The Republican Case for Health Care Repeal: Certain Uncertainty

Tuesday, January 18, 2011

Protesters of the health care reform bill react to the passage of legislation in Washington, DC (Astrid Riecken/Getty Images/Getty)

The House of Representatives begins debate today on a bill called “Repealing the Job-Killing Health Care Law Act.” (Speaker John Boehner's office dialed back the language on the legislation in a Sunday blog post, calling it "job-crushing" instead of "job-killing," but the bill's name remains the same.)

To make their case for repeal, House Republicans are honing in on the massive health care overhaul's effect on employment, at a time when that’s the most sensitive issue on American minds.

How does the Patient Protection and Affordable Care Act, which aims to expand health insurance coverage and reduce costs, kill jobs? The Republican majority offers this report, Obamacare: A Budget-Busting, Job-Killing Health Care Law.

The document is packed with facts, figures and footnotes focused specifically on the law’s consequences for business. The numbers are compelling, taken at face value, but therein lies the problem: much of the information cited in the report is just as uncertain and subjective as the Congressional Budget Office (CBO) numbers that Republicans say you can’t trust.

It doesn’t help that they get off to a rather disingenuous start. Among the opening salvos is a quote from the CBO, which Republicans cast as saying the health care law will “reduce the ‘amount of labor used in the economy by … roughly half a percent...,’ an estimate that adds up to roughly 650,000 jobs lost.” Those ellipses are there for a reason. The un-redacted excerpt reads, “reduce the amount of labor used in the economy by a small amount—roughly half a percent—primarily by reducing the amount of labor that workers choose to supply” (emphasis added).

In other words, the CBO is saying that people may choose to work less or exit the workforce entirely if health coverage is easier to afford. The effect would be job openings, not job losses. This was the original justification for Social Security, which was intended to draw seniors into retirement and out of the workforce to make room for the unemployed.

Investigating these claims is a worthwhile endeavor, not because one hopes to prove one side wrong or right, but because this is in the playbook for both parties. There are so many organizations, federations, unions, groups, universities and think tanks that can conduct studies using a tremendous variety of variables and indicators, all in the name of guessing what will happen. We are told the CBO has said X, Y and Z, but their numbers are flawed and here is why. Now, here are some numbers that aren’t flawed that tell the real story. Trust us.

For example, House Republicans also cite a National Federation of Independent Businesses (NFIB) report saying that “the employer mandate alone could lead to the elimination of 1.6 million jobs between 2009 and 2014.” But the employer mandate doesn’t take effect until 2014. The NFIB conducted simulations, and found that a mandate enacted in 2009 (which it wasn’t) could (but not certainly) lead to 1.6 million jobs lost. Nobody knows what the state of the U.S. economy will be in 2014, but we all know that it was terrible in 2009. This is like comparing apples and some other fruit that we don’t even know exists yet.

This goes on. Republicans tout that they have a letter from “more than 130 respected economists,” stating “the health care bill contains a number of provisions that will eliminate jobs, reduce hours and wages, and limit future job creation.” But 20 other economists did the same thing for the other side. To come to any conclusions about who’s right, we’d have to decide if more economists is always better, then we’d need to figure out who each economist was, and even then there’d be some kind of ideological debate without a concrete answer.

There's also a reference to a bevy of new tax forms, where the report quotes the IRS National Taxpayer Advocate, who says, “[T]he new reporting burden, particularly as it falls on small businesses, may turn out to be disproportionate as compared with any resulting improvement in tax compliance.” The full quote? “TAS has not yet reached any conclusions regarding the benefits and burdens of the requirement, but the report expresses concern that the burdens ‘may turn out to be disproportionate as compared with any resulting improvement in tax compliance’” (emphasis added).

The report argues that a tax on medical equipment manufacturers will dig into their profits, without noting that the quoted article also features Sen. John Kerry (D-MA) making the point that with 30 million more customers in the health care industry, profits are also expected to rise. We are told that restaurants and retail operations will see profits decrease as it becomes more expensive for them to provide health care, but not that the quoted article also features a union president who questions their calculations—important, when this debate has seemingly become all about questionable calculations. We are told that a tax credit would help “just three million workers,” when earlier in the report 650,000 jobs was made to seem like a huge number.

The CBO’s accounting methodology is made suspect with claims that its projections only cover the first decade of the law’s existence. Republicans call forecasts for deficit reduction the result of “gimmicks” and say the debt will balloon as a result of the law in the following decade. But the CBO did conduct estimates for 2020 and beyond showing deficits would be reduced “relative to those projected under current law” (emphasis added). It may not eliminate deficits, but it is projected to make them lower than they would be otherwise. Republicans offer their own chart showing how the debt will be affected beyond 2020, and come up with much higher cost projections.

The reality is that we just don’t know. It’s difficult to prove one set of numbers is better than another. Heck, they could all be wrong. But as a coda to the report, Republicans have chosen to highlight uncertainty as the main way “Obamacare” is a “job-killer.” We are given quotes from business owners, small and large, who say that uncertainty regarding the health care law will keep them from hiring and expanding with confidence. But it's an open question whether after reading this report, anyone is left feeling less confident—or just more confused—about the effects of this legislation.


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Comments [5]

Sue from Manhattan

Interestingly, when I tried to CALL Speaker Boehner's office about the health care bill, I got a one-line message to leave my comment at But after doing that, I got an e-mail from that site that says "
The recipient's mailbox is full and can't accept messages now. Microsoft Exchange will not try to redeliver this message for you. Please try resending this message later, or contact the recipient directly."

Looks like he's not interested in public comments.

Jan. 18 2011 05:11 PM
Nick from Ice Age 4-NJ

Anyone who was happy about the passage of the original health care bill should be seriously concerned about this upcoming repeal bill. This article by Stephen does a great job of showing how there are no real concrete facts about how this bill can play out on the economy in the future (I love the comparing apples to a non existent fruit we know nothing about, hilarious!). However, there is plenty of room for the spinsters on the right, and with help from their pundits and whatever Sarah Palin is, to mold this into some overreacted USSR style piece of legislation that is anti-American. We all know, and I think THEY know to an extent, that it isn't. In fact, I am part of a minority that believes this bill did not go far enough! I was totally in favor of the public option and I was furious that Obama dropped it.

Remember that this was a major campaign promise of the RIght. They based a very large portion of their terrible tv ads attacking it, so they at least have to make a run at it. I don't think it will work, but I am afraid that they will rally their masses with half-truths and overexaggerations much to the chagrin of Blue Cross Blue Sheild and Amerihealth, their truest partners.

Jan. 18 2011 01:29 PM
Marsha Andrews from New York City, NY 10023

If the health care system covered all options like alternative health care/Functional Medicine etc. I would be fine with the mandate but for me it's telling me I have to use practices that I don't feel comfortable with meaning unfettered belief in alopathic medicine. The government telling me what to do with my body does not sit well at all. I know the argument that if someone gets sick, we will all have to pay for it but that's what we do now anyway. My daughter doesn't want and can't afford to buy insurance right now and did go to the emergency which she then payed for but ... that was a fraction of the cost of doing ridiculous high premiums for a health care system that doesn't cover our choices of treatment.

Jan. 18 2011 11:53 AM
Jenny Lines

What is the difference between forcing people to pay a Medicare tax and requiring individuals to buy health care insurance?

Jan. 18 2011 11:23 AM
Mark from Brooklyn

If the gov't can require you to buy car insurance, why not health insurance?

Also, if people choose not to buy health insurance than why can't I choose not to have my premiums raised in order to pay for their healthcare when they go to the hospital.

Jan. 18 2011 11:18 AM

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