Tuesday, November 18, 2014

Gruber clips inspire powerful condensed defenses of the ACA

On occasion, I've made my case against opinion writers' "paragraph briefs," which make an omnibus case for something by packing disparate and often dubious assertions in comma-separated series.

An often more powerful variant, though still subject to slipping in slugs and ringers, is the link-packed paragraph brief.  These cite an array of evidence in a way that dares the reader not to take the cited authorities on faith -- each of them, maybe a half-dozen, are a click away. Of course, most of us do take most of them on faith most of the time. But the cards are on the table.

The Gruber brouhaha has driven a lot of progressive policy wonks to retrospection -- reviewing the legislative and political history of the ACA while chewing over Gruber's assertions that the process was deceptive and his apparent early impression that federal subsidies to states that built their own exchanges might not be immediately forthcoming.  That process has given rise to what's struck me as two particularly powerful paragraph briefs.

First, Ezra Klein delivers a short legislative history that rebuts the preposterous Halbig/King contention that the ACA's drafters intended to make premium subsidies available only to buyers in state-run exchanges:

[Gruber's comments suggesting that states needed to build exchanges to get federal subsidies] contradict the testimony from the Democratic and Republican congressional aides who wrote the bill. They contradict what the Congressional Budget Office (which Gruber advised) was told by Congress. They contradict the recollections of the very best reporters who covered Obamacare — notably Sarah Kliff and Julie Rovner. They contradict the debate in every state that chose to use a federal exchange. They contradict the way the Obama administration understood (and implemented) the law. They contradict the way the Supreme Court interpreted the law in 2012.
Next up is Jonathan Cohn, reviewing the history of deception in the ACA design and debate. Cohn acknowledges that the ACA's drafters cast the individual mandate as something other than a tax so that CBO would not score it as a tax hike, , and that they placed at one remove a curb on the employer's tax exemption for health benefits, shunting the tax onto insurers that provide benefits in excess of the cap rather than on the employers themselves. But those fudges were normal parts of the legislative process. As for shifting costs from the healthy to the sick by implementing "guaranteed spelled out out in a November 2009 CBO analysis examined by, among other journalists, Cohn himself.

Having argued in detail than any deception in the passage and sale of the ACA was mild, inevitable, and above the normal standard for US legislation, Cohn turns to the opposition:
Even so, the debate about the Affordable Care Act did not take place in a vacuum. Obama and his allies faced relentless opposition, almost from the start, and that opposition felt no squeamishness about twisting the truth or simply telling bald-faced lies. At various points, opponents of the Democrats’ health care legislation insisted that it would it cover undocumented immigrants (false), exempt Muslims from its provisions (false), impose a tax on real estate (false), force doctors to inquire about patients’ sex lives (false), exempt members of Congress (false), and, of course, create death panels to deprive the sick and elderly of life-sustaining care (false).
Those links are all to detailed debunks from Factcheck.org and Politifact. Those organizations aren't perfect, but in these cases they're shooting fish in a barrel.

Throughout the ACA's tortured history, the Republican short lie has always trumped the proponents' long rebuttals and explanations. A paragraph is not a sound byte. But these two "screen bites" go a long way toward exposing the long, sordid history of the GOP's politically effective slander and obfuscation.

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