Today’s elections will have major implications for healthcare reform. Back in February, Mike Sturm and John Meerschaert provided foresight on how healthcare reform could be affected by the U.S. Supreme Court’s ruling on the Patient Protection and Affordable Care Act (PPACA) and the general election. As we now know the Supreme Court preserved the constitutionality of PPACA, except that states can opt out of Medicaid expansion.
Here is an excerpt from Sturm and Meerschaert’s article “Healthcare reform in 2012: Blind curves ahead” discussing the effects of potential election results:
The November 6 general election may prove to be a bigger factor than the Supreme Court decision, because the potential result could be a complete repeal of the PPACA… here are three scenarios:
President Obama is re-elected. If the president is re-elected, a Republican-controlled Congress may try to repeal the healthcare reform legislation, but President Obama will veto the repeal. Unless Congress overrides the veto—which is doubtful because it requires a two-thirds majority in both houses—the program will move forward; the exchanges will be created, and all other provisions of the PPACA (minus any that are ruled unconstitutional) will eventually become operational. If the Democrats control either house, no repeal bill is likely to pass.
There is also some speculation that President Obama might back off of some PPACA provisions because of their political unpopularity, but this remains, at most, a remote possibility.
A Republican president is elected, but the Democrats control at least one house of Congress. No attempt at repealing the 2010 legislation is likely to pass, and PPACA will remain the law of the land. However, the real power of implementation rests with the executive branch, and it is probable that the new president’s appointees in the Department of Health and Human Services and the Centers for Medicare and Medicaid Services will delay the major provisions of the law. In particular, the exchanges will probably not be implemented by the currently scheduled date of January 1, 2014.
The Republicans capture the presidency and both houses of Congress. In this scenario, it is almost certain that the 2010 legislation will be significantly modified, if not repealed. States that have already taken steps toward setting up exchanges may or may not carry them forward in the absence of federal subsidies should the Republicans repeal the subsidies.
If polls are to be believed, the third option is a real long shot. Perhaps we will know which direction healthcare reform is headed by tomorrow morning.