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Republicans Use Gruber as Cover for Their Deadly Obamacare Lies

November 19, 2014

For Democrats, the discovery that Romneycare and Obamacare consultant Jonathan Gruber is, well, a schmuck represents a triple whammy. For starters, the arrogance of anyone calling American voters "stupid" (or even just 47 percent of them) helps perpetuate every conservative stereotype of pointy-headed Northeastern elites. Worse still, Gruber is simply wrong that key aspects of the Affordable Care Act's funding and structure--about individual mandate penalties, the "Cadillac tax" on high-end health plans and that younger, healthier enrollees would in essence subsidize--were somehow kept secret from the public. But most damaging, Gruber has given Republicans cover for perhaps the greatest campaign of political deception in modern American history, one that continues to misinform people about Obamacare while needlessly leaving millions without health insurance in the very states where GOP control is strongest.
All along, Republicans greatest fear hasn't been that the Affordable Care Act would fail, but that it would succeed. So to prevent that from happening, the Party of Lincoln turned to a strategy that perverts the wisdom of its namesake:

"You can fool some of the people all of the time, and that's our target market."

That Republican mantra may failed to stop the passage of Obamacare, but it was shockingly successful at ensuring that red states continue to have the worst health care systems in America. Consider just a handful of the GOP's killer lies about Obamacare:
"Government Takeover of Health Care" | "Death Panels" (Part 1) | "Death Panels" (Part 2) | "It May Cost You Your Life" | "Obamacare Adds Trillions to Our Deficits" | "A $700 Billion Raid on Medicare" | "Sticking It to Seniors" | "No One is Denied Health Care in America" | "You Just Go to the Emergency Room" | "Obamacare Will Destroy the Private-Insurance Market" | "Obamacare Will Bail Out Insurers" | "Felonious, Terrorist Obamacare Navigators" | "Obamacare Will Cost 2. 5 Million Jobs" | and More
Click a link above to jump to the details for each below.

Lie: "Government Takeover of Health Care." Politifact's 2010 Lie of the Year appeared near the very top of GOP spinmeister Frank Luntz's talking points in 2009. Aside from veterans (VA), the elderly (Medicare), the poor and the disabled (Medicaid), Americans get their health care from private insurers, private hospitals and private physicians. The only thing that really changed when Obamacare went into effect was that 15 million people joined the ranks of the insured.
Nevertheless, by 2010 the baseless slander about a "government takeover of health care" appeared 90 times on John Boehner's web site and had 200 instances on the RNC web site.
Lie: "Death Panels," Part 1. If John Boehner and Mitch McConnell's lie about "the Democrats' $2.6 trillion government takeover of health care" was more than a little deceptive, the "death panels" slander was downright disgusting.
Early versions of the Democratic health care overhaul contained a provision requiring Medicare to pay for end-of-life counseling its 50 million elderly beneficiaries. In the hands of Betsy McCaughey, the woman whose mythology helped torpedo the Clinton health care initiative in 1994, that statute which could have helped millions of Americans instead became "death panels." Sarah Palin, who later claimed she was speaking metaphorically, famously framed the GOP slander this way:

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil."

That would be evil, if it was true. But Palin's fraud didn't stop some of the GOP's more senior, and theoretically, more sentient leaders from regurgitating the bogus death panel sound bite. Senator Chuck Grassley (R-IA) declared, "We should not have a government program that determines if you're going to pull the plug on grandma." In the fall of 2009, Grassley went further, using the gravely ill Ted Kennedy to illustrate his lie:

"In countries that have government-run health care, just to give you an example, I've been told that the brain tumor that Sen. Kennedy has -- because he's 77 years old -- would not be treated the way it's treated in the United States. In other words, he would not get the care he gets here because of his age."

Lie: "Death Panels," Part 2. Grassley later apologized for his obscene fraud. But the damage he and his Republican colleagues had done was not erased. In fact, in 2010 conservative mythmakers launched "Death Panels, the Sequel."
This time, the smear described the Independent Payment Advisory Board (IPAB) created by the Affordable Care Act to help control Medicare costs. Sarah Kliff explained how it works:

The IPAB would only come into effect when Medicare's per-enrollee spending grew faster than the average of overall price growth (measured by the Consumer Price Index) and medical price growth. That way, Medicare costs wouldn't rise as quickly as the rest of the health-care sector, but also have some wiggle room to grow faster than the rest of the economy.

But thanks to the dramatic slowdown in the rate of Medicare cost growth, the 15 member expert panel has yet to come into being. Nevertheless, for Republicans IPAB became the second coming of Obamacare's death panels. While Sarah Palin returned to denounce "the use of 'death panel'-like rationing by way of the new Independent Payments Advisory Board," Georgia Republican Congressman Tom Price declared, "What we oppose is the president deciding who gets what."
Of course, Palin, Price and their fellow right-wing fabulists were lying to the American people, as Jonathan Cohn made clear in the New Republic:

It was a ridiculous accusation. As a briefing from the Kaiser Family Foundation explains, Obamacare explicitly prohibits IPAB from "submitting proposals that would ration care, increase taxes, change Medicare benefits or eligibility, increase beneficiary premiums and cost-sharing requirements, or reduce low-income subsidies under Part D."

Lie: "It May Cost You Your Life." In 2009, Rep. Virginia Foxx (R-NC) warned that the Affordable Care Act would "put seniors in a position of being put to death by their government." But Republicans didn't lie about what was in Obamacare; they lied about what wasn't in it as well. In October 2009, Senate Minority Leader Mitch McConnell told Dennis Miller that the so-called "public option" eventually dropped from Obamacare could have fatal consequences for those buying it from the government:

"I think if you have any kind of government insurance program, you're going to be stuck with it and it will lead us in the direction of the European style, you know, sort of British-style, single payer, government run system. And those systems are known for delays, denial of care and, you know, if your particular malady doesn't fit the government regulation, you don't get the medication...
And it may cost you your life. I mean, we don't want to go down that path."

Lie: "Obamacare Adds Trillions to Our Deficits." From the beginning, Republican opponents of the Affordable Care Act have been confronted by an inconvenient truth. Unlike President Bush's unfunded Medicare Part D prescription drug program, Obamacare reduces the national debt.
Time and again, the nonpartisan Congressional Budget Office (CBO) "scored" the ACA as a debt-reducer. That embarrassment for the GOP was most pronounced when CBO explained that a House bill (H.R. 2) proposing the repeal of Obamacare would actually increase the national debt. As the agency summed up the truth in 2012:

On net, CBO and JCT estimate, repealing the ACA would increase federal budget deficits by $109 billion over the 2013-2022 period. Repealing the coverage provisions discussed in this report would save $1,171 billion over that period, but repealing the rest of the act would increase direct spending and reduce revenues by a total of $1,280 billion.

But GOP leaders couldn't handle the truth. Then House Majority Leader Eric Cantor called the CBO assessment "budget gimmickry." 2012 White House hopeful Newt Gingrich went even further in November 2011:

"If you are serious about real health reform, you must abolish the Congressional Budget Office because it lies."

It's no surprise the 2012 Republican platform decried "the fiscal nightmare of Obamacare." On June 28, 2012, GOP presidential nominee Mitt Romney reacted to the Supreme Court ruling upholding the Affordable Care Act with this whopper:

"Obamacare raises taxes on the American people by approximately $500 billion. Obamacare cuts Medicare -- cuts Medicare by approximately $500 billion. And even with those cuts and tax increases, Obamacare adds trillions to our deficits and to our national debt, and pushes those obligations on to coming generations."

Lie: "A $700 Billion Raid on Medicare...Sticking It to Seniors." The Affordable Care Act is funded in part by $760 billion in savings from Medicare over its first decade. But those dollars come not from benefits for the nation's 50 million Medicare recipients, but in reduced payments to insurers, hospitals and providers. And every version of the Paul Ryan House Republican budget has pocketed those very same savings to help offset the enormous revenue losses from its massive tax cut windfall for the wealthy.
Nevertheless, for five years Mitch McConnell and his GOP allies have attacked Obamacare for that supposed "$700 billion raid on Medicare." As McConnell put it in July 2009:

"They are going to pay for this plan by cutting Medicare, that is cutting seniors."

The Republican demagoguery was extremely successful and more than a little ironic. Scaring the bejesus out of seniors was a key strategy in the GOP's overwhelming triumph in the 2010 midterms. But the Ryan budget 95 percent of Congressional Republicans voted for four years in a row didn't just depend on the very same Medicare reductions. As the CBO found, Ryan's underfunded voucher scheme would have dramatically shifted health care costs to seniors themselves. As Ezra Klein summed up Ryan's Medicare privatization plan:

It's hard, given the constraints of our current debate, to call something "rationing" without being accused of slurring it. But this is rationing, and that's not a slur. This is the government capping its payments and moderating their growth in such a way that many seniors will not get the care they need.

Lie: "No One is Denied Health Care in America...You Just Go to the Emergency Room." In 2013, Mississippi Republican Governor Phil Bryant explained his decision to reject the federally-funded expansion of Medicaid to 200,000 of his constituents this way:

"There is no one who doesn't have health care in America. No one. Now, they may end up going to the emergency room. There are better ways to deal with people that need health care than this massive new program."

If that formula sounds familiar, it should. It's the same GOP emergency room talking point Republicans have been using for years to prevent the passage of health care reform. In one form or another, Governor Bryant, Mitch McConnell, Tom Delay, Paul Broun and Mitt Romney all echoed President George W. Bush's 2005 jaw-dropper:

"I mean, people have access to health care in America. After all, you just go to an emergency room."

That probably came as a surprise to the millions with cancer, cardiac disease, diabetes or myriad other chronic conditions requiring regular care and treatment. When Obamacare was passed in March 2010, some 50 million Americans lacked health insurance altogether, another 25 million were underinsured and forty percent were delaying health care altogether. And with employers reducing coverage or dropping it altogether and up to 45,000 uninsured needlessly dying each year, Republicans stuck to their magic ER plan. As Romney put it in 2012:

"Well, we do provide care for people who don't have insurance, people -- we- if someone has a heart attack, they don't sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care."

Lie: "Obamacare Will Destroy the Private-Insurance Market." In August 2013, Jim Demint and his friends at the Heritage Foundation urged shutting down the federal government if the Affordable Care Act wasn't defunded. Among their arguments:

"Obamacare will destroy the private-insurance market."

But after five years of dire warnings from conservatives, the collapse of the private insurers never happened. Instead, they have flourished, thanks to the 8 million new customers Obamacare delivered them in just its first year. As I explained in earlier this year:

Even as Republicans decry the Affordable Care Act's mythical bail-out of the carriers, the insurers' CEO's and shareholders are very happy with Obamacare's prognosis for their firms.

As the New York Times reported on Monday:

Since the Affordable Care Act was enacted in 2010, the relationship between the Obama administration and insurers has evolved into a powerful, mutually beneficial partnership that has been a boon to the nation's largest private health plans and led to a profitable surge in their Medicaid enrollment.

Lie: "Obamacare Will Bail Out Insurers." When they weren't arguing that the Affordable Care Act will destroy private insurers, conservatives claimed Obamacare will bail them out. The charge stems from the ACA's "risk corridors," which through 2016 compensate insurance companies that end up with bigger costs than they expected or seek compensation from those whose profits exceed projections.
Of course, there are a few problems with Republican charges that Obamacare's risk corridors are a "slush fund" designed to bailout the insurance companies. For starters, the three-year program designed to keep premiums down will be budget neutral. Just as important, the Medicare Part D drug plan virtually all Republicans voted for in 2003 has a permanent risk corridor program. As Jonathan Cohn pointed out in the New Republic:

The reinsurance and risk corridors in Obamacare and Medicare Part D are remarkably similar, except that Obamacare's are temporary and Medicare Part D's are permanent--which is to say, they are still part of the program.

So much for the protests of James Capretta and Yuval Levin in The Weekly Standard that "It is hard to imagine that many Americans, regardless of their political leanings, want taxpayers to be on the hook for covering the losses of shareholder-owned insurance companies." In 2003, 204 of 229 House Republicans and 42 of 51 GOP Senators voted for precisely that.
Lie: "Felonious, Terrorist Obamacare Navigators." Risk corridors aren't the only feature Obamacare and Medicare share. The federally-funded "navigator" program, the network of community groups, churches, non-profits, hospitals and other organizations helping Americans sign up for insurance, is virtually identical in both the ACA and Medicare.
Nevertheless, Republicans at the state and federal level did their very best to obstruct the work of the Obamacare navigators, despite the fact that many of the same groups and individuals were also enrolling seniors in Medicare. While Rep. Darrell Issa's House Oversight and Government Reform Committee held hearings into the work of the Obamacare navigators, GOP-controlled states passed a raft of laws to make their work almost impossible. As a George Washington University study in January found:

States that have not expanded Medicaid as part of the Affordable Care Act and also passed laws limiting the ability of health care "navigators" to advise customers have compromised their residents' ability to gain access to health care.

Republicans passed measures demanding background checks, certified bonding requirements and even limitations on the speech by navigators precisely because the identical program utilizing State Health Insurance Partnerships (SHIPs) worked so well for Medicare Part D. In August 2008, Laura Summer and Jennifer Thompson of the Georgetown University Health Policy Institute authored an evaluation of the Medicare Part D outreach program for President Bush's HHS titled "Best Practices to Improve Take-Up Rates in Health Insurance Programs." Based in part on a survey of 660 counselors, program managers, and others who worked with beneficiaries, Summer and Thompson found:

Based on a careful analysis of all of the articles reviewed, two predominant findings emerge regarding efforts to promote successful take-up in health insurance programs. The first is that individuals are more likely to enroll in insurance programs and maintain their coverage when extensive personal assistance, geared to the needs of the individual, is available. The second major finding is that simpler enrollment and renewal processes increase the likelihood that individuals will obtain and retain coverage. Studies of publicity campaigns find much weaker evidence of effectiveness. In gauging the success of assistance efforts, the amount and type of assistance provided appears to be relevant as is the source of assistance. Individuals are more likely to seek and accept help from organizations and individuals that they trust and that provide culturally or linguistically appropriate assistance.

Lie: "Obamacare Will Cost 2. 5 Million Jobs." During the 2012 presidential campaign, Republicans trumpeted a CBO forecast that the U.S. jobs would decline by 800,000 due to the Affordable Care Act. When the Congressional scorekeeper upped that estimate to 2.3 million in early 2014, the GOP and its amen corner were almost orgasmic. As the National Republican Congressional Committee (NRCC) tweeted:

Non-partisan CBO report admits #ObamaCare is hurting the economy, will cost 2.5 millions jobs.

Sadly for the doomsday mythmakers of the GOP, that is not what the Congressional Budget Office said. In fact, CBO instead explained that Obamacare would free millions of Americans from "job lock" by enabling them to work part-time or even retire without fear of losing access to health insurance:

"The estimated reduction stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in businesses' demand for labor, so it will appear almost entirely as a reduction in labor force participation and in hours worked relative to what would have occurred otherwise rather than as an increase in unemployment (that is, more workers seeking but not finding jobs) or underemployment (such as part-time workers who would prefer to work more hours per week)."

Of course, that didn't stop House Speaker John Boehner from regurgitating the debunked sound bite:
"Pres. Obama's #hcr law expected to destroy 2.3 million jobs."

And so it goes. Those 16,000 new IRS agents were a myth. Contrary to claims from the likes of Rand Paul that Medicaid expansion will "bankrupt" Kentucky hospitals, it is precisely in Medicaid rejecting states like Georgia and North Carolina where the crisis of rural hospitals is occurring. It is not Obamacare, but draconian Republican abortion restrictions which is jeopardizing the GOP's supposedly beloved "doctor-patient relationship." Premiums didn't skyrocket for 2014 and they won't in 2015, either. And four and a half years after Mitch McConnell promised the GOP's 2010 slogan would be "repeal and replace, repeal and replace," Republicans in Congress have yet to put forward their supposed Obamacare replacement. Repealing Obamacare "root and branch," as McConnell proposes, doesn't mean his state's exchange "web site can continue," but that 520,000 Kentuckians will lose their new health insurance. Period.
But for the compliant U.S. media, those Republicans lies, the ones that helped deny millions insurance in red states and continue to sap Obamacare's support despite the popularity of its provisions, don't matter. As NBC Meet the Press host Chuck Todd famously described the success of the GOP's Obamacare misinformation campaign:

"What I always love is people say 'it's your fault in the media.' No, it's the President of the United States' fault for not selling it."

To put it another way, the GOP's killer lies about Obamacare don't matter because #Gruber.


Jon Perr
Jon Perr is a technology marketing consultant and product strategist who writes about American politics and public policy.

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