Health reform implementation

ObamaCare takes friendly fire

Delays in implementing popular pieces of ObamaCare are hurting it with Democrats.

Ahead of an election year in which Republicans promise to make healthcare an issue again, Democrats are criticizing the White House for delaying policies that could help build support for the unpopular law.

{mosads}Democrats complained this week about a one-year delay in a key program designed to help small businesses — a central selling point for the healthcare law that now won’t be in place when voters head to the polls next year.

“Senate Republicans will have the opportunity to campaign against Obamacare’s rising health care costs, burdensome paperwork and broken promises and could use it to motivate voters against Democrat candidates, especially vulnerable ones in red states,” Republican strategist Ron Bonjean said.

HHS has delayed by one year a provision that would have allowed small businesses in most states to choose from multiple policies for their workers. Although a handful of states will see increased competition next year, most will have just one plan to choose from until 2015.

Sen. Mary Landrieu (D-La.) told The New York Times the delay will “prolong and exacerbate health care costs that are crippling 29 million small businesses.”

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Democrats are also complaining more openly about other implementation delays. And the substance of the law itself isn’t immune from bipartisan criticism — 33 Senate Democrats cast a non-binding vote last month to repeal the law’s tax on medical devices, saying it’s a threat to innovation that could raise costs for consumers.
The party has long acknowledged that the Affordable Care Act has its flaws. Their new openness about those flaws comes after Obama’s reelection, which ensured that the law would not be repealed before it’s fully implemented.
But it also comes just ahead of the 2014 election cycle, when vulnerable Democrats in conservative states will have to defend their votes for the health law.
Landrieu is already facing a tough reelection fight next year. And one of the Republicans who has lined up to challenge her, Rep. Bill Cassidy (R-La.), is a doctor who still sees Medicaid patients when Congress isn’t in session.
In addition to rank-and-file Democrats who voted for the healthcare law, Republicans this time are hoping to defeat Sen. Max Baucus (D-Mont.) — who was the primary author of the Affordable Care Act in his position as Finance chairman.
Senate Republicans’ campaign arm attacked Baucus this week as the “ObamaCare architect.”
Flaws in the law’s execution — such as higher premiums or fewer options for small businesses — could be weapons against Baucus.
“People already don’t like ObamaCare, but they’re really not going to like the tax hikes, mandates, fees, penalties, and added red tape bureaucracy that go info effect over the next eight months. It goes from being an abstract discussion to a real life pain,” the National Republican Senatorial Committee said. 
Democratic strategists say they’re not especially worried about healthcare attacks in 2014.
Democrats point to their wins in several deeply conservative states in 2012, including Sen. Jon Tester (D-Mont.), who voted for the healthcare law, and Joe Donnelly, who won a Senate seat in Indiana despite supporting the healthcare bill when he was in the House.
“Sounds like Republicans plan to continue the same failed message strategies of 2012,” the Democratic Senatorial Campaign Committee said.
Most Senate Democrats are by no means running away from their healthcare vote entirely. Landrieu, for example, has criticized Louisiana Gov. Bobby Jindal for refusing to participate in the law’s Medicaid expansion.
But they’re more willing to support certain changes to the law, such as repealing its medical device tax. And they’re more open to criticizing the implementation — particularly on an issue like choices for small businesses, which was a key part of the rhetorical push to pass healthcare reform in 2010.
The Obama administration has also taken friendly fire from Sen. Maria Cantwell (D-Wash.), a member of the Finance Committee who was heavily involved in crafting certain parts of the healthcare law that gave new options to state governments.
Cantwell has said she would not support Marilyn Tavenner, Obama’s nominee to lead the Centers for Medicare and Medicaid Services (CMS), because of her frustration with the delays in a provision known as the Basic Health Plan.
The provision would let states bargain directly with insurance companies to create a scaled-down plan for people who aren’t eligible for Medicaid but might not be able to afford the more expensive private plans sold through newly created exchanges.
HHS has responded to Cantwell’s concerns over the recess, although in an interview shortly before leaving town, Cantwell said she wasn’t buying the administration’s explanation that it is simply too swamped with other work to implement the Basic Health Plan on time.
“Well, Ms. Tavenner definitely will not have my support and I’m not interested in how she’s going to implement the Act,” Cantwell said during a hearing in February. “I’m interested in the commitment to the administration to live up to the way the Affordable Care Act’s provisions say it should be implemented.”

–This report was updated at 5:50 p.m.

Tags Hillary Clinton Joe Donnelly Jon Tester Maria Cantwell Mary Landrieu Max Baucus

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