Lawmakers Debate Obamacare Amid Shutdown

National Journal
Sophie Novack
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Sophie Novack
Oct. 3, 2013, 9:44 a.m.

As a gov­ern­ment shut­down con­tin­ues to strain agen­cies across Wash­ing­ton, Rep. Mi­chael Bur­gess says he re­mains res­ol­ute when it comes to his op­pos­i­tion to the Af­ford­able Care Act — and his de­term­in­a­tion to do something about it.

A short-term meas­ure to fund the gov­ern­ment, without lan­guage to ad­dress Obama­care, is a non­starter, he says.

“I would not sup­port it,” the Texas Re­pub­lic­an said at the Na­tion­al Journ­al Count­down to Trans­form­a­tion event Thursday. “I can’t speak for the Re­pub­lic­an con­fer­ence.”

“There was a pro­ced­ur­al vote yes­ter­day and every­one stuck to party sides,” Bur­gess said. “This was an op­por­tun­ity [to re­open the gov­ern­ment] and it didn’t hap­pen, after 48 hours of the shut­down.”

Bur­gess and Rep. Rosa De­Lauro, D-Conn., offered a kind of point-coun­ter­point on the Af­ford­able Care Act, and the shut­down dom­in­ated much of the con­ver­sa­tion. Yet neither could of­fer a clear way to re­solve dif­fer­ences over the health care law and fund­ing the gov­ern­ment.

While Bur­gess said it is feas­ible the ap­proach will be to con­tin­ue passing sep­ar­ate ap­pro­pri­ations bills “every 45 minutes un­til they pile up and the Sen­ate has to pass something,” the Sen­ate has re­jec­ted that strategy and De­Lauro was highly crit­ic­al of the piece­meal ap­proach.

“Is it con­ceiv­able that this is a way to fund the parts of gov­ern­ment [Re­pub­lic­ans] like, and not fund the parts they don’t like?” she said.

She noted that there has been de­bate over fund­ing parks, vet­er­ans’ pro­grams, and the Na­tion­al In­sti­tutes of Health, while Head Start and nu­tri­tion pro­grams have been left out of the mix. “I think it’s tak­ing [Re­pub­lic­ans] down an elect­or­al path that is a dis­aster,” she said.

Bur­gess and De­Lauro’s states are an ex­cel­lent rep­res­ent­a­tion of con­trast­ing ap­proaches to the Af­ford­able Care Act.

Con­necti­c­ut has op­ted to set up its own state-based ex­change and will ex­pand Medi­caid in 2014. The state has em­braced ef­forts to pro­mote the law, with about $6.5 mil­lion to be spent on ads and so-called nav­ig­at­ors to help people en­roll. “The more you edu­cate people, the less fear­ful they are,” she said.

Ac­cord­ing to De­Lauro, there are about 300,000 un­in­sured people in Con­necti­c­ut, and the state has had about 400 ap­plic­ants to the mar­ket­place thus far. “People are ex­cited about the fact that for the first time they’ll be able to have in­sur­ance they can af­ford,” she said.

Con­necti­c­ut’s ex­change also has the fourth-highest premi­ums in the U.S., though De­Lauro said they will try to bring the state’s costs down fur­ther and was quick to point out that premi­um costs na­tion­wide are lower than ex­pec­ted.

“The amaz­ing thing is the gov­ern­ment can shut­down, but af­ford­able care is launched,” she said. “I say yes to that!”

The ap­proach to Obama­care in Texas has been dif­fer­ent. The state has de­clined to set up its own ex­change, mean­ing that a fed­er­ally run ex­change will be the de­fault. Medi­caid will not be ex­pan­ded, though the stakes are ar­gu­ably high­er than in Con­necti­c­ut. In a state of about 26 mil­lion people, roughly 25 per­cent of Tex­ans are cur­rently un­in­sured.

“Texas does have a ro­bust safety-net pro­gram,” Bur­gess said. “It re­lies on dis­pro­por­tion­ate-share fund­ing.” He said dis­pro­por­tion­ate-share hos­pit­als, which serve low-in­come res­id­ents, are con­cerned about their fund­ing be­ing used to help pay for the Af­ford­able Care Act. Be­cause Texas is not ex­pand­ing Medi­caid, these hos­pit­als will be without a re­place­ment fund­ing source.

Bur­gess said there is a need for changes in the laws already writ­ten, but he em­phas­ized the reg­u­lat­ory bur­den and the com­pressed timeline for the Af­ford­able Care Act rol­lout as prob­lems with the law.

Both law­makers brought up the rol­lout of Medi­care Part D as evid­ence to sup­port their po­s­i­tion. De­Lauro read a series of head­lines from when the pro­gram first began, to show it too was con­tro­ver­sial when it began. Bur­gess said Obama­care has not fol­lowed the ex­ample of the Medi­care Part D rol­lout, which he says was bet­ter co­ordin­ated.

Both law­makers ac­know­ledged there will be a wait-and-see peri­od to eval­u­ate the law. De­Lauro said there would be glitches, but that of­fi­cials can “work the sys­tem to fig­ure out how to best put it in­to place.” Bur­gess said meas­ur­ing suc­cess would be dif­fer­ent, de­pend­ing on the party.

“There will be a dif­fer­ent threshold de­pend­ing on one’s feel­ing of the law,” he said.

With Re­pub­lic­ans and Demo­crats still far apart on a gov­ern­ment fund­ing meas­ure, law­makers said the shut­down could drag on.

Asked when the gov­ern­ment will re­open, Bur­gess replied, “Later.”

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