Taxpayer's Tab: Legislative Spotlight: Health Care Reform Alternatives

Welcome to The Taxpayer's Tab -- the weekly newsletter for up-to-the-minute research from the National Taxpayers Union Foundation's BillTally Project. For more information, check out NTUF's BillTally Project and our partner, WashingtonWatch.com!

Legislative Spotlight: Health Care Reform Alternatives

In 2010, voters frustrated by runaway government spending, government bailouts of Wall Street and the auto industry, and the government takeover of the health care system catapulted House Republicans into the majority based on their promises of fiscal responsibility and willingness to repeal the Patient Protection and Affordable Care (PPACA), also known as Obamacare. As the legal challenges to PPACA worked their way through the court system, Members of the 112th Congress introduced a number of bills that would repeal, replace, or even expand the law. With the Supreme Court's ruling expected tomorrow, NTUF looks at the options legislators have offered should the law be upheld or overturned, whether in whole or in part.

Brent Kendall and Peter Landers writing in The Wall Street Journal discuss the Court's potential verdicts: The Court could declare the entire law unconstitutional. Conversely, the statute could be upheld and the Court could decide that the entire law is constitutional. The Court could also choose to strike down select portions of the law while accepting other provisions. This outcome may occur even though PPACA lacks a severability clause -- severability would allow the legislation to take effect even though certain portions of it are found to be unconstitutional.

While the House passed H.R. 2, the Repealing the Job-Killing Health Care Law Act, on January 19th by a vote of 245-189, NTUF has identified eight other bills that would also repeal PPACA. NTUF estimates that seven of those bills, as well as H.R. 2, would save taxpayers $40.3 billion annually. The bills are highlighted in Table 1 below.

Table 2, below, highlights those bills that would not only repeal PPACA but also replace it with other health insurance reforms. NTUF has been able to estimate the savings of three of the bills in Table 2. One would save more than H.R. 2 and the straight forward repeal bills. Two would save slightly less. NTUF has not been able to score the other four.

It is important to note that 25 additional bills would amend or remove select PPACA provisions. For example, H.R. 452, the Medicare Decisions Accountability Act of 2011, would rescind the Independent Payment Advisory Board's authority to reduce Medicare costs. H.R. 1370 would repeal the annual fee imposed on health insurance providers by PPACA. You can see all of the health care-related bills that NTUF has identified here.

If the Court overturns PPACA, Congress could turn to one of four universal health care bills. These bills, highlighted in Table 3, could increase annual federal spending anywhere from $500 billion to $1.2 trillion.

If portions of PPACA are upheld, legislators could use these bills to expand government control of the health care system. The costs of the bills would vary depending upon which provisions would be expanded or added to the PPACA statute.

It is something of an understatement to say that PPACA has been controversial. Regardless of the Court's ruling tomorrow, the case's legal ramifications will likely force Congress to return to the issue of health care reform and health insurance in the near future.

To learn more or discuss these bills visit WashingtonWatch.com.

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