The Commercial Appeal

Obamacare rhetoric remains the same

- CARL P. LEUBSDORF

On the first day of the week, very early in the morning, the women took the spices they had prepared and went to the tomb. They found the stone rolled away from the tomb, but when they entered, they did not find the body of the Lord Jesus. While they were wondering about this, suddenly two men in clothes that gleamed like lightning stood beside them. In their fright the women bowed down with their faces to the ground, but the men said to them, “Why do you look for the living among the dead?” Luke 24:1-5

Five years after enactment of the Affordable Care Act, the political debate between its supporters and its opponents continues to rage with remarkably little change.

But the success of the law in extending insurance coverage to millions of Americans could dramatical­ly change the terms of that debate if either the latest congressio­nal Republican legislativ­e assaults or a pending Supreme Court case threatens its future, enabling the Democrats to regain the offensive for the first time since the law was passed.

Predictabl­e statements from both sides marked the law’s recent anniversar­y.

President Barack Obama and his Democratic allies used the occasion to cite the increasing statistica­l evidence that the landmark measure has succeeded in sharply reducing the number of Americans without health care coverage, slowing the growth rate of health care costs and proving less costly than even some backers had feared.

In those five years, the White House says, 16.4 million Americans have gained health insurance, reducing the percentage of uninsured Americans from 20.3 percent to 12.9 percent and the law’s projected 10-year cost by some $116 billion.

Republican critics, meanwhile, continue to denounce Obamacare as unworkable and costly. And they’re using their new congressio­nal majorities to plot its destructio­n via the same legislativ­e procedure the Democrats used to pass it while hoping the high court will help them by ruling out a key element in financing it.

Critics claim that the law has increased average deductible­s by 40 percent for families, cost many people their existing insurance and imposed tax increases that have helped to slow the economic recovery from the Great Recession.

Last week, both the House and Senate passed budgets that included provisions directing their legislativ­e committees to draft measures to repeal the law. They plan to include it in the reconcilia­tion measure that would implement their budget, since the Senate’s GOP majority can pass that without fear of a Democratic filibuster.

But the fate of any legislativ­e challenge remains questionab­le as long as Obama is in office, prepared to wield his veto pen. Meanwhile, supporters of the law are more concerned about the pending Supreme Court case challengin­g the validity of tax credits for more than 7.5 million people who purchased health insurance from the federal government’s exchange, rather than from ones operated in 13 states.

Comments by justices during last month’s hearing on the case gave Obamacare supporters hope the court will uphold the legality of the tax credits, preventing a situation in which many beneficiar­ies would be unable to afford their health insurance.

Some congressio­nal Republican­s have indicated that, if the court sides with the challenge, they would press forward with an alternativ­e to the Affordable Care Act that would preserve such popular features as the protection against being denied coverage because of pre-existing conditions and raising the age for letting young people remain on their parents’ insurance plans.

But the prospect that Congress could agree on fixing something as controvers­ial as the Affordable Care Act seems highly questionab­le, even though failure to act would leave millions in limbo, including a million in Texas.

In any case, if either legislatio­n or the Supreme Court cripples the law, and Congress fails to restore its principal provisions, the resulting debate could focus less on the merits of the law than on the impact of the loss of benefits for many of its 16 million beneficiar­ies, who have gained access to insurance or received expanded Medicaid benefits from many states..

That, in turn, could give the Democrats the political high ground they lacked as long as the debate centered on enactment of a law that a majority of Americans opposed.

That’s because recent polls show only a minority wants to scrap it while a majority wants Congress and the Obama administra­tion to find ways to fix its flaws.

But the prospect of a changed political climate shows no sign of stopping either the array of Republican presidenti­al hopefuls vowing to repeal the law in 2017 or the congressio­nal Republican­s from proceeding against it now.

As a result, this longrunnin­g battle — and the accompanyi­ng acrimoniou­s debate — is likely to persist for some time. Carl P. Leubsdorf is the former Washington bureau chief of the Dallas Morning News. Contact him at carl.p.leubsdorf@gmail. com.

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