What they’re proposing when they push repeal

WHAT THEY’RE PROPOSING WHEN THEY PUSH REPEAL…. One of the key messages Republican officials have emphasized since the midterm elections is their intention to push, full steam ahead, with repealing the entire Affordable Care Act. We have some sense of the political difficulties of pulling that off with a Democratic White House and Democratic Senate, but as far as the GOP and its supporters are concerned, they’ll do whatever it takes to gut the system.

While we know why the right wants to do this, and roughly how they’ll go about trying, I continue to think there hasn’t been enough discussion of what the consequences of this policy would mean in practical terms. Take the effects on Medicare , for example. Jonathan Cohn’s piece on this today drove the point home nicely.

[Republicans have been] attacking the health overhaul for what it will do to Medicare. And instead of accusing Democrats of trying to dump more money into a government program, as Republicans would typically do, they’ve attacked Democrats for doing the very opposite — noting that the Affordable Care Act will reduce spending on Medicare somewhere around $400 billion over the next ten years. Apparently government-run health care is awful, except, um, when it isn’t. […]

But here’s where things could get complicated for the advocates of repeal. Consider what undoing the cuts in Medicare would entail. It would start, first of all, with restoring higher payments to the insurers that provide private coverage for people in Medicare, through what’s known as the Medicare Advantage plans. There’s a reason the health law reduces those payments: Repeated independent studies, including those by the well-respected Medicare Payment Advisory Commission, determined that the government was paying the insurers too much.

Restore those payments, and you’re wasting taxpayer dollars. And a lot of those wasted dollars will go to hiring new people to work at insurance companies. They won’t be government bureaucrats, obviously. They’ll be insurance company bureaucrats. But is that really better? Is the Tea Party in favor of waste as long as its lines the pockets of insurance executives rather than Uncle Sam?

Meanwhile, restoring the other cuts to Medicare would mean rescinding payment reductions designed to make the program more efficient.

Right. GOP candidates, including radical libertarians like Sen.-elect Rand Paul, were elected after running attack ads going after Dems on Medicare. It worked — seniors showed up and voted Republican.

But at the same time, these same GOP candidates want to repeal the Affordable Care Act, which would in turn undermine Medicare’s long-term health, make it less efficient, more wasteful, all while reintroducing the prescription drug “doughnut” hole.

It’s not a plan seniors are going to like.

Indeed, we can see a similar dynamic play out on a variety of fronts — Republicans talk about satisfying the demands of deficit hawks, but repealing the health care law would increase the deficit. They talk about taxes, but repealing the health care law would increase taxes on small businesses. They talk about being “pro-family,” but repealing the health care law would leave far fewer kids with coverage.

And they talk about Medicare and waste, but repealing the health care law would lead to more wasteful spending while undermining Medicare.

Talking about repealing the ACA is easy. If only Republicans had some sense of what it was they were talking about, we could have a far more compelling debate.