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November 09, 2012 12:25 PM Obamacare on the Negotiating Table

By Austin Frakt

From POLITICO Pulse:*

BOEHNER WANTS OBAMACARE COMPONENTS ON THE NEGOTIATING TABLE - Any moves to chip away at the law during fiscal cliff negotiations could have a game-changing effect on coverage rates, the law’s impact on the deficit, premiums and small business costs. Whether Senate Democrats would permit changes to the health law as part of a larger bargain is unclear, but House Speaker John Boehner also admitted that the law is likely here to stay. It’s both a concession and a statement of the obvious: The numbers just aren’t there for Republicans to eliminate the law. “I think there are parts of the healthcare law that are going to be very difficult to implement, and very expensive. And [at] the time when we’re trying to find a way to create a path toward a balanced budget everything has to be on the table,” Boehner told ABC News. “There certainly may be parts of it that we believe need to be changed. We may do that. No decisions at this point.”

I bet most people read this and think that Obamacare can only be used to decrease the deficit if its expenditures are raided, e.g., reducing the subsidies for coverage expansion. However, it could also be used as the basis for increased revenue. One such way is to accelerate or otherwise modify the Cadillac tax so that the employer-sponsored health insurance subsidy is more swiftly or more completely reversed. If you can find any health (or more general) economist who wouldn’t favor that, let me know.

My broader point here is that Obamacare is a mix of spending, revenue, and cuts (most prominently to Medicare). If and when it hits the negotiating table will all of those parts be in play or just the parts that Speaker Boehner doesn’t like?

* This is not a permalink. I don’t think there is one.

[Cross-posted at The Incidental Economist]

Austin Frakt is a health economist and an assistant professor at Boston University's School of Medicine and School of Public Health. He blogs at The Incidental Economist.