A Prescription for Ruin

Ezra Klein
Newsweek

If the least-popular parts of health-care reform are repealed, we could end up with its cost controls wrecked but its spending intact.

I’ve got some good news for deficit hawks: earlier this year, Congress passed legislation reducing the deficit by about $125 billion over the next 10 years. But, as they say on the infomercials, that’s not all! The bill cuts the deficit by $1.3 trillion in the second decade. That more than pays for every dollar we’ve spent on stimulus since 2008. The bill also sets up a new—and actually credible—system to keep Medicare’s costs under control. So hear that, fiscal conservatives? Hear that, bond markets? This is progress, baby. We’ll lick our deficit problem, yet.

The bill in question is the Patient Protection and Affordable Care Act, better known as health-care reform. The numbers come from the nonpartisan Congressional Budget Office. But as always, there’s a catch: the savings arrive only if the policies behind the savings are allowed to do their jobs. And in the GOP’s zeal to repeal a bill it considers a deficit-busting nightmare, Republicans are focusing their fire on the parts they should like: the cost controls.

On July 27, Sen. Jon Cornyn (R-Texas) introduced the Health Care Bureaucrats Elimination Act, cosponsored by Sens. Orrin Hatch (R-Utah), Jon Kyl (R-Ariz.), Pat Roberts (R-Kans.) and Tom Coburn (R-Okla.). The legislation doesn’t seek to repeal health-care reform (though many Republicans would also like to do that). Instead, it takes aim at perhaps its most promising cost control: the Independent Payment Advisory Board.

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