Why Republicans really want to repeal health reform

So, House Republicans have titled H.R. 2, their bill to repeal the health reform law passed last March, “The Repealing the Job-Killing Health Care Law Act.” Except the health care reform bill wouldn’t likely kill jobs, according to this analysis by the Center on Budget and Policy Priorities.

Meanwhile, CBO has explained that just as they had scored the health reform law as reducing–not increasing–the deficit (which by the way would mean that it would eventually raise national saving, grow the economy, and create jobs), repealing the (nevertheless so-called “job-killing”) health reform law would actually increase the deficit.

So what are the real reasons why Republicans want to repeal health reform? I have my guesses:

1. They think most Americans dislike health reform. This is the companion to why policymakers were so quick to extend and deficit-finance the Bush tax cuts–not because there was any evidence that the Bush tax cuts were wonderful for the economy (oh, to the contrary), but because they believed that Americans (or more specifically those Americans who vote) loved the Bush tax cuts for whatever inexplicable reasons.
2. They don’t want to expand publicly-funded health care. The health care reform act did in fact do more to expand health coverage than to directly reduce the costs of existing programs. It does mean “bigger government”–or as CBO puts it, expands the “federal budgetary commitment to health care.” But it did more than pay for that expanded coverage by the spending cuts and tax increases in the same law, which is why CBO scored it as reducing, not increasing, the deficit. Which leads to…
3. They didn’t actually want the kind of health reform that would reduce the deficit–not this way at least. As CBO’s latest analysis of this repeal bill explains (emphasis added):

PPACA and the Reconciliation Act also included a number of provisions to reduce federal outlays (primarily for Medicare) and to increase federal revenues (mostly by increasing the Hospital Insurance payroll tax and imposing fees on certain manufacturers and insurers); in March, CBO and JCT estimated that those provisions unrelated to insurance coverage would, on balance, reduce direct spending by about $500 billion and increase revenues by about $410 billion over the2012–2019 period.

What Republicans really oppose about the health reform law is the tax increases that do most of the deficit reduction in the law. These aren’t just random tax increases, though. These are the kind of tax increases (or reductions in health insurance tax expenditures) necessary to bring out-of-pocket health costs more in line with true economic costs, to reduce the excess demand for health care that drives up the market price of health care. It’s not that Republicans oppose the idea of making health care markets more efficient. It’s probably that they don’t like the idea of any kind of tax increase, and especially not the kind of tax increase that would be paid disproportionately by higher-income households, who they emphasize are the “engine of economic growth” in our economy–you know, the “job creators.”

So that’s how this bill to repeal the health reform law becomes characterized as a way to eliminate a “job-killing” law, and how the proposal is really perfectly consistent with the Republican supply-side ideology that says that tax increases, no matter of what variety, hurt the economy and reduce jobs, and deficits, if they come from tax cuts rather than spending increases, don’t matter.

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