By Reid Cherlin, GQ
It so happens that I'm packing up my apartment and moving out of Washington today after eight years of residence, most of which were spent in politics and government. One of the items I just bubble-wrapped is a framed copy of the L.A. Times front page from March 22, 2010, in which I can be seen, blurrily, clapping in the background as Barack Obama watches the House pass the Affordable Care Act. In between stowing keepsakes like this, I've been taking procrastination breaks to monitor news from this week's oral arguments. The consensus seems to be that we should crap on Solicitor General Don Verrilli for struggling to defend the individual mandate.
Don is someone I worked with and respected, so I will leave dissection of his efforts to those who are farther removed and better schooled in Supreme Court procedure. But I will say this: having spent a year of my life getting paid to defend the ACA as the White House spokesman on health care, I feel for the guy. Health care reform is very much worth defending, but going about that defense is where things get, well, difficult.
It would have been easy for Verrilli -- or any of us -- to explain single-payer health care. "Look," we could have said, "the government is paying for everyone to have coverage." End of story. But single-payer is not what our brilliant, world-leading political system gave us. What it gave us is essentially a halfsy -- an extraordinarily confusing patchwork in which some novel legislative mechanisms are used to induce individuals, businesses, insurance companies, and states into doing things that add up to concrete good.
Why did it go down that way? In part because lawmakers are essentially shortsighted, self-serving, and scared of their own shadow. But there's a bigger problem: health care as a system is incredibly complicated, and also incredibly scary and off-putting for voters to think about -- which is the reason most people never want to talk about it or learn about it in the first place.
Don't believe me? Then answer me this: what's your plan's deductible for a hospital visit? You don't know, of course, even though that's critical information. Let's try an easier one: what do you pay per month for health coverage? Most people don't know that, either. All of which makes it extraordinarily hard to communicate about the ACA persuasively or effectively.
Witness the tortured, horrible quotes issued by yours truly while at the White House. Like this one, regarding an apparent loophole in the bill:
"The president has made it clear that health insurance reform legislation should prevent insurance companies from placing annual limits on health expenditures that can force families into financial ruin," said White House spokesman Reid Cherlin. "We will continue to work with Congress on this policy."
Or this one, after -- oof! -- a regulation related to the bill revived the death panels horribleness:
"This benefit was signed into law under President Bush. The only thing new here is a regulation allowing the discussions -- authorized in 2003 by the prescription drug benefit -- to happen in the context of the new annual wellness visit created by the Affordable Care Act," White House spokesman Reid Cherlin said.
Or this one, on the new Republican House majority's intent to repeal the ACA:
White House spokesman Reid Cherlin said, "We're confident about defending the law."
Or we thought we were. Whatever its downsides, the Affordable Care Act delivers some pretty serious benefits: tens of millions more Americans covered, no more getting dropped because of pre-existing conditions, closing the Medicare donut hole, slowing the explosive growth of health care costs, and on and on. It's just that it's so goddamn hard to explain the thing -- whether you're the guy answering questions from reporters or the guy answering questions from the nine justices who will decide the bill's fate.