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Fall 2012 Issue
PUBLIC POLICY
“Obamacare”:
What could happen after Nov. 6
The Patient Protection and Affordable
Care Act (PPACA), informally called
“Obamacare,” was signed into law
by President Barack Obama on Mar.
23, 2010. Together with the Health
Care and Education Reconciliation
Act, it represents the most significant
regulatory overhaul of the U.S. health
care system since the passage of
Medicare and Medicaid in 1965.
The PPACA is aimed primarily at
decreasing the number of uninsured
Americans and reducing the overall costs
of health care. It provides a number of
incentives—including subsidies, tax
credits, and fees—to employers and
individuals in order to increase the
coverage rate. Additional reforms are
aimed at improving health care outcomes
and streamlining the delivery of health
care. The PPACA requires insurance
companies to cover all applicants and
offer the same rates regardless of pre-
existing conditions or gender. The
Congressional Budget Office (CBO)
projected that the PPACA will lower both
future deficits and Medicare spending.
Others believe it will actually increase
health care costs and the deficit.
On Jun. 28, 2012, the Supreme
Court of the United States upheld the
constitutionality of most of the PPACA.
Some of the law’s provisions are already
in effect – pre-existing conditions and
dependent coverage - but most will
be implemented in coming years. The
program’s key provisions – mandatory
insurance for individuals and mandating
many employers to offer coverage to their
employees – are set for Jan. 1, 2014.
For the record, the National Restaurant
Association (NRA) worked tirelessly to
make the PPACA more reasonable as
it went through the Congress. Once all
hope of a balanced bill was lost, they
opposed its final passage. The Ohio
Restaurant Association (ORA) also
opposed the legislation.
Candidate Mitt Romney and most
Republicans are campaigning on a
platform that includes “repeal and
replace” of the federal health care law.
Scenario #1
– Romney wins. It is
almost certain that the Republicans
will continue to control the House of
Representatives and Representative
John Boehner (R-OH) will remain the
Speaker. And, whether the Democrats
retain control of the closely divided
Senate or not, neither party is expected
to have the 60 votes necessary to
stop a filibuster by the minority party.
This means that a President Romney
and his fellow Republicans could get
repeal legislation through the House,
which they’ve already accomplished on
multiple occasions. But, they will be
once again be stopped in the Senate.
No problem, some will say. The
Republicans will have enough votes to
pass the “budget reconciliation” bill
and can use it to deny funding to many
of the provisions of Obamacare.
The argument is that even if they can’t
repeal the law they can refuse to pay for
its implementation. There also is the
“bully pulpit” factor. Will a President
Romney have enough public support
to persuade some wavering lawmakers,
including Democrats, to repeal the
PPACA? In the opinion of the ORA’s
Director of Government Affairs Richard
Mason, that’s a tall order.
Scenario #2
–Obama is reelected.
Results? See Scenario #1 above. The
only difference might be the “bully
pulpit” factor.
The political reality is that Congress likely
will remain divided and neither party,
nor its president, will be able to impose
its will completely. One way or another,
elements of the federal health care law
will likely be a factor in our lives.
Keeping this in mind, one
must ask: what happens to
the law after Nov. 6, 2012?
