Saturday, November 25, 2017
Politics

PolitiFact Florida: Rick Scott misrepresents the bipartisan origins of Obamacare

RECOMMENDED READING


Donald Trump's White House win gave Florida Gov. Rick Scott a powerful ally in his fight against Obamacare.

The former hospital executive reiterated his 2010 campaign pledge to fight for repeal of the federal health care law in a recent USA Today op-ed.

"Other than President Obama and a few stragglers, everyone now realizes that Obamacare was a terrible notion," Scott wrote. "It was sold on a lie. It was invented by liberal academic theorists who have no interaction with real families and businesses, and therefore it doesn't work."

Scott's piece misleads readers about the origins of the Affordable Care Act of 2010. It is based on ideas from not just Democrats, but also Republicans.

"Scott's comment is so sweeping that it's hard for it to be anything other than an exaggeration," said Gail Wilensky, who ran Medicare and Medicaid under President George H.W. Bush.

The "liberal academic theorists" in question, Scott's spokeswoman said, are MIT economist Jonathan Gruber, Harvard economist David Cutler and Ezekiel Emanuel, who is now chairman of the Department of Medical Ethics and Health Policy at the University of Pennsylvania.

We interviewed all three about their role in the health care law and with President Barack Obama.

Gruber developed the economic model for the law, earning him the most media attention of the three. He was instrumental in helping Massachusetts create its law, and the federal government contracted with Gruber to provide technical assistance.

The national law was patterned after the Massachusetts version. Both require everyone to have health insurance or pay a penalty, leave the current insurance system in place, and expand coverage for the uninsured through subsidies or Medicaid.

Media reports often refer to Gruber as the "architect" of the Affordable Care Act, but others who worked on the legislation dispute that characterization. Gruber's involvement with his economic model was important, but he didn't determine what policies made the cut, said John McDonough, a Harvard health policy professor who was a senior adviser to the Senate Health and Education Committee when the law was written.

As for Cutler, he appears to have had the least to do with the law. Scott's spokeswoman pointed to an October article in Politico referring to him as a "key architect" of Obamacare. But most articles we found described him as a health care adviser on Obama's 2008 campaign and an advocate of the law.

Cutler told us that he did speak with members of the Obama administration, Congress and interest groups, but "I did not serve in the administration and never wrote a line of the ACA."

Emanuel was more involved in the law as a paid special adviser for health policy to the director of the federal Office of Management and Budget from 2009 to 2011.

Emanuel now works at the University of Pennsylvania, but he wasn't working in academia while he worked for OMB. (His brother Rahm was Obama's former chief of staff.)

Emanuel worked on a lot of the details of the bill, he said, including subsidy levels.

Bipartisan roots

The fact that two of the three experts Scott had in mind have ties to the law does not change the inaccuracy of his point.

The backbone of Obamacare started forming amid earlier attempts to overhaul the health system, including by Bill and Hillary Clinton.

Their proposal for universal health care prompted Republicans to come up with an alternative in 1993. While as a party Republican senators never reached consensus, Republican Sen. John Chafee of Rhode Island introduced a bill with 18 Republican co-sponsors (although some later withdrew) and two Democrats as co-sponsors.

Chafee's bill had similarities to Obamacare. It included an individual mandate, created purchasing pools, standardized benefits, vouchers for the poor and a ban on denying coverage due to pre-existing conditions.

Another key player was the conservative Heritage Foundation, which advocated for health insurance exchanges including when Massachusetts, led by a Democratic Legislature and Republican Gov. Mitt Romney, crafted its own law in 2006.

Jonathan Oberlander, a health care policy specialist at the University of North Carolina at Chapel Hill, said some, but definitely not all, of the federal health law's creators were liberal academics.

"There were many cooks in this kitchen and these ideas were generated over a long period over time," he said. "In many respects the ACA's design and some of its major policies embodied what used to be core tenets of GOP philosophy on health care."

Scott's statement contains an element of truth but ignores critical facts that would give a different impression. We rate the claim Mostly False.

Edited for print. Read the full version at PolitiFact.com/florida.

Comments
Hillsborough Democrats have everything going for them except history

Hillsborough Democrats have everything going for them except history

TAMPA — For 15 years, Republicans have held a majority of seats on the Hillsborough County Commission.It’s the longest stretch one party has controlled the board since a corruption scandal expanded the body to seven members in 1985.But all five Repub...
Updated: 5 hours ago
Flynn may be moving to cooperate with Mueller’s Russia probe

Flynn may be moving to cooperate with Mueller’s Russia probe

WASHINGTON — In a move that could signal cooperation with the government, lawyers for former national security adviser Michael Flynn have told President Donald Trump’s lawyers that they are no longer communicating with them about special counsel Robe...
Published: 11/24/17
Trump wants to end welfare as Bill Clinton knows it

Trump wants to end welfare as Bill Clinton knows it

WASHINGTON — Overhauling welfare was one of the defining goals of Bill Clinton’s presidency, starting with a campaign promise to "end welfare as we know it," continuing with a bitter policy fight and producing change that remains hotly debated 20 yea...
Published: 11/24/17
President Trump presents his report card, passes with flying colors

President Trump presents his report card, passes with flying colors

PALM BEACH — President Donald Trump has a Thanksgiving Day message for the nation: Look at all I’ve done. Trump is telling followers in an early-morning holiday tweet that, "your Country is starting to do really well." He says: Jobs are "coming back,...
Published: 11/23/17
As rules change, many Florida immigrants face a choice: Do they stay or go?

As rules change, many Florida immigrants face a choice: Do they stay or go?

Lys Isma was born in Haiti, but she’s used to driving in Miami with a license, going to college and living without fear of being deported.The Florida International University biology student has lived in Florida since she was 9 months old. Undocument...
Published: 11/22/17

Top Trump staffers failed to file financial reports on their way out the door

WASHINGTON — President Donald Trump’s top aides — including chief of staff Reince Priebus and foreign policy adviser Sebastian Gorka — failed to file legally required financial reports after they were dismissed this summer, according to government re...
Published: 11/22/17
William March: Lee says lieutenant governor should work for a living and get a vote

William March: Lee says lieutenant governor should work for a living and get a vote

It’s an old joke that Florida’s lieutenant governor, with no duties specified in the state Constitution except to fill in if the governor is disabled or dies, has little to do except monitor the governor’s health. State Sen. Tom Lee, R-Thonotosassa, ...
Published: 11/22/17
Trump calls father of freed UCLA player an ‘ungrateful fool’

Trump calls father of freed UCLA player an ‘ungrateful fool’

Associated PressPALM BEACH — President Donald Trump started off his first day of Thanksgiving vacation by resuming his taunts of the father of a UCLA basketball player detained for shoplifting in China, saying Wednesday that he was an "ungrateful foo...
Published: 11/22/17
Trump speaks up for Moore, warns against his ‘liberal’ rival

Trump speaks up for Moore, warns against his ‘liberal’ rival

WASHINGTON — Silent for more than a week, President Donald Trump all but endorsed embattled Alabama Republican Senate nominee Roy Moore, discounting the sexual assault allegations against him and insisting repeatedly that voters must not support Moor...
Published: 11/22/17
Trump offers support for Moore in Alabama Senate race despite misconduct allegations

Trump offers support for Moore in Alabama Senate race despite misconduct allegations

WASHINGTON - President Donald Trump on Tuesday appeared to offer support to Republican candidate Roy Moore in the Alabama Senate race, saying the former state judge "totally denies" allegations that he sexually molested underage girls years ago."He d...
Published: 11/21/17