Why Did the CBO Get Obamacare Wrong?

Ask Chief Justice John Roberts

When the House began debate on repealing the Affordable Health Care Act, Republicans began warning us that we needed to ignore the Congressional Budget Office’s (CBO) forecast on their bill’s impact. They warned us before they produced a bill and they warned us before the CBO issued a report.

Why? Because they knew the results, if not the exact number. They never doubted for a minute that millions would lose health care. What was important, they reminded us, is that we’d have the choice whether to buy health care (a choice, they claim, Obamacare denies us).[1]

In the Republican version of The Good Samaritan, the Samaritan gets to keep his money because the unconscious Jew prefers dying e to taking charity. (Balthasar van Cortbemde, Courtesy of Antwerp Royal Fine Arts Museum)

In short we have the choice to not buy health care we can no longer afford because of its exorbitant price, and which doesn’t offer the basic benefits of care because insurers no longer have to provide them. It’s like the Good Samaritan said to the stricken Jew: “Aren’t you glad you have the choice to refuse me because Jews hate us. So, while you’re unconscious, you’ll need to tell me you really choose my help…No?…Oh, well.”

Then the Samaritan walks away and keeps the money he would have spent on the undeserving, unconsious Hebrew who wouldn’t even do him the courtesy of answering.

The Preemptive Strike on the CBO

The numbers never lie. It’s the explanation of what they mean.

More importantly, the Republicans launched a pre-emptive strike on the CBO before they even revealed the bill by claiming, “The CBO was off by millions with Obamacare. You won’t be able to trust their new numbers either.”

Well, that’s convincing. That thinking would be like my math teacher deciding, Phillip missed the last problem on his test so he’ll probably miss the others. I might as well ignore the rest of his answers and fail him now.

Claiming the CBO was wrong on Obamacare, so they must be wrong on the Republican bill would be like my math teacher deciding, “he missed the last test problem so I might as well stop checking his answers and fail him now.”

I learned to fix my math skills. I’d like to think the CBO could do the same.

What no one asks is, why did the CBO get those Obamacare numbers so wrong? And the answer is, they didn’t. The CBO scored the AHCA on a series of assumptions that failed to happen. Primarily, they assumed the entire bill would be enacted. Exactly like the CBO is assuming with the BCRA2017.

What no one asks is, why did the CBO get those Obamacare numbers so wrong? And the answer is, they didn’t.

Americans have short memories, and the few facts they do remember correctly, we rarely connect those memories to others that may be directly related. In this case we remember that Obamacare passed. We may even remember it was upheld by the Supreme Court.

What few Americans seem to remember, or connect to Obamacare, is that the Roberts Supreme Court did not, in fact, uphold Obamacare. They struck down a key provision: the requirement that states expand Medicaid to cover the requirements of the law. The Roberts Court ruled that States could refuse those funds and opt out of Medicaid, which my state, Texas, did. Immediately. Governor Rick Perry told Texans, “We don’t want that stinking Federal money.”

As a result (and the result of closing dozens of clinics that primarily served women and the poor because of anti-abortion regulations), thousands of Texans lost access to care. Not choice. The ability to get any care at all. And Texas wasn’t the only state.

Once those health care dollars are no longer in play, the costs of insurance pools increase for insurers, Americans who can’t afford health insurance but would have qualified for Medicaid lose their care, forcing them into emergency rooms (provided they can reach one) and drive up the cost of care, not to mention pressure on premiums. And millions of people that the AHCA would have covered, as projected by the CBO, fall through the cracks.

In short, the numbers didn’t lie and the CBO didn’t get them wrong. John Roberts threw a monkey wrench into the equation and caused the system to crash. Millions of Americans failed to gain access to care because Republicans in the Supreme Court and state legislatures turned off the Obamacare spigot.

Millions of Americans weren’t covered because Republicans in the Supreme Court and state legislatures turned off the Obamacare spigot.

So when you hear Republican Congressmen and Senators saying we should ignore the CBO estimates because they were wrong in the past, your answer should be: “And whose fault is that? You really don’t know? Then kill the bill, let us keep our care and next time do your homework.”

[1]Obamacare doesn’t deny choice. By requiring people who opt out of insurance to pay a penalty, the Health Care Act is, by Republican logic, offering every American a choice. You can buy health care or pay a penalty to help offset the cost of premiums you’re driving up by staying out of the pool. By my way of thinking this choice is far less draconian than the one offered by the “Better Care Reconciliation Act of 2017,” which offers worse care and no reconciliation whatever. It offers only the consolation that, if you’re like my wife and I, you won’t be paying any premiums at all in the near future.

author of Cigerets, Guns & Beer and Raising Hell.

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