The law won't be fully implemented until 2014, so the 2012 elections will also have an effect, Aaron said. "Between now and 2014 the enormously difficult task of implementation has to take place both in Washington and in 50 state capitals," he said.
The states will be looking to Washington for funding as they set up the crucially important health insurance exchanges. The Congressional Budget Office predicted that by 2019, 24 million low-income people will get their insurance through these exchanges, and a large number of them (those with incomes up to four times the poverty level) will get federal subsidies. That means states will need to set up the exchanges and the federal government will have to fund them. Both those moves could be affected by Tuesday's results. Twenty states already have filed lawsuits opposing the health reform law.
In Washington, the new Congress could begin to satisfy demands to repeal the new health law by simply refusing to fund it. Aaron said there are funding holes in every aspect of the law. "Each one of them will have tens of millions or hundreds of millions [of dollars] necessary to make effective certain provisions of the bill," he said. "The larger issue is the appropriation of funds for implementation, which, if withheld, could cripple the whole bill."
On Other Fronts
Social Security and Medicare. Boehner has suggested raising the Social Security retirement age to 70. He said this would be phased in over 20 years, if approved. "We're all living a lot longer than anyone ever expected," Boehner said. He also put income- and inflation-indexing of benefits on the table.
In addition, Rep. Paul Ryan, R-Wis., the likely chairman of the Budget Committee, has drawn a "Roadmap" that would partially privatize Social Security and would set up a Medicare voucher system for those currently under 55. (People over 55 would keep the current program.) The GOP leadership has not signed on to Ryan's ideas.
Ryan is a member of the presidential deficit commission that will make recommendations on government spending, including Medicare and Social Security. Fifty-three million Americans receive Social Security benefits and 46 million receive Medicare.
William Galston, a budget analyst at the Brookings Institution, said plans to privatize parts of Social Security have gone nowhere, the most recent flop under former President George W. Bush. "His return on investment was less than zero," Galston said. "Seniors will worry about Social Security, but I honestly don't think as a political matter they have that much to worry about."
Jobs. In their campaign pledge, Republicans said they would make permanent the Bush-era tax cuts, not just for the middle class but for everyone. The GOP asserts the tax cuts will create jobs and help stabilize the economy.
Age discrimination in the workplace. Legislation died in Congress earlier this year that would have provided the same protection for older workers as for people of color and women. It stemmed from a 2009 Supreme Court ruling that an employee, in this case financial analyst Jack Gross, must prove by direct evidence that age was the main factor in his demotion.
Federal spending. Republican candidates have pledged to roll back federal spending to the levels in the 2008 budget. That would mean cuts in hundreds of federal programs affecting Americans of all ages, if the Republicans adhere to their pledge to make the cuts "across the board," exempting only national security. But in previous years, such pledges have been difficult to keep, so there may be a lot of horse trading over what programs actually get cut.
Taxes. Depending on how the current Congress addresses the pending expiration of the 2001 tax cuts in a post-election lame-duck session, the next Congress will likely have to consider what to do with the income and capital gains tax cuts scheduled to expire in January. Any extension of the tax cuts could increase the need to raise revenues to close a budget deficit projected at $1.4 trillion this fiscal year.
Elaine S. Povich is a veteran Washington-based correspondent.
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