OBAMACARE JULY 1, 2013
Millions of Americans who are too poor or too sick to buy health insurance today will finally have a chance to get coverage next year. And if the Republican congressional leadership has its way, many of these people will never find out about it.
As you have read in a few places, perhaps even here, the federal government is starting a public education campaign about Obamacare—not to promote the law, mind you, but simply to inform the public about the new insurance options that will be available once the law takes full effect. In 2005, the Bush Administration ran a similar campaign to let seniors know about the Medicare drug benefit. A year later, Massachusetts officials launched their own effort to educate residents about insurance options that the state’s new health law was making available. In that campaign, Massachusetts authorities famously enlisted the Boston Red Sox as partners.
Sounds innocuous, right? Not to the Republicans. Last week, as word spread that the Obama Administration had approached professional sports leagues about forging a similar partnership, GOP leaders warned the leagues to stay away. “It is difficult for us to remember another occasion when [a] major sports league took public sides in such a highly polarized public debate,” Mitch McConnell and John Cornyn, the highest ranking Republicans in the Senate, wrote in a letter on Friday. Among other things, they noted, Democrats had used “legislative gimmicks” to enact the law—an apparent reference to the Democrats’ use of budget reconciliation process in order to overcome a Republican filibuster in the Senate.
The letter came one day after Congressman Steve Scalise, head of the Republican Study Committee, sent a similar letter of his own. That missive, sent to the NBA and NFL, predicted that Obamacare would have a “devastating impact on your fans and business partners across the country” and warned the leagues not to do the administration’s “dirty work for them.”
I know: Republican opposition to the law hardly qualifies as news and neither does the effort to undermine it. But the language of the letters reveals a great deal about GOP values. When did publicizing insurance options become “dirty work”? How is helping people to access public services “politically charged”? And if it sounds naïve to expect more cooperation from an opposition party, contrast this Republican behavior with the way Democrats responded to the Medicare drug benefiit as the Bush Administration prepared for its launch eight years ago.
Like today's Repubicans, Democrats had strong and genuine objections about the substance of what became known as Part D. Democrats had wanted the government to run the drug program directly, just like it administers doctor and hospital insurance. Instead, Bush and his allies had crafted a program that relied exclusively on private insurers to deliver the benefits, while preventing the government from using its purchasing power to reduce prices. Part D was also pure deficit spending: Neither the Bush Administration nor its congressional allies made even a pretense of trying to pay for it with revenue or offsetting cuts. Note the contrast with the Affordable Care Act—which, according to the Congressional Budget Office, is actually reducing the deficit.
As for legislative tactics, Republicans today are angry that Democrats used the budget reconciliation process. But there's nothing illegitimate about using the reconciliation process for a bill that reduces the deficit, particularly if it's necessary to stop a determined minority from blocking a majority vote. You can't offer similar justifications for what the architects of Part D did in 2003, as they were trying to craft and pass their bill. At one point, a senior Bush Administration official actually threatened to fire a government actuary, because the actuary had delivered an unfavorable cost estimate. An inspector general later concluded the Bush official could have been subject to disciplinary action, if only that official hadn't already left office to become a lobbyist.
The final vote on Part D was equally notorious for its shenanigans. House Republican leaders, struggling to build a majority, had to extend voting by an unprecedented three hours. It wasn't pretty and Tom Delay, who was House Majority Leader at the time, eventually received a “public admonishment” from the House Ethics Committee for his actions during those waning hours. (The Committee found that DeLay had offered political favors so that then-Rep. Nick Smith of Michigan would change his vote. Many close observers, including my former colleague Timothy Noah, think the evidence suggests DeLay offered an actual bribe, in the form of $100,000 in campaign contributions for Smith's son, who was then running for Congress. DeLay denied this.)
In short, Democrats had plenty of good reasons to be angry about Part D. Democrats never tried to undermine the law’s implementation—a point Norm Ornstein, the political scientist at the American Enterprise Institute, made via e-mail:
Democrats were furious with how the Medicare prescription drug bill passed. But once it was law, they weren't going to punish needy seniors to sabotage Bush's accomplishment. It is remarkable to use threats of congressional power to intimidate sports organizations so that people who need insurance or need help knowing what is available to them will suffer by being kept in the dark. Stick it to millions so you can stick it to the president? That is statesmanship? No, it is cruel and outrageous.
Of course, one reason that Democrats didn't block education and outreach efforts for Part D is that they believed in the law's goal: Helping people who struggle with high medical bills. Some Democrats even ended up voting for Part D, albeit with great hesitation, because they figured that protecting vulnerable seniors was worth whatever concessions it took.
Republicans like to say that they, too, think it's important to help people who can't pay for medical care. Last week's actions make that claim even more suspect than it was before.
Jonathan Cohn is a senior editor of The New Republic. Follow him on twitter @CitizenCohn