Calling The Bluff On Senator Cruz – and 5 Reasons It’s A Safe Bet!

Posted on | September 30, 2013 | 3 Comments

Mike Magee

October 1st is tomorrow, the day enrollment for the new Affordable Care Act’s health insurance exchanges begin. This includes state exchanges in the states which have elected to create state options, and the federal exchange everywhere else.

The law is complicated and complex. All agree there will be bumps. But it will be transformative for healthcare, and will have broad public support in a short time, just as Medicare does today.

Of course, those opposed suggest the world is ending, and threaten to shut down the government if the law proceeds. But the President, the Democratic party, and (quietly behind the scenes) a number of Republican leaders, are unwavering in calling the bluff. Why are they so comfortable? Here are five reasons.

1. The law has been pretested in Massachusetts, where it was enacted by a Republican governor who developed it with an instruction book designed by the American Enterprise Institute. This provides great insight into the complex issues (pro and con) that will need to be addressed as we move along.

2. The Affordable Care Act is the law of the land, reinforced by the decisive last Presidential election. It became a law with the tacit support of provider and insurer organizations who are now critical to its implementation. Furthermore it’s implementation is being managed by the highly capable former governor and state insurance commissioner of Kansas, HHS Secretary Kathleen Sebelius. (By the way, her father was Jack Gilligan, Congressman from Ohio in 1965 when Medicare became law.) Secretary Sebelius is on top of this, and has flexibly adjusted time lines to assure success.

3. Many large employers who have carried the economic burden of healthcare for a half century, and who have tried independently to redesign and re-engineer health care in the U.S. with limited success (through associations like the Business Roundtable’s Health and Retirement Committee – at it since 1972.), see the new law as expanding their options. Already multiple employers are pursuing varied pathways that generally move from defined health benefits to defined health contributions. Some advantage the new insurance exchanges as an option.

4. The carrot: The law gives primacy to states, which can form their own state run exchanges or form a partnership model with the federal government. The stick: If not, states must provide access to federal exchanges. 26 states have formed their own exchanges or are planning partnership models, and 25 have defaulted to “Federally-facilitated Exchanges”. Some Republican led states have hung tough, refusing to form state exchanges, viewing this as being “supportive” of legislation they oppose. But as popular federal options take hold in their states, with the support of major state employers, their opposition will rapidly erode. Especially since major support of their Medicaid programs up to 138% of the Federal Poverty Level (a part of the Affordable Care Act) is essential to their states economic viability.

5. Having Senator Ted Cruz as your most visible leader is about as helpful to the Republicans as having Senator Joe McCarthy out there was during the 1950’s. Reckless and offensive to major Republican leadership, divisive within party ranks, and unsupportable by independents, he’s a dead end, and a short term one at that. He has about as much political longevity as his most vocal political supporter, Sarah Palin, did.

Will the debt limit be extended? Will the government default on it’s financial obligations? Only time will tell. But three things are already certain. First, the Affordable Care Act will be successfully implemented nationwide. Second, after bumps, bruises, and adjustments in the short term, as with Medicare, it will be widely popular. Three, as a result of this legislation, Americans’ health will rise and health care costs per capita will decline.

For Health Commentary, I’m Mike Magee

Comments

3 Responses to “Calling The Bluff On Senator Cruz – and 5 Reasons It’s A Safe Bet!”

Nancy Menzel
September 30th, 2013 @ 12:19 pm

Typo: Tomorrow is October 1, not November.
J Muller
September 30th, 2013 @ 12:38 pm

Correction – John J. “Jack” Gilligan, Sibelius’ father, was Congressman from, and later Governor of, of Ohio, not Kansas
Mike Magee
September 30th, 2013 @ 5:11 pm

Thanks, Nancy.