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What Does the Election Mean for Obamacare?

By Nina Owcharenko

The Heritage Foundation

What’s next for Obamacare now?

The bad news is that many of the health care law’s serious effects were delayed until after the election. Ten of its 18 new tax hikes have yet to kick in. And there is still so much about the law that we don’t even know.

Former House Speaker Nancy Pelosi (D–CA) was absolutely right when she famously remarked in 2010 that “we have to pass the bill so that you can find out what is in it.” Thus far, we have seen revelations of increasing costs, higher taxes, and a flood of directives from Washington bureaucrats—yet there are countless major features of the law that have not been decided.

Just a few of the questions that remain: What will a qualified health plan look like? What will be in the essential benefits package that insurers are required to provide? How will the employer and individual mandates to purchase insurance be implemented? The list goes on.

Thankfully, this isn’t the end of the story. Obamacare is not here to stay. Despite the 2012 election, the assumption that the health care law will stay on course is another example of the left’s wishful thinking. Of course, efforts for a complete repeal will likely face the same fate as efforts in the last Congress did. But there are ample reasons, as well as opportunities, to change the course of this law.

Public opinion has not changed. Exit polls show that more Americans still want the law repealed in full or in part.

So much of the law has yet to be developed. As more regulatory details emerge, they will generate even more public controversy and create even more practical obstacles for implementation. These instances will provide ample opportunities for legislative remedial action.

Bipartisan opposition to the law will continue. While the House vote earlier this year pressured five Democrats to support full repeal, more significant were the various piecemeal repeal bills that gained bipartisan support. Most notable: Repeal of the Independent Payment Advisory Board (IPAB), the unelected group of experts in charge of cutting future Medicare payments, passed the House and had more than 234 co-sponsors—Republicans and Democrats. These efforts will likely gain more attention in the future, as will efforts to weaken other elements of the law. House majority leader Eric Cantor (R–VA) has already vowed a vote on the IPAB repeal again.

The states can and will have their say. Two of the largest elements of the health care law—the massive Medicaid expansion and the costly subsidies scheme funneled through government exchanges—are heavily dependent on state compliance. But the June Supreme Court decision reaffirmed that states are not at the mercy of the federal government. Many state officials realize that there is little upside to joining forces with Washington in implementing this disastrous endeavor, thus further eroding the long-term viability of Obamacare.

Major lawsuits are moving ahead. The recent Supreme Court decision was not the only lawsuit against Obamacare. There are a number of lawsuits making their way through the federal courts. The anti-conscience mandate requiring virtually all employers to finance abortion-inducing drugs, sterilization, and contraception undercuts religious freedom. Today, there are already 40 suits representing more than 100 plaintiffs against it. An Oklahoma lawsuitraises a new legal question on the employer and individual penalties. More suits will certainly follow as more of the law is exposed.

These unending complications give us the opportunity to present a more desirable alternative. Patient-centered, market-based reforms are the best antidote to Obamacare’s top-down, government-run scheme. The Heritage Foundation’s Saving the American Dream plan offers such a path.

If the election had turned out differently, it would have been easier to repeal Obamacare. But that does not mean that Obamacare is here to stay. The only difference is that dismantling it will now be a more protracted and messy process.

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