OK. Now What?

Barry, my friend the CPA, is undoubtedly smiling. Barry formed a Tea Party of one, almost twenty years ago. His goal was to always have divided government. As long as the Democrats or Republicans were restrained, were kept from controlling both Houses of Congress and the Presidency, there would be some level of gridlock. Only the most important legislation could be passed. The moment either side had real power, all Hell broke loose. Last night was a good night for Barry and the many people who long for a smaller government.

This blog, however, is about health insurance and health care, not politics, so I will leave the list of winners and losers to others. Politics do play a huge role in how health care is delivered in this country and an even larger part in the foreseeable future. And health insurance, health care, and our system of entitlements had equally large roles in last night’s results. They are intertwined. The Republicans took the House last night. They almost captured the Senate. How will this impact health care?

The short answer may be “Not Too Much”.

President Obama came to office in the midst of a financial meltdown. He had three paths in front of him – a Crisis, a Disaster, and an Issue. He faced a divided country and had the chance to invest his political capital into only one. The Crisis was the economy and unemployment. The Disaster was Americans fighting and dying in two wars. The Issue was health care and specifically the uninsured and underinsured of our country. He chose the issue and spent the majority of his first two years and political good will pushing through an unpopular, poorly designed piece of legislation.

The Patient Protection and Affordable Care Act succeeded in energizing the opposition. Even centrist Democrats and Republicans were outraged by this combination of government overreach and intellectual dishonesty. Democrats representing swing districts, like John Boccieri, were pressured into supporting a bill that almost single-handedly caused their defeat.

Republicans have campaigned against the PPACA. Some have implied, some have even promised, to repeal this legislation. Can this legislation, passed only seven and a half months ago, be reversed? And, more importantly, do the Republicans want to?

NO and NO.

The Patient Protection and Affordable Care Act is not going to be repealed or reversed anytime soon. Oh, I’m sure Speaker-designate John Boehner will run a bill through the House. It will be great political theater. And, it will be risk free. The legislation won’t get through the Senate, and even if it did, it would be vetoed by the President.

I sincerely doubt that the Republicans would want to repeal this legislation. This is a fundraising bonanza. Campaigning against PPACA is far more profitable than solving the problems that necessitated the law.

So, we have a bad bill and the real possibility that cynicism may rule the day. Plus, we have yet to mention the insurers who have already spent millions to comply with the new rules and regulations. I firmly believe that the insurers have devised a path to real success under a government run health plan where they provide supplementary coverages. The major insurance companies would then have no desire to repeal the law.

We are quickly approaching the next calendar triggers of the health care legislation. It is possible that the Republican lead House of Representatives, far more interested in extending the Bush era tax cuts than anything else, might tackle meaningful reform in early spring. In a yet to be exhibited act of political maturity, the House could even draft a bill to limit and refine the PPACA. Such legislation could be passed by the Senate and signed by the President. It is possible. I leave the question of probability to you.

We had a major governmental change last night, a massive swing from the left to the right. What has changed in regards to the delivery of health care, the affordability of health insurance and the access to needed medical care? Alas, not much.



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8 Responses to OK. Now What?

  1. JT Tan says:


    change is hard, especially when it doesn't seem to be a discussion on win-win scenarios for everyone, but rather two very contentious sides struggling purely for the power to dictate their side.

    Sad, but good to know there probably won't be immediate volatility on the bill.

  2. Mary Louisa L'Hommedieu says:

    Thanks, Dave. This will be an interesting time for all of us in health care.

  3. Frank Gaughan says:

    Good post Dave! Very thoughtful & insightful. At the very least a message has been sent to Washington: Politicians who disrespect and ignore the will of the American People do so at their own professional peril…

  4. Ellen J says:

    it's a damn shame that the tide has shifted…it's a damn shame that the healthcare reform bill is sucky, but better than none…it's a damn shame that in this great country, there's so few competent individuls willing to lead. Dave, it's a damn shame you're not President.

  5. Dave Cunix says:

    Pat Paulson once said "In America, any boy can grow up to be President. And if he doesn't grow up, Vice-President.
    I guess that I am more suited to be the Vice-President.

  6. RNNN says:

    I don't know, but I tend to think that the PPACA was such an Obama baby that he will not let it be changed in any way. If only our Representatives (and Senators as represenatives) would do just that, represent the people– I believe that is what the Founding Fathers really had in mind– and just forget the politics that get in the way of what is best for we the people. I know, David, this is not Utopia and we don't live there, so don't think I don't know the reality. I live the health care reality every day at work, especially with my current employer which will remain unnamed. Holly

  7. […] biggest winners were the Republicans.  This blog noted on November 3, 2010, the day after the Republicans won the House, that the GOP had no real interest in repealing the […]

  8. […] advantage/disadvantage of a blog is the existence of a paper trail. OK. Now What? was published on November 3, 2010, the day after the Republicans regained control of the U.S. House […]

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