The Coming Delay and Defund Battle

Published July 22, 2013

The House votes to delay the employer and individual mandates, teeing up a battle in the fall  over the CR which could be explosive. “House lawmakers on Wednesday voted to  approve two separate bills amending portions of the Affordable Care Act, the  latest moves by the GOP to try to throw up hurdles to the Obama health law. The first bill would codify the year-long delay to the obligation on companies to  provide health care coverage to their workers from next year. The second would  delay a similar obligation on individuals to purchase health-care insurance. The  vote on the first bill delaying the employer mandate passed 264-161, with 35  Democrats joining Republicans in supporting it. The vote on the second  legislation was approved by a vote of 251-174. On that measure, 22 Democrats  sided with the majority. Neither bill is expected to be taken up by the  Democratic-controlled Senate. The White House said the president would veto  either bill if it was advanced to his desk by Congress.” Keep in mind that on  the employer mandate vote, he’s promising to veto something which simply  codifies what he’s doing already.

What we’re seeing here is a shift from the Repeal and Replace battle to the  Delay and Defund battle. This is ground where it’s more difficult for Democrats  in swing districts to oppose the attempt. On the employer mandate, one in six  House Democrats bucked their president. On the individual mandate, one in nine  House Democrats did. Privately, many Democratic staffers have expressed a  willingness to delay the law and “implement it right” as opposed to running in a  year when the implementation is providing daily reminders of the  administration’s failure to measure up to its promises.

Here’s an interesting piece from Klein and Kliff on the implementation PR push, which contains multiple  warning signs for the difficulty of making the law a reality. “In states that  refuse the Medicaid expansion, residents whose incomes are above the poverty  line ($11,490 for an individual) will still have access to tax credits for  purchasing private insurance on the exchanges. Those below the poverty line,  however, will not receive help obtaining coverage. That lessens the law’s reach,  and creates an unexpected messaging problem: How does the White House tell  certain citizens that they earn too little to qualify for any help? “How do you  explain this in a way that seems fair and reasonable, that the higher income  people get help but you don’t?” said Mike Perry, a founding partner at  Democratic polling firm Perry Undem Research. “Advocates on the ground are  really struggling with that group. They want to have a positive message but  don’t know what to say.”

“Perry and his co-founder, Tresa Undem, have arguably conducted the most  extensive research on encouraging insurance enrollment under the law; in April,  Undem conducted a briefing for administration officials on how best to reach  young Americans. They have found, overwhelmingly, that Americans are uninformed  about the health law — and are deeply skeptical when they learn about it. When  they asked a recent focus group whether a $210 premium was affordable, only 29  percent of likely marketplace enrollees said yes. Then, Undem and Perry phrased  the question a bit differently. They told the focus group participants that,  with their tax credits, they would save “$1,908 a year compared to what you  would pay on your own.” All of a sudden, 48 percent of the participants thought  that insurance was affordable. But 48 percent is still less than  half.”

[First Published by Real Clear Politics]