Still Trying To Attack The Affordable Care Act

by Stuart Shapiro

Earlier today I posted about the impending onset of the Affordable Care Act.  This reality hasn’t stopped Republicans who still want credit with the Tea Party for trying to repeal ObamaCare.  As part of the budget negotiations, Republicans are trying to repeal three of the smaller provisions of the ACA.

The Prevention And Public Health Fund

The prevention fund was designed to help local communities combat disease and promote wellness. Republicans deride it as a “slush fund.”

Initially set at $15 billion, GOP leaders convinced the president and Democratic leaders to chop it by $6.25 billion in the payroll tax cut deal early this year. Having sensed that Democrats are willing to reduce its size, they’ll hope to continue chipping away at it.

Overpaid Premium Subsidies

The ACA provides subsidies to help Americans within 400 percent of the poverty line buy insurance on the exchanges. Republicans see that as a major source of potential savings.

Democrats have previously agreed to alter the formula to save money, and Republicans see further opportunities. One policy idea they have to extract more savings is to force those who incorrectly received subsidies to pay them back. Another is to recapture subsidies from those whose incomes rise above the 400 percent of the poverty line shortly after they get the payment.

Center For Medicare And Medicaid Innovation

The ACA allotted $10 billion to create an agency called the Center For Medicare And Medicaid Innovation, which would be tasked with testing payment reforms and new delivery system models to improve efficiency. Republicans see the money as a waste.

Does anyone else see the irony here?  Two of these three (the first and third) are designed to cut medical costs and hence the deficit. I guess the GOP only cares about deficits when it doesn’t demagogue Obamacare.

About Stuart Shapiro

Stuart is a professor and the Director of the Public Policy program at the Bloustein School of Planning and Public Policy at Rutgers University. He teaches economics and cost-benefit analysis and studies regulation in the United States at both the federal and state levels. Prior to coming to Rutgers, Stuart worked for five years at the Office of Management and Budget in Washington under Presidents Clinton and George W. Bush.

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