As far as lies go, the Affordable Care Act (ACA) is known most for President Obama’s if you like your plan, you can keep it line which earned him Politifact’s Lie of the Year in 2013. Those paying closer attention may cite the Obama Administration’s flip-flop on whether or not the penalty on the individual mandate was a tax. The administration only embraced it as a tax when the Supreme Court ruled it as constitutional based on the government’s ability to tax.
Republicans were no better. They repeated outright lies to fuel the public discontent that was the Tea Party movement. Their claims ranged from Obamacare as a job-killer; employed death panels; was a government take over of health care; would ration care; and would come between the patient and their doctor. All of these lies, told by members of the GOP have been thoroughly debunked.
The biggest lie of all is the GOP’s feigned outrage over Obamacare from the start – because they were for Obamacare before they were against it.
1993 Health Reform Efforts
Health Security Act of 1993: During President Bill Clinton’s first term he took on health reform, appointing First Lady Hillary Rodham Clinton as his point person. The product of that effort was known as the Health Security Act of 1993, or Hillarycare. One of its biggest obstacles was the misconception that Hillarycare was a single-payer system. This was later proven false. At heart it was largely a private insurance market reform with the addition of a Medicare-style public option and other provisions.
Health Equity and Reform Today Act: A GOP counter proposal to Hillarycare, cosponsored by Republican Senate Minority Leader Bob Dole, Sen. Chuck Grassley, Sen. Orrin Hatch, Sen. Mark Warner – a total of 20 senators in all – was called the HEART Act of 1993. This market-based bill included provisions such as: an individual mandate; vouchers for low-income earners; a ban on denying coverage based on pre-existing conditions; standardized benefits; and creation of purchasing pools. This is the bill that serves as the seed of Obamacare as we know it.
The nonprofit organization, Kaiser Health News, provided a look at both Obamacare and the HEART Act of 1993 via this side-by-side comparison (edited here for clarity). With few exceptions, the similarities are staggering.
|Senate Bill 2009||Sen. Chafee (R) Bill 1993|
|Requires Employers To Offer Health Insurance To Employees|| Yes (above 50 employees, must help pay for insurance costs to workers receiving tax credits
|Yes (but no requirement to contribute to premium cost)|
|Standard Benefits Package||Yes||Yes|
|Bans Denying Coverage For Pre-existing Conditions||Yes||Yes|
|Establish State-based Exchanges/Purchasing Groups||Yes||Yes|
|Offers Subsidies For Low-Income People To Buy Insurance||Yes||Yes|
|Long Term Care Insurance||Yes (sets up a voluntary insurance plan)||Yes (sets standards for insurance)|
|Makes Efforts To Create More Efficient Health Care System||Yes||Yes|
|Reduces Growth In Medicare Spending||Yes||Yes|
|Medical Malpractice Reform||No||Yes|
|Controls High Cost Health Plans||Yes (taxes on plans over $8,500 for single coverage to $23,000 for family plan)||Yes (caps tax exemption for employer-sponsored plans)|
|Prohibits Insurance Company From Cancelling Coverage||Yes||Yes|
|Prohibits Insurers From Setting Lifetime Spending Caps||Yes||No|
|Equalize Tax Treatment For Insurance Of Self-Employed||No||Yes|
|Extends Coverage To Dependents||Yes (up to age 26)||No|
|Cost||$871 billion over 10 years||No CBO estimate|
|Impact On Deficit||Reduces by $132 billion over 10 years||No CBO estimate|
|Percentage Of Americans Covered||94% by 2019||
92-94% by 2005
GOP: Partisanship First
When viewed through this lens, Republicans opposition against Obamacare then, and now, is purely partisan. Even if you disregard the GOP pledge to obstruct President Obama from the beginning, you need only look to the 2012 Republican presidential nominee, Governor Mitt Romney, to connect the dots. Known as a moderate, Romney made a campaign promise to repeal and replace Obamacare with something far better and cheaper.
Problem with that? Well, as governor of Massachusetts Romney signed into law his own market-based plan, known as Romneycare. This plan is strikingly similar to Obamacare, with familiar provisions such as the individual mandate, subsidies for low-income earners, and a state-based exchange. And on the campaign trail he even took credit for Obamacare’s foundation in Romneycare – effectively self-selecting as team captain for a GOP that was for Obamacare before they were against it.
I will never understand why a more pragmatic politician like Romney went to such lengths to disavow his own record. Or how Senate GOP would knowingly mislead Americans about a bill that looks very much like one of their own. Those still making the argument today that Obamacare is bad for America are pure ideologues with little interest or regard for facts or history.
To pretend that Obamacare is not rooted in a 90s GOP health reform plan, as well as its Romneycare predecessor, is an intellectually dishonest argument. It is one thing to contend that the bills are different – which I find it hard to believe anyone would disagree. But it is another to contend they are foreign to one another, or that one is not a result of the other. They are clearly connected.
This is Obamacare’s greatest lie.