Three Lies and the Ugly Truth About GOP Health Care Obstruction

According to a recent George Mason University study, the average Republican statement analyzed by nonpartisan fact-checkers is three times more likely to be declared false than true.

Republicans, therefore, are playing the inverse of a game popular with teenagers: Instead of two truths and a lie, Republicans give you three lies and then the truth. Let's play a round:

Lie #1: "Obamacare increases the deficit." If by "increase" they actually meant "decrease," then Republicans would be telling the truth. But they're not.

Lie #2: "Obamacare is unconstitutional." Saying it doesn't make it so, unless five Supreme Court justices say it too. And they don't.

Lie #3: "Obamacare creates Death Panels." Lie of the Year. Invented by Sarah Palin. Need we say more?

Truth: The GOP's goal in obstructing Obamacare is to "drive up costs." Yes, they're finally admitting it.

Bloomberg News broke the story of how a coalition of conservative organizations is opposing Obamacare implementation with the explicit goal of driving up healthcare costs for consumers. Groups like the Heritage Foundation, FreedomWorks and their GOP allies in state legislatures are attacking the health insurance exchanges - arguably the most "free market-based" creation of the entire Affordable Care Act - for the following reason:

Their goal is to limit enrollments, drive up costs, and make it easier to roll back all or part of the law later... The exchanges are intended to lower the cost of coverage by spreading the risk for insurance companies. Opponents predict that if there isn't a large enough group or mostly high-cost sick patients sign up, insurance plans won't be affordable, said Josh Withrow, legislative affairs manager for FreedomWorks. "If enough people don't get in to these exchanges, it's essentially going to be unfundable," said Withrow.

It's in this context that Republican state legislators' unwavering obstructionism of Obamacare begins to make sense. When dozens of Republican-led legislatures refused to set up health insurance exchanges under the Affordable Care Act, Republicans claimed to be curtailing federal power. But in reality, they were expanding it, because the ACA requires Washington to set up exchanges for any states that decline.

In two of the states closest to making their exchanges operational (both with Democratic majorities), the pressure of competition is already driving down insurance premiums for consumers. But instead of following the Democratic example, Republican-led states have largely chosen the path of greatest resistance - and greatest cost.

Still more Republican-led states have stubbornly refused to implement Obamacare's Medicaid expansion. They have done this despite study after study showing that, because the expansion allows federal dollars to displace state and local spending in other areas, most of these same state governments would actually save money by accepting the expansion.

But in some of the Republican holdout states, GOP legislators have devised various "alternatives" to Medicaid expansion that allow them to continue railing against Obamacare while only leaving some of their constituents out in the cold. The details vary by state, but these GOP plans all have this in common: they cover fewer people, while spending more state dollars to do it.

Wisconsin is once again the vanguard of the latest Tea Party trend. Instead of expanding the successful Medicaid program, Republican Governor Scott Walker and his rubber-stamp legislature are pushing an alternative we'll call "Scott Walkercare."

Walker initially claimed his plan would cost Wisconsin taxpayers about $3 million less than current law, but the non-partisan Legislative Fiscal Bureau (reporting, it should be noted, to a Republican majority) found that the Walker plan instead adds "an additional $49 million in costs - a swing of $52 million from Walker's estimate."

But if the comparison to current law is unfriendly to Walker's plan, the comparison to Obamacare is simply devastating: expanding Medicaid would cost Wisconsin taxpayers $253 million less than Scott Walkercare through 2020. And for the extra quarter-billion dollars Walker wants to spend, Wisconsin taxpayers would get health care coverage for 28,000 fewer Wisconsinites.

Florida House Republicans are playing Scott Walker's game as well. Despite support for the federally-funded Medicaid expansion from GOP Governor Rick Scott and the Republican-led state Senate, GOP House leaders instead offered an alternative that "uses only state money -- up to about $300 million a year -- to provide basic health coverage to 130,000 people." Accepting Medicaid expansion, by contrast, would cover up to ten times as many Floridians at a savings of $100 million annually.

And then there's Michigan. Michigan Republicans have so far ignored Republican Governor Rick Snyder's call to accept Obamacare's Medicaid expansion, which would provide $1.2 billion in savings to the state budget and create 18,000 new jobs. But the GOP alternative embraces an idea that was once used mercilessly - and with no basis whatsoever - to savage the President and his plan: rationing.

Michigan Republicans instead proposed limiting residents to four years of Medicaid coverage in their entire lifetime.

Under "Bolgercare" (we'll call it that because GOP House Speaker Jase Bolger is the idea's most prominent backer), Republicans wanted to extend "other limits on cash welfare, food stamps, unemployment insurance and housing assistance" into the health care arena - effectively declaring that if cancer, diabetes, and other chronic conditions (which make up the bulk of Medicaid spending) don't simply go away because Jase Bolger says so, then low-income residents suffering from them are flat out of luck.

More federal power? More government spending with less to show for it? Rationing and "death panels"? How did the Republican Party come to embody everything they claimed to hate about Obamacare?

It happened because the Republican attacks on Obamacare were false to begin with, so by every objective measure they used to savage the President's plan, the Republican alternatives couldn't help but fare worse.

Republicans' one remaining hope is to raise health care costs through their own obstruction, and then hope the President takes the blame. But what was once a secret strategy is now out in the open.

The game is up.