With the Senate finally under their control, the Republicans have now articulated their first legislative steps when it comes to the Affordable Care Act. Instead of trying to repeal the law, Speaker of the House John Boehner and Senate Majority Leader Mitch McConnell will instead put up for a vote a measure that will significantly gut the employer mandate. Currently the ACA requires all employers with more than a hundred employees to provide health insurance to all of their full-time employees—and for the purpose of the law, 30 hours or more counts as “full time.” Boehner and McConnell wrote in the WSJ that they want to change that threshold so that only employees who work 40 hours or more count as full-time. That means that businesses will not be required to provide insurance to any employees who work less than 40 hours.According to Bloomberg, defining full-time as 40 hours will make it easier for employers to evade the mandate for many of their employees, effectively inflating the number of Americans who will then buy insurance on the federal exchange:
“Without changing the total number of hours worked by its employees, an employer might reassign hours worked so that there are more employees just below the 40-hour threshold than there would otherwise be,” according to the CBO report in February.As a result, CBO estimated, between 500,000 and 1 million people would be moved into Medicaid or onto health exchanges, and half a million would wind up without insurance.Congress’s Joint Committee on Taxation estimated a 40-hour-per week threshold would increase the federal budget deficit by $73.7 billion over 10 years.
This measure is of course not an instance of the constructive, alternative health care vision many ultimately want to see the GOP roll out. Moreover, making the ACA more expensive to taxpayers will play poorly in some ways—even if the GOP will also be able to argue that this change will save jobs by reducing the burden on employers. Given that conservatives have frequently fretted over the ways the ACA will increase the deficit, it will require a tricky bit of rhetorical gymnastics to make the case that we need to change the ACA in a way that will increase the deficit even more.Nevertheless, this remains a smart move politically for the GOP leadership, for several reasons. The employer mandate is unpopular among both supporters and critics of the law, so the GOP has picked a good target. No less a supporter than Ezra Klein once called for the employer mandate’s total repeal. At the same time, the GOP isn’t attempting to repeal the mandate entirely, but just hollow it out, so it seems like a less drastic measure than was suggested by the party’s past “repeal it now” rhetoric. If the GOP leadership is successful in passing this through both the House and the Senate, it might acquire some of the political capital necessary to enact further, more substantive changes to the U.S. health care system.Forcing a vote on gutting the employer mandate will also put a spotlight on any remaining politically vulnerable Democrats who voted for Obamacare. The House already passed a measure like this in April with the support of 18 Democrats, but the Senate let it die after President Obama threatened to veto it. If the measure now comes to the Senate, it will be fascinating to see how many Democrats vote for it; it’s a vote that could tell us a lot about how the midterm rout is influencing the Democratic rank and file. The challenge for the GOP leadership will be to hold its own rank and file together in order to pull off a successful vote. If the Republicans can pull it off, they may be well positioned to push forward even more sweeping health care reforms.