Ever since the US Supreme Court issued its startling decision on the Affordable Care Act (ACA) Thursday morning, the presidential campaigns of both Barack Obama and Mitt Romney have been spinning the ruling like crazy.
Just some of the issues with wildly different political interpretations include: Defining the details and impact of what the court says plainly is a form of taxation – the basis, in fact, of the constitutionality of what critics call “Obamacare.” What the outcome would be for Medicare. The number of already-insured Americans who would have to scramble to find new health care coverage. Whether or not the ACA is a “job-killer.” Whether or not the deficit would go up or down as a result of this landmark legislation.
Obama may have won big in the high court – “Did Obama Just Get His Mojo Back?” asks the headline on a piece at Slate – but both the President and his likely GOP competitor have major political challenges as a result of the ruling.
For Obama, it’s the ACA’s cost to individuals and families of a massive new government program designed to reform health care insurance in major ways, and Republicans were quick to jump on that.
In the GOP’s Saturday radio address, Sen. John Barrasso, R-Wyo. (who’s a physician) said this:
“President Obama has repeatedly promised, and I quote, 'if you're a family making less than $250,000 a year, my plan,' he said, 'won't raise your taxes one penny.' Now, all of America knows the truth. The President's health care law hires more IRS agents to investigate you and to make sure you buy insurance – but it fails to deal with the shortage of nurses and doctors to actually take care of you.”
The Supreme Court’s majority opinion did say the ACA is constitutional because of Congress’s taxing authority, so that’ll take some explaining by the Obama administration.
What Romney has to explain is why that’s substantially different from his signature achievement as governor of Massachusetts: A statewide health insurance program that includes an individual mandate and the taxing authority to enforce it.
“I don't think of the mandate as a tax – I think of it is a free rider penalty,” Jon Gruber, the MIT economist who helped craft the Massachusetts and national laws, told Politico.com. “But if you want to think of it as a tax, then it is exactly the same tax … Romney imposed.”
Michael Widmer, president of the Massachusetts Taxpayers Foundation – a business-backed fiscal watchdog that has analyzed the state’s health care law for years – agreed, Politico reported. “If one’s a tax, the other’s a tax,” he said.
USA Today has done a good job of fact-checking the points of contention (and spin) on the court’s ruling.
Obama’s assertion that “nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses and not enough on your health care?” That’s overreach, USA Today’s scrutinizing finds, since “most of these rebates will go to employers, not individuals.”
Romney’s claim that “Obamacare is a job-killer?”
“Claims about the health care law killing jobs are overblown…. It's true that the amount of labor in the economy would be reduced by ‘a small amount,’ about half a percent, according to the [nonpartisan] Congressional Budget Office. That currently equals about 675,000 jobs. But the jobs would not be lost or killed. Most of those workers would have the ‘financial resources’ – because of the subsidies provided by the law – to retire or reduce their hours, the CBO says.”
What’s not subject to dispute (although they surely can be spun) are the latest poll figures on how Americans feel about what the high court’s just done in upholding government-mandated health care insurance.
“Consistently, a majority of voters said that they oppose the individual mandate (53 percent); believe taxes will increase (52 percent); believe their personal health-care costs will increase (56 percent); and disapprove of Obama’s handling of health care in general (58 percent),” reports Newsweek’s Daily Beast. “Only 24 percent of those polled said that they believe the ruling will make the country better off.”
A USA Today/Gallup Poll finds a similar split with a slim majority wanting part or all of the law repealed.
That’s a problem for Obama, who has a major selling job to do.
For Romney, the problem is being forced to talk about health care (and his own “Romneycare” legacy) when he’d rather focus on the economy. And of other polling showing majority support for key elements of the ACA
• Sixty-one percent of respondents favored allowing young adults to stay on their parents’ insurance plans until age 26.
• Seventy-two percent of respondents wish to maintain the requirement that companies with more than 50 workers provide health insurance for their employees.
• Eighty-two percent of respondents favored banning insurance companies from denying coverage to people with pre-existing conditions.
At the moment, Romney and congressional Republicans have no detailed plan for preserving those popular features once they’ve “repealed Obamacare on day one.”