
Or Obama could just appoint these people medical czars, and fund it with fed quantitative easing.
You can’t spend money legally without an appropriation. For Obama , that may not be a complete obstruction.
I see lots of fraud in workers comp cases I review. The insurance carriers worry about being sued, especially when most of the cases involve Spanish speaking patients.
Hi Mike,
It’s one of your Chicago cousins here. I just stumbled across your blog by complete serendipity–I had been discussing Frank Flanagan here at home, jumped on the Internet, Googled his name +homicide +Chicago Police, and A Brief History was the first hit. I clicked–and just about fell out of my chair when I saw the 1940’s pic of you with Bud and Marion (I recognized them both right away, but said to my wife, “who the heck is that ugly kid??” I kid, kid). Then I scrolled down and saw the more recent pic, so, then I have spent the last half hour looking through your site, figuring out whose it was, etc.
I think I recognized just about all your kids from seeing them at your mom’s 100th. Our older daughter, Corey, is a senior at UIC in biology and chemistry, thinking of either med school or graduate biology. Younger daughter Amy is in 8th grade, just turned 14, and today took the placement test for h.s. My dad is staying at his house in Long Beach, IN most of the time now (85 on 12/5)–they got some snow this a.m. Everyone else is status quo (I just had a little BCC removed from my cheek and am now a scarface).
I can’t recall if I told you that my wife (maiden name Kennedy) has two cousins, Patti and Mike, whose mother is named Ruth.
Nice piece on Frank F. I printed it and will take it up to LB Monday for my dad.
Anyway, I’m glad I found your spot on the web. Happy upcoming holidays, you darn southern Californian. Don’t you miss the change of seasons?
It’s good to hear from you Kevin. I miss seeing your dad the last couple of times I was back there. I am actually enjoying the seasons with gorgeous red maples. I moved to the mountains last summer and now live at Lake Arrowhead, which is about 5200 feet elevation. We will probably get snow by Christmas and last spring it snowed the weekend before Memorial Day.
Most of my Frank Flanagan post was on another blog called ChicagoBoyz and which is mostly U of Chicago alumni. Kerry Cole had told me Frank’s daughters were not happy about the post, which is too bad if true. Pat, of course, is now gone. They are part of my childhood memories and very happy part.
Stay in touch.