Ryan Plays the Long Game on Obamacare

Ryan Plays the Long Game on Obamacare

Rep. Paul Ryan has indicated that House Republicans have no intention of following those Republican governors who have accepted Obamacare as the “law of the land,” as Gov. Chris Christie called it last month. On Sunday, Ryan, who chairs the House Budget Committee, told Fox News Sunday host Chris Wallace that the ten-year balanced budget plan he will roll out this week assumes that Obamacare will be repealed.

Wallace’s response to Ryan was blunt: “Well, that is not going to happen.” Ryan shot back: “Well, we believe it should. That is the point. But this is what budgeting is all about, Chris. It is about making tough choices to fix our country’s problems.” Ryan also indicated that he wanted to eliminate the Independent Payment Advisory Board (IPAB), the panel that Obamacare creates to cut costs by choosing which benefits to restrict.

Ryan’s insistence on repealing Obamacare will cheer conservatives, who have been frustrated by the defections of several prominent GOP governors, who have chosen to accept Obamacare funding to expand Medicaid for their states. Those include Christie, as well as several, such as Virginia’s Bob McDonnell, who joined the lawsuit that won states the right to opt out of the Medicaid part of the plan under the Tenth Amendment.

Though some Democrats have accepted the idea of amending Obamacare in certain respects, or repealing small parts of it–such as the new tax on medical devices, which hits biotech firms in Massachusetts, prompting liberal Sen. Elizabeth Warren to call for it to be dropped. However, repealing the law as a whole would take a Republican Senate and a Republican White House–two goals that eluded the party in November 2012.

Ryan is evidently hoping that long-term budget realities will eventually turn the argument in his–and his party’s–favor. He is also counting on the willingness of Republicans to make a stand in favor of ambitious budget proposals, when the caucus as a whole has tended to avoid confrontations with President Barack Obama since the election (except in the case of the budget sequester, which was a proposal of Obama’s own design).

Regardless, the fact that Ryan is able to balance the budget, without raising taxes, by assuming the repeal of Obamacare is a strong signal of the price of fiscal responsibility. The argument is that Americans can have universal health insurance, or they can have fiscal reform, but we cannot have both–and if we do not have the latter, eventually we will not have the former, either, as debt swallows our ability to pay for federal programs.

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