Not only has the Affordable Care Act been attacked by Republicans for being a government takeover of the healthcare system or for creating death panels that will kill your grandparents in their sleep or for busting the federal budget and your own or for limiting your choice of policies and doctors, now the GOP has a new line of attack: ObamaCare is creating more moochers!
Even though that whole moocher thing didn’t work so well in the 2012 presidential election, it is so much a part of the right-wing’s dogma about Democrats and Democratic constituencies that they simply can’t let it go.
Roy Blunt, my own senator, appeared on this week’s Fox “News” Sunday. And, of course, he followed the newest ObamaCare’s-a-moocher-maker script on what Republicans should say in response to the release of the CBO’s analysis of some of the effects of the Affordable Care Act on the nation’s labor supply.
Before we get to what Blunt said, let’s look at the question Chris Wallace asked him and the way that question was set up for him and the way the reactionaries want us all to understand the issue. Wallace played a cherry-picked clip of Congressional Budget Office Director Doug Elmendorf’s testimony before the House Budget Committee last Wednesday. Here’s a transcript of the clip Wallace played:
DOUG ELMENDORF, CBO DIRECTOR: By providing heavily subsidized health insurance to people with very low income and then withdrawing those subsidies as income rises, the act creates a disincentive for people to work, relative to what would have been the case in the absence of that act.
Wallace stopped the clip there. What Fox viewers (and Roy Blunt) didn’t hear was what Elmendorf said next:
Now these subsidies, of course, makes those lower income people better off.
Yes. He said that. Right after he talked about the disincentive to work. He said that these folks would be better off. And he continued to explain:
This is an implicit tax, not the sort of tax we normally think about where if the government raises our taxes, we are worse off and face the disincentive to work more. Providing a subsidy, people are better off but they do have less of an incentive to work and I think they would respond to that by working somewhat less.
As you can see, the whole idea that folks would stop working or reduce the time they spend working is essentially based on what economists “think they would respond to” in terms of being better off because of the ACA. And it turns out that the CBO’s number-crunchers were influenced by the work of a conservative economist, as Jonathan Chait (“How Obamacare Became the New Welfare”) notes:
The Congressional Budget Office’s budget update last week surprisingly adapted an analysis, advocated by conservative economist Casey Mulligan, that Obamacare would induce the equivalent of two million full-time jobs in reduced labor. Now, in addition to its previously recited horrors, Obamacare was taking money from hard-working Americans to finance indolence.
Mr. Mulligan has been an outspoken critic of the Affordable Care Act from the start. Last October he criticized it for—sound familiar?—creating “a reduction in the reward for working” and suggested that its full implementation this year might cause “a recessionary double-dip.” So, he’s not a fan of the law, and it is unclear why the CBO embraced some of his thinking as to the effects it will have on the labor supply.
But such thinking is part of the long-time conservative critique of Democrats and their fondness for safety-net programs. On Sunday, Chris Wallace asked former-intellectual-turned-Fox-commentator George Will: “is giving people a cheaper way to get health insurance without working so much — is that a good thing or a bad thing?” As he always does, as he is no doubt required to do to get his big paycheck from Fox, Will took aim at liberals:
People forget Social Security was advocated, Chris, in the 1930s, as a way of getting people to quit working, because they thought we were confined to a permanent scarcity of jobs in this country. Second, it is the point of progressivism to put in front of the American people an increasingly rich menu of temptation to dependency on government. In order to change social norms and eventually national character, the president said, “I want to fundamentally change America,” and these disincentives to work are part of it.
Of course! President Obama and the Democratic Party want people to be dependent on government. They want people to stay in what Paul Ryan called the “poverty trap.” They want all Americans to quit working and become moochers. Makes perfect sense, right? That idea, which Rush Limbaugh and other right-wing radio personalities have aggressively pushed for more than two decades now, is what Republicans want voters to now specifically associate with “ObamaCare.”
But what about that idea? What about that poverty trap? You might be surprised. Jonathan Chait writes:
What’s more, as Jared Bernstein and Edwin Park point out, by lifting the threshold for who gets subsidized insurance, Obamacare actually reduces this poverty trap. Before Obamacare expanded it, Medicaid had extremely low income thresholds. It varies state by state, but the average state cut off Medicaid to people earning just 61 percent of the poverty line, a pitifully low sum. If you’re a single parent in Texas, you lose your Mediciad if you earn more than $3,600 a year. A family of two in Alabama loses its Medicaid once its income, after deductions, hits the lofty sum of $2,832 a year. That’s a severe incentive to keep poor people from obtaining full-time work.
Of course, Texas is boycotting Obamcare’s Medcaid expansion, and is thus keeping in place this strong incentive for its poorest citizens to stay out of the workforce. (If conservatives are worried about fostering a culture of dependency in these Obamacare-boycotting red states, they are keeping their fears very, very quiet.) The states choosing to expand Medicaid are correspondingly increasing the incentive for the very poor to enter the workforce.
As the above-cited economist Jared Bernstein makes clear:
During a hearing today on the latest CBO report, Rep. Paul Ryan declared the health care law to be “a poverty trap.” He’s way off base. In fact, he’s got it backwards…
None of this is to deny the CBO’s point that some people with incomes above the poverty level will choose to work less to avoid reductions in their premium subsidy. But those choices are not the ones faced by the poor who live in states where the ACA is the law of the land. In those states, the law has thoroughly reversed the poverty trap. Rep. Ryan should know that and correct the misimpression he’s created.
Of course Paul Ryan, Roy Blunt, or any Republican for that matter, will not correct any of the misimpressions, not to say lies, they have created. And many mainstream journalists will continue to promote a false equivalence by reporting Republican misinformation and Democratic attempts to correct it as if both are morally equal and just part of the game of politics. Thus, if Democratic politicians want to keep their jobs and keep health insurance reform alive, it is up to them to get very aggressive in their defense of the ACA, especially with people like Roy Blunt running around and making mischief on television.
Which leads me finally to Blunt’s appearance on Fox yesterday. Chris Wallace, after playing the partial Elmendorf clip, asked Blunt this question:
WALLACE: Now, Republicans say this proves that ObamaCare is a job killer. Democrats say it means that fewer people will be locked into jobs. Senator Blunt, what is wrong with that, the idea of fewer people locked into jobs?
Now, of course Wallace knows that ObamaCare is not “a job killer.” The CBO report made clear and Elmendorf testified that the law would actually create jobs not kill them. But Wallace chose to set the question up by contrasting a Republican “job-killer” lie with a Democratic truth, to wit: the law allows some people to opt out of jobs they are locked into because of their need for employer-provided health insurance. And Blunt took the bait and further muddied the waters:
SEN. ROY BLUNT, R-MO.: Well, I think any law you pass that discourages people from working can’t be a good idea. Why would we want to do that? Why would we think that was a good thing? How does that allow people to prepare for the time when they don’t work?
This number is about three times as big as the number that was on the table when people that voted for the president’s health care bill voted for it in 2009 and ’10 when the estimate was it would cost the equivalent of 800,000 full time jobs. Now, they’re saying 2.3 million, and the best face can you put on that is that means people that don’t want to work don’t have to work. Surely, that’s not what we want to encourage. And that’s what this law does encourage.
Let’s start with his first declaration: “I think any law you pass that discourages people from working can’t be a good idea.” Oh, yeah? The Social Security law discourages people from working. Lots and lots of them. And lots of them are Republicans. Is Social Security a bad idea, Senator Blunt? Is Medicare a bad idea because it also discourages people from working? Apparently, Blunt thinks that making it possible for people who have worked all their lives and simply want to exit the labor force into retirement is a bad thing. No wonder he supported the infamous Paul Ryan Medicare-mutilating budget plan. I guess people should just work until their dead.
But more than that, notice how Blunt, like all Republicans are now doing and will continue to do until election day this November, focuses on those alleged “2.3 million” people who “don’t want to work” or “don’t have to work.” That is essentially the argument that was made more generally during the 2012 election. Paul Ryan said the following at a fundraiser in June of that election year:
Do you want the American idea of an opportunity society with a safety net where you can take a risk, start a business, make a difference, succeed and be honored for being successful? Or do we go down the path the president is proposing — a social welfare state, a cradle-to-the-grave society where we have more takers than makers?
The only difference now, in this election year, is that Republicans are targeting a specific effort by Democrats, embodied in the Affordable Care Act, to help low-income folks get affordable health insurance. And they think they have the CBO on their side this time.
But what about that CBO report and Director Elmendorf’s seemingly common-sense claim “that by providing a somewhat smaller incentive to work, somewhat fewer people would work”? Nobody argues that there won’t be some number of people who will do exactly what Elmendorf suggests they will do. As Jonathan Chait makes clear:
It is true that any means-tested government benefit will discourage some class of people from working. If a subsidy is available only for people below a certain income level, then people whose income approaches that income level will lose some incentive to earn more.
By its very nature, the concept of means-testing—which Republicans themselves have always embraced—involves people calculating whether working more actually makes them better off. People do that all the time when, for instance, they reach retirement age. The issue here is how many people will do what Elmendorf suggests. And relative to that issue Suzy Khimm (who used to be with the Washington Post’s Wonkblog) makes an excellent point:
It’s also worth taking the CBO’s findings with a grain of salt. The office had previously forecast that Obamacare would reduce the total hours worked by the equivalent of 800,000 workers, then updated its forecast based on more recent research. But one new study that CBO cited in its report actually “found no significant effect of Medicaid on employment or earnings” when Oregon expanded the program in 2008.
Austin Nichols, a researcher at the Urban Institute, says such evidence makes him skeptical that Obamacare’s effect on the labor market will be as large as the CBO predicts. “I don’t think we’re going to see the kinds of reductions in labor supply that Elmendorf is talking bout today,” says Nichols. “We have also evidence from Massachusetts that doesn’t show a large impact.”
Paul Krugman wrote that the “reduced labor supply” noted by the CBO and exploited by dishonest Republicans does in fact add to “the true cost of health reform.” But he demonstrates, through what he calls “some pretty prosaic economics,” that the effects are fairly modest. He ends:
Should you care how much other people work? Yes, a little – but not so much that it should change anyone’s views about health reform.
The truth is that at this point nobody really knows, with any degree of legitimate certainty, what direct and indirect effects the Affordable Care Act will have not only on the labor supply, but on other areas of the economy. As I have said many times, the ACA is an experiment. Much more time and evidence is needed to figure out whether the law will work as designed, whether it will need significant changes, or whether it should be scrapped altogether. But we have one political party that does not want it to work, will not lift a finger to fix any problems with it, and wants only to kill it before it has had a chance to prove or disprove itself.
Unfortunately for Missourians—especially for those Missourians who could get health insurance were it not for Republicans blocking Medicaid expansion—Roy Blunt is part of that one political party.