Dear Rep. Ferguson, I’m a goat farmer, and I wanted to explain the flaws in your Obamacare/goat metaphor

By Matthew Bays, Thistle Thickets Farm

(C) Matthew Bays, 2017, all rights reserved.

This essay is in response to the story “A GOP congressman used an extended goat metaphor to critique Obamacare. We illustrated it.” by Alvin Chang, vox.com http://www.vox.com/policy-and-politics/2017/1/13/14267848/goat-obamacare-metaphor-cartoon

Greetings Rep. Ferguson. My name is Matt. I heard about your metaphor involving goats and the Affordable Care Act (ACA). My wife and I have been raising goats together for years at Thistle Thickets Farm in Panama City, FL. You can think of us as goat experts, or goatsperts, if you will. That’s why I was compelled to reach out to you when I heard about your Obamacare metaphor involving goats.

Now you seem to think that the American healthcare system as a nice house, and the ACA as some maligned goat that’s been rampaging throughout it since 2010. I can understand that opinion. There are some serious problems with the ACA: Premiums are too high. Provider networks are too small. There are too few insurance options like in our own neck of the woods in Northwest Florida. This might even be an OK analogy. After all, goats can be very mischievous. They eat everything and generally can cause mayhem when in areas they shouldn’t be, all in the search for food. Take a look at our barn after one of many goat escapes we’ve had to deal with. Not fun.

Figure 1: Yes, a goat escape is not fun, much like bad healthcare policy.

Again, I completely understand your great goat concern. I understand you want to fix this. You have the idea that you need to force the goat out of the house before trying to clean it up. At first blush this sounds like a reasonable approach. However, take it from me, grabbing a goat by the horns and forcing it to go anywhere is easier said than done. Goats are strong. If they don’t want to go somewhere because they like it better inside the house, they’re going to fight you every step of the way. Similarly, completely getting rid of the ACA all at once is a heavy lift. You’ll need eight Senate Democrats to break ranks and vote to completely repeal it. That’s not going to happen.

Figure 2: Would you want to wrestle this goat? It’s basically the entire Senate Democratic caucus.

However, this isn’t even what you’re talking about doing in your metaphor. Instead, you’re talking about the reconciliation repeal bill making its way through Congress. This bill isn’t so much getting the whole goat out of the house as chopping off parts of the little guy with a hacksaw. You’re wanting to chop off his tail, an ear, maybe even a leg or two, and then throwing the parts out the window. These are the parts of the ACA such as the individual mandate, the subsidies for low-income Americans, and Medicaid expansion. Other parts, such as the requirement to cover all Americans regardless of pre-existing conditions, regulations for covered benefits, and the marketplace system, all have to stay until fully repealed with Democratic cooperation.

Take it from me, a goat in pain and all chopped up is dangerous, and much worse for the house. It’s going to bleed everywhere and just run around crashing into things in a panic. Take the example of this little gal. She broke her leg a few years back, and it was not a fun experience for any of us.

Figure 3: A hurt goat is not a happy goat. Just like a partially-repealed, very complicated healthcare law is not a happy healthcare law.

When you combine the lack of a penalty for not having health insurance with a requirement for insurers to insure anyone, or require a lot of essential benefits without subsidies to cover them, it’s going to make the healthcare system in a lot worse shape. Premiums will skyrocket. People will be unable to afford insurance and drop it unless they’re sick. And why wouldn’t they? You completely got rid of the penalty for doing so. It would be foolish not to game the system in that case. Insurers will bail faster than you can say bale of hay. Your repeal and delay reconciliation plan is not a good combination. The house is going to be a disaster.

But you know this. You’re just hoping that the Democrats are going to bail you out of this mess. You’re crossing your fingers that after you wreck the ACA, they will help you replace it. But why would they do that? After all, you just maimed their precious goat… I certainly wouldn’t help someone that hurt one of our goats! Additionally, you might be forgetting that in a few years the real owners of the house, the American people, are going to have another election and see how the caretaker of the house, you Republicans in Congress and the White House, have done in fixing it up or at least keeping it as clean as it was when you took over. And while before you took over there might have been a few goat berries (the expert lingo for goat poop) on the floor and a sofa chewed on a bit, after you maim that goat there’s going to be a bloody mess in the living room. Why on Earth would the Democrats help you clean that up? They’d love to point at it and tell the voters that they should be put back in charge of the house. Planning on their help only after chopping up their poor little goat is not a good strategy.

No, the best way of getting a goat to go where you want is to entice it with grain. Goats love grain. Your neighbors across the aisle probably have plenty of grain, too. If you just ask nicely, they might even help you get the goat to go in the general direction you want. Likewise, there are plenty of areas to compromise for a re-vamped ACA. You could make the required benefits a lot more lax to lower premiums. You could make it easier for states to experiment with different healthcare models. You could have mechanisms to entice companies in providing insurance to rural areas. You could rework the subsidies to be fairer to middle-income Americans. All of these are perfectly reasonable fixes. The Democrats might even be ok with working with you if the choice is that or having their goat hurt.

Figure 4: Goats love the grain of bipartisan compromise.

Anyway, I hope you take this explainer seriously, and re-think your plans for the ACA. A lot of people are relying on that goat for their healthcare. Some small businesses like family companies, small non-profits, and even goat farmers only have access to subsidized healthcare plans on the exchanges. Millions would be hurt if your repeal and delay plan goes through. These are real lives in the balance, not pop culture icons and memes used for a laugh or to get an idea across, often like goats.

Figure 5: There’s no healthcare analogy here. Just a picture of cute baby goats.