Mulhall column: We confuse Obamacare with morality
“Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.”
— Matthew 25:40
A recent social media meme, which with the introduction of the American Health Care Act appears to have dropped off the radar, defended Obamacare (ACA) by saying “there’s a difference between health care and health insurance.” The upshot is the ACA didn’t cause high medical costs. By inference, we shouldn’t ascribe rising insurance costs in the wake of the ACA to the ACA, and we certainly shouldn’t repeal the ACA, especially in light of all the good it could do.
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As one columnist I read recently put it, “Caring for sick people and the least among us saves money in the long run — and it’s moral.”
To me, admiring the moral twinkle of the ACA’s care for the least among us rings hollow due to the parliamentary maneuvering, semantic dissonance and unapologetic deception required to pass it.
First, without the Senate’s crafty application of Senate rules, Obamacare would not have become law.
In 2009, Senate Democrats held a tenuous, 60-vote majority hinging on the two Independent senators who caucused with them. Meanwhile, House Democrats enjoyed a solid majority.
The Senate passed the ACA. Then Edward M. Kennedy passed.
In a January, 2010 Massachusetts special election for Kennedy’s seat, Republican Scott Brown defeated Martha Coakley, decrementing the Senate Democrats’ 60-vote block to 59. Since the House controls the purse, the Senate would have to vote again on necessary fiduciary modifications, and without a Republican defection, House changes would not pass.
So Harry Reid cut a deal with Nancy Pelosi. If the House passed the Senate bill, the Senate would pass any House changes in a separate bill — even without 60 votes.
The House dutifully passed the Senate’s version of the ACA and sent it to the president. Then, it passed the Reconciliation Act of 2010 and sent it to the Senate. Harry Reid invoked Senate reconciliation, which changed the supermajority requirement to a simple majority, and the act passed 56-43.
While this sort of Parliamentary shell game is not uncommon — we saw it recently when the Senate changed a rule for the confirmation of Justice Gorsuch (a rule reversal with origins in George W. Bush’s nomination of Miguel Estrada) — procedural escapades play fast and loose with representative governance.
Second, a tax by any other name is still a tax. Merriam-Webster says a tax is “a charge, usually of money, imposed by authority on persons or property for public purposes.”
The ACA “penalizes” the uninsured to force the purchase of government health care. That’s taxation, a bedrock for leviathan government.
Even George Stephanopoulos, ABC News chief anchor and former Clinton political adviser, saw ACA “penalties” as taxes (or perhaps he was just helping reinforce the charade) when in September 2009 he asked President Obama, “Under this [the individual] mandate, the government is forcing people to spend money, fining you if you don’t. How is that not a tax?”
The president’s response? “George, you — you can’t just make up that language and decide that that’s called a tax increase.”
Like President Obama, congressional Democrats and the Congressional Budget Office performed rhetorical gymnastics to cast the individual mandate as some kind of monetary wrist slap.
The idea of “fines” and “penalties” persisted until the Supreme Court ruled in National Federation of Independent Business v. Sebelius. In that decision, the court held that to be constitutional, the ACA’s individual mandate had to be tax. “The Federal Government does not have the power to order people to buy health insurance” Chief Justice Roberts wrote, “[but] The Federal Government does have the power to impose a tax on those without health insurance.”
Hence, the ACA’s “penalty” was a tax after all, and it’s no stretch that think this was the intent all along.
Semantic dissonance is in itself no basis for mistrust. Coupled with marshaling a Senate rule change to ensure ACA passage, however, referring to a tax as a “penalty” was no mere euphemism. Avoiding the term “tax” was a lynchpin for the ACA’s passage.
Consider, finally, the words of Jonathan Gruber, MIT economics professor and principal ACA architect. In an Oct. 17, 2013, YouTube broadcast, perhaps overcome by unbridled hubris, Gruber admitted that “lack of transparency” about the individual mandate was central to ACA passage. The ACA was “written in a tortured way to make sure CBO did not score the mandate as taxes,” Gruber said, smiling.
Gruber continued, revealing a disregard for what he might call “the unwashed American people”: “…[C]all it the stupidity of the American voter or whatever, but basically [voter stupidity] was really, really critical for the thing [ACA] to pass.”
If parliamentary sleight-of-hand and semantic indirection do not debilitate the ACA’s morality, the words of Jonathan Gruber do. Crowing over successful deceit is not only gauche, it begs the question, “What’s so important that you’d avoid honesty to get it?”
Events before, during and after the ACA’s passage reveal an ends-justify-means approach to enacting government-run health care. If in Matthew 25:40 a kernel of truth exists, perhaps the way we treat the least among us does matter. Through this prism, deceit, particularly of the least among us, falls far short of any respectable moral standard.
Mitch Mulhall is a husband, father and longtime valley resident. His column appears on the second Friday of each month.
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