I wrote a column earlier this week in which I said that the report by the Congressional Budget Office on the federal budget over the next decade might have delivered the “death blow” for ObamaCare. Pete Wehner responded here by saying he was not as “optimistic” as I. The truth is that I didn’t write the column in a spirit of optimism or pessimism. What was striking to me about the CBO report was how it detailed a problem with ObamaCare that had gone all but unnoticed in the debates over its passage and in the criticisms of it since: The way in which its complex system of subsidies might create perverse incentives for people who receive the subsidies. The very real possibility is that this “disincentive to work,” as the CBO’s own director put it to Congress, will be the proverbial straw that breaks ObamaCare’s back. It’s not the report itself, in other words; it’s what the report reports.
This is far from the worst aspect of ObamaCare, really, but it’s a problem no one who supports the bill could possibly have wanted to have to cope with. Add it to all the other bad news since ObamaCare’s official launch on October 1 of last year, and you have a program that is increasingly difficult to defend on its own merits, that might pose profound political risks to those who do try to defend it, and that may provide profound political benefits to those who oppose it and seek its repeal and replacement by a better set of health-care reforms.
Its defenders have been reduced, over the past couple of days, to a series of risible partisan “gotcha” responses that indicate just how desperate things are getting for those who support ObamaCare.
Risible response #1: Republicans dishonestly mischaracterized its findings by claiming the report said 2 million will be thrown out of work when all it said was that the lure of subsidies will cause the departure of workers from the workforce equivalent to 2 million full-time jobs. OK, perhaps there was a failure of nuance in the effort to seek quick political gain, but the Talmudic analysis of the difference between the two is ridiculous. Fine, so 2 million won’t be thrown out of work; rather, they will leave working voluntarily because the deal they get from the government for not working is too good to pass up. That’s a better argument?
Risible response #2: Republicans and conservatives are hypocrites because they also claim to want to decouple health care from employment. For decades now, conservative health-care reformers have pointed out that the single worst policy decision in this entire mess was to give employers the tax deduction for providing health care rather than giving the deduction to each individual worker. But the reason for this was to empower individuals and to give them the responsibility for policing their own health care decisions rather than creating a deranged system in which the consumer has no idea what anything actually costs and has no incentive to shop around for a better deal. It wasn’t to decouple health care from employment by making the dole more attractive than self-sufficiency.
Risible response #3: Conservatives mischaracterized the report’s findings on the number of uninsured under ObamaCare. Without it, the report says, there would be 57 million uninsured by 2024. With it, the report says, there will be 31 million uninsured by 2014. Thus, ObamaCare will provide health care to 26 million people who otherwise wouldn’t have it. So it’s good. The point I made in my column was that President Obama said in September 2009 there were 31 million uninsured. The report says in 2024 there will be 31 million uninsured. If 31 million uninsured was unacceptable in 2009 and the key fact in creating this new $2 trillion program, how could the projection that there will be 31 million uninsured in 2024 be considered an endorsement of ObamaCare’s success? In any case, what is missing from any such projection is the fact that one way or another, had there been no ObamaCare, there would still have been significant revision at some point of the health-care system, which everyone acknowledges is broken. Since we can’t know what other changes might have been made, we can’t possibly know how many uninsured there might have been in this alternate 2024.
The law’s defenders are finding it necessary to fight battles on its behalf they had no idea they would have to fight and for which they are understandably ill-prepared. It’s one thing to say the law is necessary, and that it will have good effects; it’s quite another to have to say it’s OK that it will lead people out of the workforce in order to collect government benefits—and nyah nyah nyah Republicans and conservatives. ObamaCare is now law, and the degree to which is is a badly-designed, jury-rigged mess is mostly what people are coming to know about it. That is why I said this report may mark the moment its doom was sealed—because it’s springing leaks in places no one ever thought he was going to have to patch, even as Obama and his people continue to try to plug the holes that everyone already knows about.