POLICY AND TECHNICAL
"What do you mean by defunding Obamacare?"
Defunding Obamacare means attaching a legislative rider to a "must pass" bill (debt limit, annual spending bill, etc.) that 1) prohibits any funds from being spent on any activities to implement or enforce Obamacare; 2) rescinds any unspent balances that have already been appropriated for implementation; and 3) turns off the exchange subsidy and new Medicaid spending that are on auto-pilot.
"There is no such thing as defunding Obamacare."
That is a false statement. Congressmen who assert this are either asserting that funding is not being spent to implement Obamacare (false) or that a defund amendment cannot technically be executed (again, false). Defunding Obamacare can be done, and it has been attempted by the House of Representatives recently. For instance, in 2011, after gaining the majority, the Republican House included such a defunding provision on the continuing spending resolution (HR 1) when the bill first passed the House. The provision was later discarded in negotiations with the President and the Senate, but the effort began with promise.
"What is the urgency to defund Obamacare now?"
On January 1, 2014, Obamacare’s new main entitlements—the Medicaid expansion and the exchange subsidies—are scheduled to take effect. Open enrollment for both programs begins on October 1, 2013, at the start of the new fiscal year. According to the Congressional Budget Office (CBO), the federal government will spend $48 billion in 2014—and nearly $1.8 trillion through 2023—on these new entitlement programs. Also on January 1, Americans will be forced by their government to buy a product—health insurance—for the first time ever. Individuals and families who don’t comply will be penalized by tax penalties administered through the Internal Revenue Service (IRS). The Obama Administration has requested over $400 million in funding and nearly 2,000 bureaucrats for the IRS to implement the individual mandate and 46 other statutory provisions in the law. Within the Administration, the blizzard of Obamacare rules and regulations continues apace. Regulators have now written over 20,000 pages of Obamacare-related rules and notices in the Federal Register. Many of these regulations will increase the cost of insurance; CBO concluded Obamacare would raise individual health insurance premiums by $2,100 per year.
"Isn’t defunding Obamacare impossible because most of the funding is ‘mandatory’ (or on ‘auto-pilot’) and cannot be amended via the annual appropriations process?"
No. According to the nonpartisan Congressional Research Service (CRS), the Department of Health and Human Services (HHS) and the IRS, "will incur substantial administrative costs to implement the law’s private insurance reforms and its changes to the federal health care programs." And while Obamacare provided $1 billion in mandatory implementation funding when it was enacted, HHS projects that this is largely spent. According to CRS, Obamacare "administrative costs will have to be funded through the annual discretionary appropriations." Furthermore, annual appropriations bills routinely carry funding limitations to block all sorts of activities (for example, the Hyde Amendment), as well make changes to mandatory spending. These latter provisions are called "changes in mandatory program spending" (CHIMPS). Even if these riders were not so common-place, the stakes of so many provisions of Obamacare scheduled to take effect would present grounds for an exception.
"Isn’t defunding impossible because there is not a specific funding stream for Obamacare? Funding is embedded throughout the federal government and not specifically designated."
No. Congress is aware of all of the programs that fund Obamacare because CRS has provided such a list and the Appropriations Committees are well-versed in the funding intricacies of the law. However, a blanket prohibition against funding all activities associated with implementing the law is all that is needed to halt implementation. Each program does not have to be specifically defunded.
POLITICAL AND STRATEGIC
"My Congressman supports repealing Obamacare but not defund…."
It is wonderful that Congressmen support repealing Obamacare, but it’s not enough. The House has had numerous votes to repeal Obamacare, but the chances of statutorily repealing the law decreased once President Obama won a second term. Conservatives cannot wait another three-and-a-half years to begin dismantling Obamacare; they need to leverage current opportunities to defund Obamacare on "must-pass" spending bills.
"Since Obamacare is the President’s ‘signature achievement’ won’t he veto any effort to defund the program? Why should conservatives make this the focus of their anti-Obamacare efforts?"
There is a critical window of opportunity to stop the flow of funding for Obamacare from now until October 1, 2013, when the new fiscal year begins. It is during the same window that the President and Congress must pass bills to fund the government for the coming year. It is entirely appropriate for conservative members of Congress to use this opportunity to say, "No more funding for Obamacare!" and wage a serious and determined fight. If the Republican House girds for this fight—and wins the national argument with the urgency coming from a number of scheduled implementation dates and the law’s rising unpopularity—President Obama will be forced to compromise.
"If you don’t have the votes for a statutory repeal, why would you think you can get the votes to defund Obamacare?"
The Constitution grants the House of Representatives the ultimate "power of the purse." If Congress chooses not to fund Obamacare activities for the upcoming fiscal year, the Obama Administration cannot act to implement the law. The President’s party does not control the House of Representatives, which must originate debt limit and spending bills to fund the government. And the House Republican Majority was elected in 2010, on the basis of its platform against Obamacare.
"Won’t adding a provision to defund Obamacare to a ‘must-pass’ appropriations bill lead to a government shutdown?"
Obviously, this will set up a major political confrontation with President Obama, but it is the sort of conflict that will allow conservatives in the House of Representatives to remind the American people that the worst aspects of Obamacare are about to take hold and a defunding rider is the only thing standing in the way.
If House Republicans insist on defunding Obamacare, it is possible that the Obama Administration will shut the government down. This would not be the end of the world, and it needs to be an option. President Clinton shut the government down in 1995, by refusing to sign legislation to fund the government. While most pundits in Washington DC believe that this was a catastrophic political failure for Republicans, it is a fact that the House Republicans maintained their majority in 1996, even with a popular president of another party on the ticket. And their willingness to not accept all of Clinton’s demands was crucial towards eventually balancing the budget and reforming welfare. The nation can no longer afford for conservatives to leave political leverage on the table.
"Shouldn’t Obamacare opponents focus instead on repealing pieces of the law where there is bipartisan support—for example, the medical device tax or the IPAB—in order to reinforce the fact that Obamacare is not set in stone and make its supporters take hard votes?"
Washington is filled with special interest groups lobbying everyday to secure a "fix" for the part of Obamacare that affects their industry. There is no "fix" for this law and every time Congress caves to a special interest and makes the law "better" for that group, a little less momentum exists for full and final defunding or repeal. "Fix" votes also give Obamacare supporters every opportunity to appear reasonable and willing to fix the worst excesses of the law. The grim reality is that if the opponents of Obamacare are not willing to use every bit of political leverage at their disposal—a Republican majority in the House of Representatives, mostly made up of Congressmen from safe seats with constituents who strongly object to Obamacare—to halt implementation of the law, then it will be set in stone. There is simply no more time, particularly as the massive exchange subsidies are made available and the Medicaid expansion takes effect.