Belfast Telegraph

‘Obamacare’ victory may not heal a sick America

President Obama’s healthcare reforms should be signed into law next week. But Republicans are intent on spoiling the party, writes US Correspondent Jim Dee

In spite of the desperate efforts of homophobic and racial epithets pitting conservative protesters to intimidate Democratic lawmakers arriving for Sunday's pivotal Congressional vote, America's year-long healthcare reform circus reaches a crescendo next Tuesday when Barack Obama finally signs the overhaul legislation into the statute books.

So, let the spin begin.

Wrapped in full rhetorical regalia, Democrats are gushing over themselves about the bill's historical nature and say a new day has dawned for America.

Republicans agree. But they say it's a Dawn of the Dead, as in the alleged devouring of America's free market healthcare by Washington's insatiable bureaucratic zombies.

Continuing their often hysterical scaremongering diatribes about a new era of 'socialism' and 'totalitarianism' that the legislation will - supposedly - spawn, the Grand Old Party is vowing that the fight is far from over. And they're likely right.

For, in spite of being within sight of the finish line, there are still flies in the ointment that may come back to haunt the Democrats.

To begin with, the process of 'reconciliation', whereby Senate Democrats hope to meld the bill they passed in December with Sunday's House bill, has chinks that Republicans are hell-bent on exploiting.

Reconciliation (by which a bill can be passed by a straight 51-vote majority instead of a filibuster-proof 60-vote supermajority) stipulates that any changes to Senate-passed bills must involve budget items only.

Republicans will use their portion of debate to kill provisions which they most oppose by using budget incompatibility justifications.

When whatever version of a bill gains Senate passage, and Obama's second signature signals the capstone of the process, attorneys-general from 11 states have vowed to immediately file suit to block its implementation on the grounds that it is unconstitutional. Such challenges will take time. Then there is the labyrinthine legislation itself.

It is a complex jumble of tax cuts and increases (depending on incomes), phased-in insurance industry restrictions and regulations, federal mandates regarding individual obligations to purchase insurance (replete with purchasing subsidies for low and middle-class families) and the expansion of government-run Medicare to cover millions of non-elderly poor people.

Although some of the provisions will kick in before November's mid-term Congressional elections, many - such as a prohibition on insurance companies denying coverage to people with pre-existing conditions - aren't slated for enactment for four years or more.

Lastly, the mandate to buy heath insurance from a private company or face a fine - irrespective of any tax-cut and subsidy support - has outraged many Democratic, Republican, and independent voters.

And their anger that an industry that has spent decades unabashedly raising premiums and restriction coverage is about to reap annual windfalls of hundreds of billions of dollars in profits at the public's expense may prove fertile electoral ground for Republicans.

Last week, Obama and his allies appealed to wavering Democrats to support the bill on the grounds that its failure would irrevocably cripple Obama's Presidency.

Later, commentators portrayed Obama's gambit as a masterstroke that has significantly strengthened his presidential standing.

That may or may not be true. Proof will lie in his ability to forcefully counter the anti-healthcare-reform Republican tirades that will wash over the public courtesy of Fox News in the coming weeks.

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