House votes to repeal year-old health care law

By Herb Jackson, The Record -- New Jersey Republicans and Democrats relied on shaky and sometimes contradictory statistics to argue the dangers and benefits of last year's sweeping overhaul of health insurance before the GOP-dominated House voted to repeal it Wednesday.

The 245-189 party-line vote was largely symbolic because the House bill has almost no chance of passing the Democrat-dominated Senate, and President Obama promised a veto if it does.

House Republicans said the repeal was the first step toward crafting a new bill that provided common-sense and cost-cutting measures. That bill will take time to craft, however, and both parties spent most of Tuesday and Wednesday arguing about the impact of erasing last year’s law from the books.

Rep. Scott Garrett, R-Wantage, said the law needed to be repealed because it would “destroy” jobs, and cited the Congressional Budget Office to back him up.

On the contrary, the law would create jobs, countered Rep Frank Pallone, D-Long Branch. He also relied on CBO to support his argument.

Rep. Rob Andrews, D-Haddon Heights, charged: “The majority are adding $1 trillion to our national debt with this vote.”

Rep. Leonard Lance, R-Clinton Township, rebutted: “The health care law includes sleights of hand to mask the true cost. For example, it includes six years of entitlements and subsidies that are paid for by 10 years of taxes.”

Reality lies between those extremes.

The nonpartisan web site factcheck.org, citing CBO and other sources, concluded the law would have little impact on overall employment. Some low-paying jobs might be eliminated by small businesses facing a future mandate to cover workers, but jobs in the health care industry would be created when more people have insurance.

The CBO also said that following every mandate in last year’s law – and the only thing CBO is allowed to do is assume that laws on the books will be followed – would reduce the deficit. As a result, CBO said earlier this month that a repeal would increase the deficit.

But Medicare’s chief actuary said some of the law’s assumptions about savings could be unrealistic, so the deficit picture is much murkier. Congress has also shown in recent years that when laws requiring Medicare savings are about to kick in, members often will vote to prevent cuts and add the cost to the deficit.

Rep. Bill Pascrell Jr., D-Paterson, said in a news release that repeal would allow insurers to deny coverage to at least 108,000 people with pre-existing medical conditions in his district alone.

But Pascrell was relying on estimates released this week by the U.S. Department of Health and Human Services of how many people actually have such conditions, and not the number actually seeking insurance who cannot get it.

But dealing with pre-existing conditions illustrates how complicated the current health system is, and how black-and-white pronouncements are usually inaccurate.

New Jersey for nearly 20 years has had a “take all comers” law that prohibits companies that sell policies to individuals and small groups from refusing coverage, so the horror stories of sick people unable to get coverage are not as prevalent in the Garden State.

Those policies are expensive, however, in part because the coverage risk is spread among relatively small pool of patients, many of whom have expensive health problems. The policies also require someone with a condition, such as a history of cancer, to pay premiums for up to a year before treatment for the condition would be covered.

The new federal law called for creating regional or national “exchanges” where people could buy coverage that would presumably be cheaper because risks would be spread among a larger group.

Those exchanges are not due to begin operating until 2014, however, so the law also provided funding to states to set up high-risk pools in the interim.

Governor Christie decided to accept up to $141 million from the federal government to set up the state’s own pool, called NJ Protect, rather than let Washington devise one. While not cheap, NJ Protect policies are federally subsidized and do not include the same one-year exclusion as the state-regulated policies.

But to be eligible, someone must have had no insurance for the previous six months, which means people paying for coverage under the previous state program could not immediately switch.

So far, NJ Protect has signed up just 274 people, according to Marshall McKnight, spokesman for the state Department of Banking and Insurance.

A repeal would halt parts of the new law that have already begun to take effect, especially changes to the Medicare prescription drug benefit.

Checks of $250 were sent last year to Medicare recipients who hit the “donut hole,” a point at which federal benefits stop and patients must pay the full cost of drugs until their expenses are high enough for coverage to resume. This year, recipients in the “donut hole” are supposed to receive cheaper drugs as well, as part of an agreement with pharmaceutical companies.

PAAD, the state-run prescription program for low-income seniors, also got extra federal aid because of the law, and that money last year helped Christie cancel a planned increase in patient copayments.

Other issues surrounding the law are not as clear-cut. Christie’s transition team, for example, said the overhaul would result in New Jersey getting more Medicaid money from Washington in the future, when people with higher incomes are able to enroll. But to get that money, Christie could be barred from cutting back on Medicaid benefits this year to save state money.