Supporters of obamacare claim the president simply delivered
what he promised during the campaign, so the American people should
stop demanding the law’s repeal. But that isn’t true. As a
candidate, Obama actually campaigned against many of the law’s most
important provisions.
Obama’s biggest policy switch came on the mandate that all
Americans buy health insurance coverage. The health care plan Obama
unveiled to great fanfare in 2007 and henceforth campaigned on
contained no mandate. Hillary Clinton’s plan did. Obama attacked
Clinton’s mandate relentlessly. He said the right reform was not to
pass a mandate, but to lower costs.
“The reason Americans don’t have health insurance isn’t because
they don’t want it, it’s because they can’t afford it, which is why
my plan doesn’t have a mandate and goes further in cutting
costs…” he said in Iowa in November of 2007.
“Hillary’s idea is that we should force everyone to buy
insurance,” Obama went on. “But this is yet another issue where she
is not being straight with the American people because she refuses
to tell us how much she would fine people if they couldn’t afford
insurance.”
Throughout the primaries, Clinton and John Edwards kept
attacking Obama for not having a mandate. They said his refusal to
impose one meant he wasn’t offering truly universal coverage.
Obama’s response was to hit back with more attacks on the very idea
of a mandate. He said it simply wasn’t realistic.
“When Senator Clinton or Senator Edwards say they’re going to
mandate health care, but they haven’t talked about either how to
enforce it, or how to make it affordable to people, then it’s not
really a mandate. Anymore than if we mandate that people get car
insurance. But [if] they can’t afford it, they just don’t get it,”
he said on November 21, 2007.
Obama then tried to link Clinton’s and Edwards’s plans to
Romneycare.
The Associated Press reported on November 26, 2007, “The Obama
campaign circulated a memo to reporters yesterday demanding to know
how Clinton would enforce the mandate, noting that one state —
Massachusetts — has taken that route and consumers that do not get
coverage lose their personal tax exemption, a $219 cost.”
On November 30, 2007, when the Clinton campaign attacked Obama
for running a television ad in Iowa that claimed his plan insured
everyone when it obviously did not, Obama spokesman Reid Cherlin
released a statement that said, “Rather than spending their time
attacking Barack Obama, the Clinton campaign should explain how
exactly they plan to force every American to buy health insurance
even if they can’t afford it.”
One of Obama’s TV ads during the primary said, “Hillary
Clinton’s attacking, but what’s she not telling you about her
health care plan? It forces everyone to buy insurance, even if you
can’t afford it, and you pay a penalty if you don’t.”
Hmmm. What does that sound like?
Obama didn’t fail to include an individual coverage mandate in
his plan. He intentionally excluded a coverage mandate, and he
campaigned aggressively against one on the grounds that it would be
a significant financial burden on many Americans. That isn’t just
my interpretation. Here is New York Times columnist Paul
Krugman’s assessment from Feb. 4, 2008:
“You see, the Obama campaign has demonized the idea of mandates
— most recently in a scare-tactics mailer sent to voters that
bears a striking resemblance to the ‘Harry and Louise’ ads run by
the insurance lobby in 1993, ads that helped undermine our last
chance at getting universal health care.”
Yet despite “demonizing the idea of mandates” during the
campaign, Obama reversed himself and embraced mandates only six
months after being sworn in as president.
On July 17, 2009, Obama told CBS News, “During the campaign I
was opposed to this idea because my general attitude was the reason
people don’t have health insurance is not because they don’t want
it, it’s because they can’t afford it. And if you make it
affordable, then they’ll come. I am now in favor of some sort of
individual mandate as long as there’s a hardship exemption.”
Obama took months to craft a health care plan for his campaign.
Then he spent more than a year defending it. In all that time, he
never doubted that an individual mandate was a horrible idea, but
in his first six months in the White House he suddenly had enough
free time to stop and realize that, hey, Hillary was right after
all? That’s less believable than John Edwards saying he cares about
poor people.
Candidate Obama said his plan would lower insurance costs. The
Associated Press reported in March that the legislation won’t. It
will simply subsidize premiums. And speaking of costs, the health
care plan Obama campaigned on projected annual costs of between $50
billion and $65 billion a year. The bill he signed on March 23
costs much more than that by the administration’s own low-ball
estimates. It is likely to cost more than twice what Obama
campaigned on once all the costs, such as the “doc fix,” are
factored in and Congress fails to follow through with the alleged
cost-cutting measures.
Another huge piece of the law that Obama campaigned against in
2008 is its tax on employer-provided health insurance. When John
McCain proposed removing the tax break for employer-provided plans
for the purpose of decoupling health insurance from employment,
Obama called it “the largest middle-class tax increase in history.”
But on March 14, 2009, less than two months after Obama was
inaugurated, the New York Times reported, “The Obama
administration is signaling to Congress that the president could
support taxing some employee health benefits.”
Obama later endorsed taxing “Cadillac” health plans as a means
of both funding his expansion of health care subsidies and
discouraging employers from offering generous coverage. That
contradicted probably his most-often repeated talking point: that
you’ll get to keep the coverage you have if his reform passes. You
won’t, and that is by design. The legislation was written to
encourage employers to shift to less generous plans.
When Obama said in Dover, New Hampshire, on September 12, 2008,
“I pledge to you that under my plan, no one making less than
$250,000 a year will see any form of tax increase. Not income tax,
not capital gains taxes, not any kind of tax,” he followed that
line by pointing out that McCain “can’t make that pledge” because
he would tax employer-provided insurance.
Obamacare not only taxes employer-provided insurance, but taxes
medical devices people of all income levels use and fines anyone of
any income level who doesn’t buy health insurance.
But of all the president’s health care reform reversals, his
most important is arguably one of process, not policy. One of the
greatest appeals of Obama the candidate, and one that seems to have
drawn independents to him, was his self-proclaimed bipartisanship.
He positioned himself as the centrist candidate in part by
repeatedly opposing what he called a “50+1 strategy” of winning
political battles. He would seek broader consensus, he said.
In 2005, he said, “What I worry about would be that you
essentially have still two chambers, the House and the Senate, but
you have simply majoritarian absolute power on either side. And
that’s just not what the Founders intended. You know, the Founders
designed this system, as frustrating it is, to make sure that
there’s a broad consensus before the country moves forward.”
Two years later, he told the Concord Monitor while
campaigning in New Hampshire, “We’re not going to pass universal
health care with a, with a 50-plus-one strategy.”
We are not. But he did.
So although Obama campaigned against an individual mandate,
taxing employer-provided health insurance, making people change
coverage they like, letting premiums continue to rise, raising
taxes on the middle class, spending more than $65 billion a year on
reform, and passing health care reform by a simple majority, once
in office he pushed hard for and ultimately accomplished all of
these things.
You might call that the audacity of rope-a-dope. And the
American people are the dopes.
