Early Sunday morning, House Republicans moved the government ever closer to a shutdown by passing a continuing resolution bill that would impose a one-year delay in the implementation of the individual mandate portion of the Affordable Care Act (ACA), repeal the tax on medical devices, and allow a "conscience clause" which would permit organizations to opt out of providing contraceptive services. The resolution, which otherwise approves funding the government through December 15, is guaranteed to be rejected by the Senate Democrats when they reconvene on Monday afternoon.
Republican obstinacy in the pursuit of repealing Obamacare may not be a costly maneuver in the friendly environs of certain Republican congressional districts, but it is a clear example of a party that seems to have only marginal concern with making health care available to the uninsured.
None of the GOP-specific reforms that are proposed in the Republican Study Committee's American Health Reform Act are included in the House bill. That is a true indication that Republicans are not serious about health reform. Rather they are using this as a wedge issue to drive out moderate Republicans, challenge Democratic Senators from red states, and hopefully recreate the voting fervor within their base that resulted in the Tea Party wave of 2010.
Furthermore, nothing in the continuing resolution will prevent the exchanges from going live on October 1. The Congressional Research Service noted that much of the ACA comes from mandatory spending, and the Department of Health and Human Services said the reform implementation fund would not be impacted by any delay in appropriations. The continuing resolution only impacts discretionary spending.
The GOP's strategy is designed to disrupt the rollout of the exchanges, making it more difficult for people to make up their own minds about health care. Additionally they want to delay the individual mandate in the hopes that people would choose not to enroll, thus raising the cost of premiums.
In other words, they want to make it harder for people to obtain health insurance.
Bolstered with the confidence of knowing that they have nothing to fear from their gerrymandered districts, House Republicans are willing to disrupt the lives of millions of Americans with a government shutdown in order to prevent the possibility of allowing uninsured Americans the opportunity to obtain health insurance.
They have staked their reputations, the future of their party, and possibly the future of America on an all or nothing gambit to block the implementation of the president's signature piece of legislation. It is a strategy that has had less-than-stellar results. In 2010 it resulted in an unprecedented victory. In 2011 it led to a downgrading of the U.S. federal government's credit rating, and in 2012 it cost them the White House and the Senate. This tactic has failed in the legislature and the courts and this time it is doomed to fail again.
Even a novice political strategist can see that the GOP is trying to delay the implementation of the law until after the 2014 election with the hope that they will at that point control the Senate. It is a gamble that is costing millions of people the opportunity to obtain health insurance. What happens if the Democrats agree to delay the implementation until January 2015? People will be uninsured for another year, and the GOP will ask for another delay in the fall of 2014.
That is an outcome that only people with insurance could afford to support.