Man-made climate change

So what next? Look for ideas that can achieve that consensus and that the president is likely to sign. That shows legislators who can govern, which is what Americans keep saying they want.

My friend, the redoubtable Donna Hill, suggests eliminating the medical device tax and the “Cadillac tax.” “The latter never made much sense anyway,” she says. “Essentially, the very people who were saying ‘the health plans offered today are inadequate’ are now saying, ‘but don’t make them too good or we’ll punish you.’”

Avik Roy of the Manhattan Institute went further than ideas that might garner bipartisan support and suggested some measures he believes the president would sign. Among them are removing regulations that drive up costs, such as a change to the PPACA regulation that requires insurers to pay for expensive brand-name drugs even if a generic would work, and repealing the employer mandate which, he believes, pushes more employees into part-time work.

However tempting it may be to ponder PPACA crumbling under the weight of a decision in favor of the plaintiffs in the federal vs. state exchange subsidy battle (King v. Burwell) it would serve well to remember that exercises of convenient regulatory legerdemain (as we have seen in the past) might resolve the issue in a way that preserves the status quo. In the end, most changes will have to come from Congress.

John Greene, vice president of congressional affairs for the National Association of Health Underwriters, cautions about expecting too much, too soon. “There is pent up desire to clear the decks of low lying fruit on which all sides can essentially agree to address on a host of issues,” he has said. “There is only likely to be one early health care vehicle leaving the station and that is the [sustainable growth rate] or doc fix that expires in March 2015.”

As the next Congress gets down to business we will see if they heed the advice of Senator-elect Cory Gardner (R-Colo.) who told his party that, “If we can’t govern with maturity and competence, two years from now we will see a wave in the other direction.” Political climate change can chill just as quickly as it has warmed.

See also: Does your culture eat your strategy for breakfast?