The Republican strategy to kill the Affordable Care Act (Obamacare) could have some unintended consequences. The House recently approved a bill (HR1) that would bar using government appropriated funds to pay workers or contractors to implement any part of the Affordable Care Act. The Congressional Budget Office (CBO) studied the likely effects of de-funding health care reform and its cost to the government.
De-funding any and all parts of the Affordable Care Act would mean states would not be provided money to develop insurance exchanges that would enroll people in health insurance plans starting in 2014. It would also kill the already implemented Pre-existing Condition Insurance Plan that is available to people who have been turned down by insurance companies.
But the Republican bill would also affect ongoing programs such as Medicare Advantage and Medicare Part D drug plans. The CBO report said the funding ban would prevent Medicare from establishing contracts to administer its Part D drug program, as well as its Medicare Advantage program. All Medicare Advantage and Part D contracts expire on December 31, 2011. According to the CBO, since Medicare funding comes under the Affordable Care Act, contracts to pay insurance companies to manage Medicare Advantage and Part D would be banned under HR1. That would cause quite a bit of chaos for the eleven million people enrolled in Medicare Advantage and the 30 million or so with Part D drug coverage.
So it looks like Republican efforts to stop health care reform with a broad brush would kill things they hate, but also important programs that currently exist. Fortunately, the House of Representatives can come up with crazy bills and approve them until the cows come home. The same or similar bills must be approved by the senate, and then they have to be signed by the President. So Medicare Advantage and Part D are safe for now.