Media is using the CBO to play politics, as usual. Here’s why you need to think before buying into the fear-mongering.
As Republicans on the Hill move to repeal the Affordable Care Act (ACA), the media and Congressional Budget Office (CBO) are keeping up with them. That has lead to at least one fairly misleading headline, and report. “18 million would lose insurance in first year of Obamacare repeal without replacement, CBO report says” is on the Washington Post now, and it is based on a CBO report on the effects of H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015. Generally speaking, neither the news article nor the CBO report are inaccurate. The reason why they are both misleading is that they are both running on the assumption that repeal of the ACA will look exactly like H.R. 3762 says it will, without a single change or additional legislation. That is what they have to work with, and so that is how they generate their numbers.
The obvious problem with that is the nature of politics and the legislative process. It’s not likely that this piece of legislation will pass exactly as it is, for one thing. It’s also possible that Republicans would address the issues that this CBO report points out in amendments to this legislation, or in other bills or resolutions. I say possible, but in all honesty, it’s highly unlikely that repeal will look remotely similar to just H.R. 3762 over time. That’s the other point that is important to remember. The CBO makes projections ten years into the future based on just what they have in front of them now. This non-partisan organization does not make assumptions about what Congress hasn’t considered yet, even when conventional wisdom suggests that whatever is currently under consideration will not be the “end-all-and-be-all” on a given issue.
So, what does that mean?
It simply means that those headlines and reports are accurate for right now, in this moment in time, and will become meaningless as soon as there is even the slightest change in the legislation that eventually is passed on this matter. Also, it is important to recognize one of the regular complaints from Republicans about ACA in the first place. Their distaste, beyond creating a massive bureaucracy, has been with the fact that everything is in one law. They have repeatedly pointed out that the American health care system is highly complex, and it would have been far better to approach each facet with a separate piece of legislation. This didn’t work in the minds of Democrats, because they knew they wouldn’t get everything they wanted without an all-encompassing law.
To address the current headline, the 18 million people who would theoretically lose insurance under H.R. 3762 would be split between Medicaid expansion and individual subsidies. Both of those groups could be dealt with in other bills, such as a temporary Medicaid expansion maintenance bill and something as simple as permitting insurance companies to sell across state lines. The reason why individual insurance rates are typically higher is two-pronged, and while legislation can’t fix the “power-buying” companies enjoy from volume, it can remove restrictions for insurance carriers on the market. This isn’t rocket science, and we see this in most other forms of insurance already. Instead of insisting that the government provide for everyone, perhaps the people would be better served if they started asking government to get out of the middle of medical insurance transactions.
The point here is that none of these numbers are written in stone, even if the CBO makes it seem that way. While the people have been slacking of late when it comes to being proactive with their representatives in Washington, there’s nothing stopping them from becoming more active now. And they should. First, people need to stop viewing reports like this with doom and gloom, and just accept them. Tell your representatives and senators if you aren’t pleased with what will happen if they pass a law like H.R. 3762. The fact is that if your people on the Hill are brutally honest, even they should be admitting that this law is like a band-aid on a bullet wound. It’s a starting point, but it’s not the final solution. But, no matter what, remember that there shouldn’t be just one bill to replace ACA – that’s what got us into this mess in the first place.