PolitiFact 'Lie of The Year': 'If You Like Your Plan, You Can Keep It'

It's end of the year honors time, here in the media, and with it comes another round of remembering the most dubious political achievements of 2013. Over at PolitiFact, that means it's time for the "Lie Of The Year" -- a dishonor they've been bestowing since 2009, without managing to particularly discourage people from lying. There are years where PolitiFact whiffs rather badly, but this year, they get a lay-up:

It was a catchy political pitch and a chance to calm nerves about his dramatic and complicated plan to bring historic change to America's health insurance system.

"If you like your health care plan, you can keep it," President Barack Obama said -- many times -- of his landmark new law.

But the promise was impossible to keep.

Impossible to keep, and yet arguably critical to secure the passage of the law.

The best way to describe how the Affordable Care Act came to be the reason so many people actually lost their plans after Obama promised it wouldn't happen, is simply to note that the law grafted a lot of significant changes onto an already complicated health insurance marketplace. In the status-quo ante, the health insurance system already had a lot of cracks and fissures that could end up depriving customers of plans they liked -- between January 2008 and December 2010, for example, some 44,000 Americans were losing plans they'd like to have kept each week.

The Affordable Care Act, however, went at that existing arrangement with hammer and tong, with the underlying goal of getting as many people who previously could not obtain insurance at all into the system. The law, basically, dramatically altered the marketplace, and as PolitiFact points out today, that caused the ground to shift under the feet of about 2 percent of the total population that was previously insured.

That's enough to stoke outrage. Possessing health insurance is critically important and people who obtain insurance plans take comfort in the continuity of these safeguards. Yes, some of these plans, when examined, turn out to be threadbare. But emotionally, Americans who obtain insurance fear being without it. And the cancellations wrought by the Affordable Care Act came at an inopportune time -- the economy was fragile, unemployment was still high, and most importantly, many of the people who lost insurance could not get the HealthCare.gov website to work.

Perhaps the Obama administration simply underestimated the extent to which people losing their plans would trigger fear, anger, and anxiety, but there's no doubt that "If you like your plan, you can keep it," shows a lack of sensitivity to basic human emotions.

The Obama administration compounded this by handling this whole matter very badly. Their too-clever-by-half explanation for what went wrong essentially boiled down to the grandfathering clause in the law, and blaming the insurance companies. As I explained a few months ago:

One of the provisions in the Affordable Care Act is a grandfathering clause, intended to exempt the employer-sponsored insurance plans that were in existence at the time of the Affordable Care Act's passage from having to follow the contours of the Affordable Care Act. The problem with the line, "If you like your plan, you can keep it," is that it suggests that what's being grandfathered, here, is the customer's possession of a plan. But what was actually grandfathered were the plans that existed at the time, themselves.

What that means is that everyone could retain their plans so long as no alteration was made to those plans by their providers. However, the very minute a provider made a tweak to those plans, they lost the grandfather protection, and compliance with the Affordable Care Act's new standards became necessary.

The thing is, Department of Health and Human Services estimates as early as 2010 predicted that substantial numbers of people would lose their policies in this fashion. So, "If you like your plan, you can keep it," is the loud-shouted spin over the whispered warnings of HHS wonks. It's the slogan on a poster wheatpasted over the scary crack in the wall.

So why do I suggest that it was critical to secure the passage of the law? Well, I'm afraid you have to account for the cynicism of our politics.

I am one of those types of people who vastly prefers to be leveled with, as opposed to being shined on. But even I can see how one might prefer "If you like your plan, you can keep it," to "When the law is implemented, it will vastly reshape the insurance market, which means a not-insignificant portion of the population will be dropped by their insurers or funneled onto plans that cost more, and not all of these people will end up finding their affordable opportunity on the new health insurance exchanges." The latter statement's honesty is the sort of thing that sends political advisers screaming from the room.

PolitiFact puts this rather well: "Boiling down the complicated health care law to a soundbite proved treacherous, even for its promoter-in-chief."

That's what makes "If you like your plan, you can keep it," a particularly galling and nettlesome sort of lie -- it's the sort of falsehood that greases the wheels for a law's passage. You can look at it and see, quite plainly, that the Affordable Care Act wouldn't exist without the glib and misleading pronouncement.

Like so many other things related to Obamacare, how people will ultimately judge Obama for this statement is entirely dependent on the law working in the way it is intended. In five years' time, if the law has delivered on the benefits it promised to the millions of Americans who lacked health insurance, it will remain one of those "ends justifies the means" cases that sits like a nauseous lump in our guts.

On the other hand, if in five years' time the law is a straight-up shambles, then Democrats are going to lose a lot of elections. But much more importantly, it will be decades before any lawmaker has the political courage to try to help the uninsured.

That's a pretty good argument for leveling with people, and maybe losing a legislative fight being a better strategy than glibly glossing over things and taking one's chances.

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