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THE MUSINGS OF A TRADITIONAL SOUTHERN DEMOCRAT

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Friday, April 11, 2014

Sebelius Exits, but Health-Care War Endures - HHS Secretary's Departure Won't Do Much to Close Bitter Partisan Divide Over Health Law

From The Wall Street Journal:

The resignation of Kathleen Sebelius signals the departure of the official who, fairly or not, had become the face of the deep and bitter partisan divide over Obamacare. But the Health and Human Services secretary's departure won't do much to close that divide.
 
Instead, the Affordable Care Act now is entrenched as the most deeply divisive social program in recent memory, and it figures to stay that way through the November election and beyond.
 
That means there simply won't be any serious attempt to fine-tune the law until the political situation sorts out. Until then, Obamacare will have to rise or fall as it is, with the White House doing what it can unilaterally to adjust the health-care law.
 
Meanwhile, the two parties will roll out dueling Obamacare anecdotes—horror stories about consumers with lost or unaffordable coverage from Republicans, good-news stories about Americans newly healed through their new coverage from Democrats—until voters have their say in November's midterm election.
 
Virtually every Republican will run pledging to wipe the law off the books. Just hours before news of the Sebelius resignation broke, Ohio Sen. Rob Portman, who helps oversee the Republicans' Senate campaign committee, was asked what position he would advise GOP candidates to take on Obamacare this year. He replied: "I would advise all of them to run on repeal and replace."

Most Democrats, conversely, are digging in behind the law, regardless of misgivings. They are taking the fact that 7.5 million Americans now have signed up for health insurance under Obamacare—a figure that seemed impossible just two months ago—as a sign of a corner turned.

Thus, November's national election figures to be the third straight in which the health-care overhaul plays a central role in the debate. And there is only a slim chance that this year's vote will produce anything like a consensus on whether Obamacare is accepted or rejected as a permanent part of American life. More likely, that question won't be settled until the 2016 presidential contest.

For her part, Mrs. Sebelius appears to have taken advantage of that recent upturn in the law's fortunes to resign, having made good on the pledge she made months ago to see the program through its shockingly tattered and troubled rollout last fall.

In retrospect, she and President Barack Obama made a key strategic error in overseeing the program's launch, as they both now acknowledge. They believed the key to initial success lay with the nation's insurance companies, and whether they provided a sufficiently robust menu of health-care plans, so their attention was focused there. They didn't imagine that the relatively more mundane question of whether Americans could actually get on a website and sign up for the policies would become the far bigger issue.

Now that the sign-up question has been resolved, more or less, attention will turn back to the original question of whether the insurance offerings are sufficient to do the good works promised: provide coverage for most, bend down the curve of health-care costs, and do it all without adding to the federal deficit.
 
The jury will be out for a while. Mr. Portman, for example, argues that if the new system merely reduces the number of uninsured Americans to 30 million from the 45 million or so at the time the law was implemented, it won't have done any more than Republican proposals to expand insurance pools for high-risk patients, make insurance more portable and implement tax credits to buy coverage could have done.
 
Amid the conflicting claims, Americans are watching warily from deep partisan trenches. In the most recent Wall Street Journal/NBC News poll, 70% of Republicans said that they would be more likely to vote for a candidate who pledged to repeal the health-care law; 77% of Democrats said they would be more likely to vote for a candidate who pledged to keep the measure in place and fix it.
 
On Obamacare, Americans really are from either Mars or Venus, and the departure of Kathleen Sebelius will do little to bring them together on the same planet.

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