This is the first in a series of posts. I had written this as one piece, but it was way too long. So I am going to try it in lots of little nibbles. I will post one nibble every two hours over the next two days.
At a town hall meeting in Portsmouth, New Hampshire yesterday, the President said:
THE PRESIDENT: (L)et me just say there’s been a long and vigorous debate about this, and that’s how it should be. That’s what America is about, is we have a vigorous debate. That’s why we have a democracy. But I do hope that we will talk with each other and not over each other — (applause) — because one of the objectives of democracy and debate is, is that we start refining our own views because maybe other people have different perspectives, things we didn’t think of.
Where we do disagree, let’s disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that’s actually been proposed.
In the spirit of informed and vigorous debate, let’s look at what the President said about the pending legislation at yesterday’s Portsmouth town hall.
THE PRESIDENT: Now, let me just start by setting the record straight on a few things I’ve been hearing out here — (laughter) — about reform. Under the reform we’re proposing, if you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan.
And yet here is what CBO said about the House bill:
CBO: In addition, CBO and the JCT staff estimate that nearly 6 million other people who would be covered by an employment-based plan under current law would not have such coverage under the proposal. That figure includes part-time employees, who could receive subsidies via an exchange even though they have an employer’s offer of coverage, and about 3 million people who would not have an employer’s offer of coverage under the proposal. Firms that would choose not to offer coverage as a result of the proposal would tend to be smaller employers and those that predominantly employ lower-wage workers … people who would be eligible for subsidies through the exchanges … although some workers who were not eligible for subsidies through the exchanges also would not have coverage available through their employers. Whether those changes in coverage would represent the dropping of existing coverage or a lack of offers of new coverage is difficult to determine. (p. 5)
According to CBO, the President’s statement is incorrect for a portion of these 6 million people who as a result of the House bill would lose employment-based coverage they would otherwise have under current law. Some of those 6 million people would lose the opportunity to get employment-based coverage, while others would “represent the dropping of existing coverage.” CBO reached similar conclusions. Here is a more detailed explanation of this problem that I wrote for an earlier draft of the Kennedy-Dodd bill, under which 10 million people would not have lost the health plan they would otherwise have under current law. CBO dialed this number down to 3 million for a later draft of Kennedy-Dodd.
This is an inevitable consequence of moving away from a system that is so heavily biased toward higher subsidies for employment-based coverage. My preferred plan would have a similar effect. Nonetheless, the President is overpromising, at least relative to CBO’s view of the House bill.
(photo credit: White House, Pete Souza)