The Price is Not Right
Understanding How a Street Magician Will Use Misdirection to Kill the ACA and Take Away Your Health Care
The President’s choice to lead the Department of Health and Human Services, Rep. Tom Price, R-Ga., is set to become the latest Republican street magician to expertly use misdirection to convince the American public that the President’s promise — “better insurance at a lower rate for everybody” — can somehow come true.
It can’t.
The Price confirmation hearings have fully revealed Republican commitment to doublespeak when publicly discussing their “plan” to replace the Affordable Care Act. Indeed, even though the President’s central promise is “better insurance at a lower rate for everybody,” Mr. Price repeatedly refused to answer yes to the simple question:
“Do you agree that no Americans would be worse off under Trump’s executive order to ease provisions of the Affordable Care Act?”
Instead, Mr. Price repeatedly dealt well-practiced, slick punchlines that sound terrific — but meant nothing at all.
For example, Mr. Price would not commit that no one would be harmed by the repeal of the ACA. Mr. Price would not commit that no one would lose insurance coverage.
What did the street magician say instead?
“I commit to working with you.” And that all Americans must have “access to health insurance.” And he said these two things, over and over again.
We are not naïve in the ways of Washington. We know it’s necessary, politically, to pay off the marker on the six-plus year effort to slay the ACA. But the President promised to replace the ACA with something better. For everybody.
Here’s the deal. The President’s promises of “better insurance at a lower rate for everybody” present more than a simple challenge. They defy the laws of mathematics and logic — and maybe physics. The President and the Republicans appear to be running a street magician’s three-card monte scam, where the three cards reflect the truth of a wonderful promise, but where we are never able to see all three cards at the same time and never able to pin down any one specific card before its location has been hidden from view.
Don’t believe me? Hold this juxtaposition in your head. In the same week that Mr. Price claimed in his testimony that there is a “plan,” the 90-minute tape recording of the Republican members of Congress is released, privately acknowledging, confessing, and hand-wringing over their complete lack of any cohesive replacement plan to present to the American public.
So, we can kick to the curb any notion that Mr. Price has credibility when he says “we have a plan.” Yes, they might have ideas. Like Captain Barbosa in Pirates of the Caribbean, they might have guidelines. But reinventing health care is perhaps the most complicated Rubik’s cube of legislation facing Congress since, well, the ACA. And a true executable plan will have to take all the ideas and guidelines and put them on paper, make them cohesive, make the moving parts work together and fully reveal their complexity. Remember the President’s first press conference with stacks of papers that allegedly contained his “plan” to divest ownership of his companies? A national health care plan that can actually be implemented will require detail of far great volume — anyone telling you different is selling you some snake oil. And as clarified by the Republican ACA tape recording, neither the President nor the Republicans have yet to put pen to paper on page one.
The Republican ACA tape recording also destroys any illusion that Republican elected officials have had a replacement plan at any time during the past six years and previous 65 attempts to repeal the ACA. Mr. Price’s current proclamations mean only one thing — he’s going to be the new street magician pulling a fast one on the American public in relation to each of the President’s three promises relating to health care.
Despite the debacle and shredded veracity created by the Republican ACA tape recordings, the President and the Republicans have no choice but to smile, rail at the ACA for failings they refused to help fix for over six years, and maintain the illusion that they will keep the President’s promise of “better insurance at a lower rate for everybody.”
So, buckle your seatbelts. You’re being dealt into this three card monte hand. Here is how you can know it’s happening, promise by promise.
PROMISE #1 — BETTER INSURANCE.
Let’s keep this simple. Imagine you are taking your grocery cart through the line and ringing up your “insurance products.” To even be “as good as” the ACA, you’d need to put into your grocery cart the following products that are immensely popular with the American public, with no exceptions: (1) no lifetime caps on coverage; (2) no cancellation for pre-existing condition conditions; (3) portability; (4) your children stay covered until age 26; (5) free preventative care for women; and (6) no uninsured waiting periods. (As a side note to ACA haters: you didn’t have all of these products in your imaginary shopping cart before the ACA, because no insurer offered all of these products to you — so of course you didn’t pay as much when you went through the grocery line.)
If and when the Republicans ever come up with a “plan,” when we actually can see the stacks of file folders with the actual writing on them used as a prop at a press conference, we’re all going to have to check to see if the new “better” plan puts ALL of these six products in our cart. Because otherwise, the President and Republicans are selling us something “worse” and calling it “better.”
If the “replace” is not better, with all six items in the cart, the President is breaking his promise. And if the President and Mr. Price call it “better,” all of us — conservative or liberal — will understand we are being misdirected, and that it is doublespeak to call the offer of fewer products “better.”
Oh, and we must all watch for the most insidious of all the doublespeak being deployed to break the promise of “better” — the creation of high risk pools. When we hear that phrase we need to decode it immediately, and know that this is where the sick, elderly, and those with pre-existing conditions are carved out of the herd of any “better” insurance program and pushed into higher premiums, higher deductibles, and lower caps because shoving our most vulnerable into these pools, pushing them into a much worse product, may be how you choose to sell the rest of us a “better” product. Do this, Mr. President and Mr. Price, and you’ve not only broken Promise #1, you’ve quite shamefully done it on the back of those we should be helping, not hurting.
You can “work with us” all you want, Mr. Price. You can provide us “access.” But if the grocery cart you sell us doesn’t include the same six products we’ve had with the ACA, then you’ve broken the very first promise the President has made. You’ve only worked to give us access to insurance that is worse.
PROMISE #2 — LOWER PREMIUMS.
I propose we all cut the President some slack here. We have to be fair. We understand that if we are buying more from the imaginary insurance grocery store, we should and likely will have to pay more. Because we get more. It’s like if we want to get more national defense, we’d have to pay more. Or if we want to have more highways or bridges, well, we’d have to pay more. Or, referencing one of the President’s early corporate attack-tweets, if you want to pay less for a new Air Force One, you ask for fewer bells and whistles. I costs less, but you get less.
We love ideas around lowering premiums! Make America great here? Sure! Implement your ideas around crossing state lines, importing drugs, use a better magic wand from Olivander’s, we don’t care. Never have. We are on your the same side here. We always have been. People are beginning to understand that the six years of untruths spread about the ACA are increasingly easy to debunk (e.g., quoting anecdotal high premium problems without applying subsidies to examine real rates; ignoring market adjustments from pre-ACA regional inequalities). People are also beginning to understand that problems with the ACA have never been denied by Democrats for the last six years. Instead, Republicans have never agreed to work in a bipartisan way to fix these problems within the construct of the ACA, instead putting all effort into killing the entire ACA for political victory as evidenced by voting for a complete repeal 65 times.
There’s only one thing you can’t do here to fulfill Promise #2, Mr. President and Mr. Price— and that’s to meet the promise of lowering premiums by breaking Promise #1, and offering insurance that is worse.
That’s the scam we’re all watching for here. You can’t take things out of our shopping cart and lower the premium, and claim you’ve met your promise. Because you haven’t. Because, we’re smart and we’re watching, and if all you’ve done just lower premiums by taking things away, that’s not “better,” you’re just selling something less, and “worse.”
PROMISE #3 — FOR EVERYBODY.
Another tough promise for the President to keep, and we the people need to shoot straight with each other on this one, too. It does cost more to provide coverage for everybody. It’s underwriting. Which means it’s math. All of us will pay more so that enough funds are collected to allow coverage for all. And if we are meeting Promise #1 (“better”), we understand that we’re paying more for that, too. Some 20 million people bought coverage premised on programs in which Promise #1— the “better” insurance products in our shopping cart — is not broken. Here, like your Promise #2 to lower premiums, we’re with you Mr. President, if you have better plans to meet this promise #3 (“everybody”), we the people are eager to support you.
But — if what you are really, really doing is meeting your promise to provide insurance for everybody by breaking your promise to provide better insurance (taking things out of the shopping cart), then again, that’s the three card monte scam, and we’re watching for it.
LET’S BE HONEST.
Mr. President and Mr. Price, if you want to live up to your promises — you need a version of the ACA. If you don’t intend to meet the promises — be honest! You’re not campaigning anymore. Tell your supporters, tell us all, that you want to solve the problems of health care by selling us less, by offering worse coverage, by taking the features of the ACA out of our shopping cart.
How about this — purge yourself of the biggest whopper right now — that “no one will take your insurance away.” Because of course, to the extent that if you have insurance right now, it is a contract. It can’t be taken away.
Until the contract expires sometime in the next year. Oops.
And at that time, yes, absent a full shopping cart to protect you, an insurer can absolutely choose not to renew you. Because, maybe, you’ve had cancer. Or a heart condition. Diabetes. Or, you’re old. So, Mr. President and Mr. Price, we’re on to the whopper that somehow we shouldn’t worry about you keeping your promises because a plan to “replace” will come in due time.
We know from the Republican ACA tape recordings that there is currently no plan. Being honest about what you really want to do versus “and it’ll be a great plan and make America great” would refresh us. That would be a policy debate. Perhaps the American people would rally around the plan. Perhaps they won’t. Of course, we all know that many people choose to remove items from their shopping cart at the register. They want choice, the option to buy less and have less.
Mr. President and Mr. Price, do you trust your supporters enough to tell them the truth?
Looking to do your part? One way to get involved is to read the Indivisible Guide, which is written by former congressional staffers and is loaded with best practices for making Congress listen.
