Health Affairs

Republicans were handed a convincing defeat at the polls, not only losing the race for the presidency but also losing ground in the Senate. The good news for the country is that Republican leadership is not in denial. The day after the election, Speaker of the House John Boehner outlined a balanced approach for easing federal policy off the fiscal cliff. He offered a combination of revenue increases and spending cuts, with an emphasis on “real changes to the structure of entitlement programs.”

Two days later, President Barack Obama responded by offering his own balanced approach—more federal spending, lower taxes for everyone but the wealthy, and the certainty of much higher budget deficits for years to come unless the savings proposed by the president last February actually materialize. This draws the line where it was before the election, with no sign that this will lead to meaningful policy negotiations.

This seeming recalcitrance is likely the result of the irrational exuberance that often strikes newly elected officials. To paraphrase Alan Greenspan, irrational exuberance has unduly escalated the president’s political asset value. Contrary to his current stance, President Obama does not have a strong hand in the upcoming fiscal debate. If he wants to avoid a double-dip recession and leave a positive legacy, he will have to accept compromises and sell them to his Democratic colleagues in the Senate. That inevitably means health policy, including the Affordable Care Act (ACA), will be on the negotiating table.

The Supreme Court has spoken, but problems built into the Affordable Care Act (ACA) have not been resolved by the decision and may have worsened.  Even accepting the law’s assumptions about how the health system should be reformed, actually putting all the pieces in place is exceptionally expensive and difficult.  If President Obama wins a... Read the rest of this entry »

For the second year in a row, Rep. Paul Ryan (R-Wis.) has advanced a comprehensive budget plan that would restructure Medicare and Medicaid, repeal the big-spending portions of the Affordable Care Act (ACA), and ultimately resolve the fiscal crisis facing this country.  Critics react that the Ryan plan would dismantle health care as we know... Read the rest of this entry »

Editor’s Note: Below, Joseph Antos provides his take on Budget Control Act of 2011, which embodies the deal reached by President Obama and congressional leaders to increase the nation’s debt ceiling. See also Jonathan Oberlander’s post on the same topic. Congressional leaders and the President have come to agreement on a deal to increase the... Read the rest of this entry »

Editor’s Note: Below, Joseph Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, discusses President Obama’s State of the Union address. See other posts on this topic by Len Nichols and Kavita Patel.  In his State of the Union address, Barack Obama said the key to winning the future is... Read the rest of this entry »

Editor’s Note: In the aftermath of President Obama’s State of the Union address, what is the state of health reform? Where do we go from here? In the post below, Joseph Antos of the American Enterprise Institute addresses these questions. In other posts, Henry Aaron of the Brookings Institution and Timothy Jost of Washington and... Read the rest of this entry »