By Viji Sundaram, NAM
EDITOR’S NOTE: Even before the GOP regained control of the House in the midterm elections, they had been vowing to eviscerate or repeal the landmark health care reform act signed into law by President Obama this past March. Indeed, many Republicans had campaigned on a repeal platform.
The GOP’s message-machine is trying to convince the public that the Affordable Care and Patient Protection Act (ACPPA) is health care spending legislation. Supporters of the law in Washington, D.C., say that on the contrary, the law is the biggest deficit-reduction measure ever passed, with the potential to save the country an estimated $1 trillion in the second decade of its enactment.
Much of the implementation of the reform bill will occur at the state level, and California has already forged ahead by approving the setting up of the so-called “health exchange,” through which individuals and small businesses can shop around online for the best health-care values for their needs.
NAM asked Anthony Wright, executive director of Health Access California, to weigh in on some of the concerns that Americans, especially California residents, may have about how the midterm elections will impact implementation of the law.
NAM: Newspaper reports say that one of the reasons for the electorate turning from blue to red is the health care reform law — that the results are a referendum on an entitlement that the public not only never wanted, but actually hated. Three separate polls — by NYT-CBS. Pew and Kaiser Family Foundation — all indicate a decline in support of the health care law in recent months.
Wright: The polls have been pretty steady. Folks are roughly evenly divided about health care reform, despite the impacts of $100 million in ads against health reform [after the bill was passed]. In California, there is plurality support.
A CNN poll showed that the first issue for the electorate, by 61 percent, was the economy and jobs. Health care was a distant second, at 19 percent, and even that was split in terms of people in favor or against. This election was about a bad economy, and perhaps broader frustration with government. California rejected the well-funded candidates for governor and U.S. Senate, who were for “repeal and replace.” In fact, most people are not for repeal, and [the numbers go down even more] they know the details of what they would repeal.
Even if Congress succeeds in passing a repeal measure, President Obama holds the veto pen. But Congress can decide not to fund certain provisions of the health reform act. If that happened, what California health care programs are in the greatest danger of being adversely impacted?
Wright: The new Congressional leadership in the House could put funding at risk, like for community transformation grants and other specific projects. What’s more worrisome is the fight over the overall budget to implement health reform at the national level, leading to a potential government shutdown, similar to what happened the last time the Repuiblicans took over Congress in 1994-95.
Earlier this week, the Obama administration approved a $10 billion so-called Medicaid waiver, which is expected to benefit thousands more Californians over the next five years. Will this waiver be jeopardized by the anti-ACPPA folks in Washington? And what exactly does the waiver do?
Wright: The waiver is not in jeopardy. This is what administrations have the authority to negotiate with individual states.
The waiver allows for a greater federal investment in California’s Medi-Cal program and health system on which we all rely, particularly key safety-net providers like public hospitals.
What about the provisions in the law that have already been implemented—like “aged out” kids getting back on their parents’ health care plan until they turn 26, and access to preventive care services? Could these provisions be frozen while Congress debates repeal?
Wright: No. The law is the law, and we need to make sure that Californians take advantage of the new benefits available under the law.