Putting the Brakes on ObamaCare: WSJ

By GRACE-MARIE TURNER

If Republicans take control of one or both houses of
Congress this fall, many will have been elected with a promise to
"repeal and replace" ObamaCare. But what are their options, really?
There likely will be an initial showdown, but President Obama will
surely veto any challenge to the law, and it would be hard to imagine
mustering the votes to overturn it.

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Information
is the key weapon. Republicans can use congressional hearings to
explain what ObamaCare is doing to the economy and the health sector.
Their strongest cases would be built around jobs, the cost of health
care, and the rising deficit.

If
evidence shows that looming mandates on employers are crippling
job-creation, they should be repealed. If health costs are rising, as
they inevitably will be, Congress needs to hold hearings to investigate
the causes and explain why the offending taxes and regulations must be
repealed.

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Chad Crowe

Here are six key strategies that a Republican Congress could employ to put on the brakes:

• Defund it.
House Republican Leader John Boehner of Ohio has vowed to choke off
funding for implementation of the legislation, starting with parts that
are especially egregious such as the "army of new IRS agents" needed to
police compliance.

While
Republicans could target the most damaging provisions of the legislation
and tie their defunding measures to appropriations legislation that the
president wants and needs to sign, they'd better be ready for battles.
When former House Speaker Newt Gingrich lost a stand-down with President
Clinton over closing down the government in 1996, it was widely seen as
a setback for GOP efforts to scale back big government.

• Dismantle it.
To focus committee action and floor votes, Republicans can look for
provisions in the law that Democrats are on record as opposing. For
example, Senate Budget Committee Chairman Kent Conrad (D., N.D.) has
said that the new federal program to fund long-term care—the Community
Living Assistance Services and Supports Act, or CLASS Act—is "a Ponzi
scheme of the first order, the kind of thing that Bernie Madoff would
have been proud of." Mr. Conrad and five of his Democratic colleagues
sent a letter to Senate Majority Leader Harry Reid (D., Nev.) before the
legislation passed opposing the program and expressing "grave concerns"
about its fiscal sustainability.

Other
highly unpopular provisions include the requirement that all businesses
must file 1099 forms with the IRS to report any purchases totaling more
than $600 in a year. This is designed to raise about $17 billion over
10 years from tax cheats. Rep. Dan Lungren (R., Calif.) was the first to
introduce legislation to repeal this gigantic paperwork burden. Many
Democrats in vulnerable districts who voted for the health law are also
anxious to repeal this provision, which the National Federation of
Independent Business says will impact 40 million businesses.

• Delay it.
Republicans can also vote to postpone cuts to the popular Medicare
Advantage program, postpone mandates requiring that individuals and
businesses purchase and provide health insurance, and delay imposition
of the $500 billion in taxes required by the law. Mr. Obama wouldn't
likely sign such legislation, but the debate would shine a light on
problems that haven't received nearly enough attention.

• Disapprove regulations.
The Congressional Review Act of 1996 (CRA) gives Congress the authority
to overturn regulations issued by federal agencies if both houses
approve, with a two-thirds majority needed to override a presidential
veto. This would be difficult to pull off. But proposing a resolution of
disapproval under the CRA gives Republicans a platform to express
strong disagreement and bring attention to especially egregious rules.

The current congressional majority wants to gut the CRA,
and the House passed a bill that would eliminate the requirement that
federal agencies submit their rules to Congress before they can take
effect. The Senate has not yet acted, but this measure should be on the
Republicans' watch list for the rest of the year.

• Direct oversight and investigation. Other
aspects of ObamaCare are ripe for public hearings. For example, rules
dictating how much insurance companies must spend on direct medical
benefits are already hugely controversial—even before they have been
issued. Businesses are also aghast at the narrow openings they have to
protect their current health plans from onerous federal regulation.
Republicans could summon many witnesses to testify about the impact of
this regulatory straightjacket.

Congress
also must keep a careful eye on the evolving cost estimates and
deficits. Former Congressional Budget Office Director Douglas
Holtz-Eakin estimates that the cost of the subsidies for private
insurance could rise to $1.4 trillion —triple the $450 billion assumed
by the current CBO. This is because the legislation creates strong
incentives for businesses to drop coverage and dump their employees into
federally subsidized insurance. Congress has a responsibility to
protect taxpayers from what surely will be exploding costs.

Republicans
also will want to call Donald Berwick, head of the powerful Centers for
Medicare and Medicaid Services, to testify before Congress and detail
his regulatory agenda for implementing the health-care law. He escaped
that duty earlier this year when the White House avoided his Senate
confirmation by giving him a controversial recess appointment.

• Delegate to the states. Congress
should encourage states to press forward with their own innovative
programs. For example, Gov. Mitch Daniels's popular and fiscally
responsible Healthy Indiana Plan expands coverage to the uninsured using
a health savings account model. And the lightly regulated Utah Health
Exchange provides a marketplace for individuals and small businesses to
purchase affordable, portable health insurance. Both are threatened by
ObamaCare. The more that states are marching forward with reform that
suits the needs and pocketbooks of their citizens, the easier it will be
for Congress to repeal ObamaCare and start over.

Americans intuitively understand that government can't
pay for huge new entitlement programs and the expansion of Medicaid with
imagined cuts to Medicare, while still improving Medicare's long-term
solvency. They also know that job creation is flat and that employers'
fear of ever-rising health benefit costs is part of the problem. They
need to hear the evidence that their fears are valid.

The
real wallop of ObamaCare will come in 2014, when most of the spending
begins and businesses and individuals are hit with intrusive and
expensive mandates. The main job of Republicans, should they capture
Congress, will be to slow down implementation of the law and explain to
the American people the damage it will do—and already is doing—to our
economy. If the White House changes hands in 2012, they can be ready to
start with a clean slate and begin a step-by-step approach to sensible
reform.

Ms. Turner is president of the Galen Institute.