- - Monday, September 28, 2015

Recently Meg McArdle wrote a piece for Bloomberg View about GOP alternatives to the Affordable Care Act.

While most will read the article and come to a conclusion about the content, the real story, the real action, is in the comment section. It’s in the comment section where you learn not what the article says, but more importantly what people think it says and means. And it’s in the comment section where you also find out what people really know, what they think they know, and why they think they know it about existing policy.

For example, there’s a commenter ru56by who was extremely critical of the GOP alternatives noted by Ms. McArdle. This commenter stated that there was “no provision to pay for it … ” Since this person is critical of the GOP alternative of how they would pay for the ACA replacement, it could be assumed that the commenter has a complete understanding of how the ACA is actually paid for.

So I asked the obvious question of ru56by: “Do you know how the ACA is paid for?” The answer, as expected, focused on Medicare cuts and the surtax on high cost plans — also known as the Cadillac tax. However, along with that answer about the Cadillac tax came this most revealing tidbit: “Scott Walker proposes to do away with the the (sic) tax exemption on employee income used to purchase health insurance through their employer. I don’t know about you, but that would be a $6,000 tax increase to me.”

So the GOP plan ends the tax exclusion but the ACA does not. Really?

This comment best exemplifies the beauty of progressive policies and the corresponding media coverage. Nobody knows who pays for the ACA and they won’t know they’re paying for the ACA until it’s too late to act. In this case, the person paying for the ACA is in fact ru56by. He just doesn’t know it yet.

After a rather long explanation as to how the Cadillac tax really works, that it was designed to wipe out the tax break he gets for his employer sponsored plan by forcing employers to stop offering plans and replace that tax free benefit with a taxable wage, this self described well informed commenter fired back with both barrels: “Walker’s proposal taxes dollar one of an employer policy. Ryan’s budget eliminated half the tax subsidy. You obviously don’t know what you’re talking about.” (Emphasis added.)

After another attempt to straighten out our friend ru56by, both barrels were again fired: “your responses are uninformed nonsense.” (Emphasis added.)

This led to a final effort to inform ru56by, an effort that included listing multiple documents and videos showing that the Cadillac tax does in fact wipe out the tax exclusion currently enjoyed by ru56by, the very same tax exclusion he’s so angry about losing as part of the GOP alternative. Included in this list of references are videos of explanation from Zeke Emanuel and Jake Tapper.

This time the response was a Howitzer: “I don’t need to watch propaganda videos. I have an education and make it a point of being informed on a topic before shooting off my mouth. You should try it.”

Yes, Zeke Emanuel and Jake Tapper clearly are putting out Conservative propaganda. (Sarcasm clearly intended.) 

This leads to the political problem of repealing and replacing the ACA. Right now the typical working person, across all income classes, does not realize that they are actually a target of the Affordable Care Act’s Cadillac tax. A recent article written by Forbes contributor Howard Glickman in favor of keeping the cadillac tax notes that repealing the tax would offer a tax cuts as follows:

So how is it possible that repealing the Cadillac tax provides tax relief across all income classes yet it is not even widely understood that the Cadillac tax causes additional tax liability across all income classes? Even after Grubergate the American people do not know that in the game of “pin the tax on the donkey,” they’re actually the donkey.

The imposition of the Affordable Care Act on the American people was one of the greatest sales jobs by perhaps the greatest sales team of all time. And it was all done with the help of a complicit media. People are convinced beyond all reason, beyond all evidence, that the law helps others but has no negative impact on them. This was the exact purpose of the statement: “If you like your company plan, you can keep your company plan.” That slogan is simply not factually correct.

Any plan to repeal and replace this law must first include a re-education program for the American people. It must first be learned and completely understood that we’ve been lied to and that we are going to lose our company plans as we know them, pay more taxes and be responsible for greater out of pocket costs. Only then will it be understood why some if not all of the ACA must be replaced.

That process will take extremely strong leadership and the help of the media. Without those two factors, people like ru56by, people who assume themselves to be educated and informed (“I have an education and make it a point of being informed on a topic before shooting off my mouth. You should try it.”), will fight such a proposal to the end and beyond as a matter of health care policy.

The problem we have right now is that our leaders lack integrity. When I’ve been asked about health care policy, my answer is very consistent: “Honesty is the best policy.” The wonks and the media should not be hiding the true nature of the Cadillac tax from the American people. Nobody ever disagrees with me on that point.

We haven’t had a whole lot of honesty in this country for a long time. We need to find one honest person, a person of integrity, to lead the charge. We the people are tired of the Washington games. We’re tired of the wordsmiths, the carefully written speeches that are long on qualifiers and short on substance. We deserve better.

This country is ready for a change, real change. There can be no more “lack of transparency is a huge political advantage.” We’re $20 trillion in debt and at each others’ throats. Enough is enough.

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