President Obama’s health care overhaul marks its second anniversary this week, and from the way Republicans and Democrats on Capitol Hill are talking about it, you would think they are looking at two entirely different laws.
The administration and its congressional allies have homed in on provisions among the law’s 1,000 pages that offer quick returns: extending parents’ plans to cover young adults, expanding drug coverage for seniors and eliminating lifetime benefit caps.
But for Republicans, the focus is almost exclusively on the long-term costs of the law and potential limits they say the government will be forced to impose on care. Both, they argue, will cancel out any immediate benefits.
And to pack an extra political punch just days before the Supreme Court hears a challenge to the law, House Republican leaders have said they will hold a vote before the end of the week on legislation repealing a key part of the law - a panel of appointees charged with curbing Medicare costs called the Independent Payment Advisory Board (IPAB).
“Nearly two years since its passage, the Democrats’ health care law remains deeply unpopular,” said Rep. Dave Camp, Michigan Republican and chairman of the House Ways and Means Committee. “IPAB, which is a critical component of the law, illustrates why those concerns are still so strong.”
Democrats are pointing to immediate benefits from the law in an effort to rehabilitate its image in the minds of voters, who take a dim view of it two years after its passage. An ABC-Washington Post poll released Monday found that Americans oppose the law by 52 percent to 41 percent.
And the law also faces legal pressures. The Supreme Court holds several days of oral argument on the law next week, with a ruling expected this summer.
The House IPAB repeal vote will mark the 26th time the House has voted to repeal all or part of the health care law, although nearly all of the efforts have been blocked in the Democrat-controlled Senate.
The problem with IPAB, Republicans charge, is also the main problem with the rest of the Affordable Care Act: too much federal control over health-care decisions. Painting the federal law as a tangle of federal bureaucracy and oppressive regulations, they say it will cause health care costs to rapidly inflate, weighing on businesses and crushing job creation.
“This ‘government knows best’ approach is why Americans across the country support repeal, and it is also why there is strong bipartisan support here in Congress to repeal IPAB,” Mr. Camp said.
But Democrats said they have plenty of evidence that the law is working, taking special pains this week to highlight how it has helped such Democrat-leaning voters as young adults, women and seniors.
House Democrats gathered Wednesday to applaud a new requirement for insurers to cover children up to age 26 on their parents’ plans. While the number of uninsured as risen in most age categories since the law was passed, the number has dropped among young adults with some 2.5 million added to insurance rolls, according to estimates by the administration.
“I can think of no stronger provision in the Affordable Care Act there is than to protect young people under the age of 26 and enabling them to go on their parents’ health insurance plan,” said Rep. Donna Edwards, Maryland Democrat.
And a group of Democratic female senators pointed to provisions aimed at helping women, praising the law for “groundbreaking advancements” in women’s health.
Under the law, insurers can’t drop women from coverage when they get pregnant or charge them higher premiums than men. Insurers must also cover preventive services such as mammograms and contraception without charging co-payments, among a number of other provisions.
“That was what the Affordable Care Act was all about,” said Rep. Lois Capps, California Democrat. “Fixing a broken health care system … for women across this country and for their families, this law gets it right.”
The administration also added muscle to the effort, with Health and Human Services Secretary Kathleen Sebelius announcing last week an initiative called “MyCare” where the administration posts a video each day of an individual who has benefited from the law.
On Monday, it was a woman identified as Helen R., a senior who would fall into a gap in Medicare prescription drug coverage called the “doughnut hole,” but she now will receive a 50 percent discount on drugs under the health care law.
On Tuesday, the administration highlighted Vanessa Mishkit, a nurse in Tampa, Fla., who still will be able to obtain coverage for her son despite serious birth defects because the law bans insurers from denying coverage based on pre-existing conditions.
And on Wednesday, there was a video about Steven Giallourakis, 21, of Cleveland, who can remain on his parents’ plan as he combats chronic medical conditions from cancer treatments.
But while Democrats emphasized that the regulations are good news for consumers, Republicans predicted a very different outcome, warning of serious side effects from imposing more rules on insurers and businesses.
Republican Sens. Tom Coburn of Oklahoma and John Barrasso of Wyoming released a “checkup” on the health care law, in which they said a medical loss ratio governing how much insurers can spend on overhead will cause a collapse in the private insurance market, causing millions of Americans to lose their insurance plans, cost the economy 788,000 jobs and increase Medicare’s unfunded liabilities by $2 trillion.
Besides all that, Republicans also have focused attacks on how the health care law will effect overall federal spending.
Rep. Cliff Stearns, Florida Republican and chairman of the oversight and investigations subcommittee of the House Energy and Commerce Committee, complained about a report by the Congressional Budget Office estimating that the law will cost more than originally expected.
“These are not partisan points - these are objective fact,” Mr. Stearns said. “Proponents of the law promised lowered premiums, they promised lowered costs and they promised that if you didn’t want your coverage to change, it would not. That is simply not the case.”