Does America Trust Barack Obama?
The Obamacare rollout saw public views of the president's trustworthiness reverse. This could seriously undermine the rest of his presidency.
Of all of Abraham Lincoln’s profound observations about politics and life, one in particular, uttered on September 2, 1858, in Clinton, Illinois, captures the essence of representative democracy: "You may fool all the people some of the time; you can even fool some of the people all the time; but you can’t fool all of the people all of the time." This sprightly aphorism distills to its essence Lincoln’s belief that the collective judgment of the electorate is essentially sound—perhaps not in every instance or in whole, but over time it is sufficiently sound to protect the foundations of the nation. Democracy works because it is in the hands of the people.
Less well known is the statement uttered by Lincoln to introduce his famous dictum: "If you once forfeit the confidence of your fellow citizens, you can never regain their respect and esteem." Put the two together, as Lincoln did, and you get a sense not only of the futility of trying to fool the American people but also the danger posed to any politician who tries it.
Which brings us to Barack Obama. His presidency is in freefall, and there is strong evidence that the freefall is related to the ever-dangerous issue of trust. In June 2012, a Gallup poll suggested that 60 percent of the American people considered Obama "honest and trustworthy." A Quinnipiac University poll asking the same question last month showed that only 44 percent viewed him as honest and trustworthy. Fully 52 percent said he wasn’t.
What happened? Most political observers and commentators have attributed this ominous development to Obama’s repeated assurances to the American people that, under his Affordable Care Act, they could keep their doctors and insurance plans if they liked them. He often added the word "period" at the end of his promise for added emphasis, as a way to highlight the potency of his word. But his word proved unreliable when millions of Americans in the individual health insurance market, lost their health plans and doctors as a result of provisions of Obama’s signature legislation.
No doubt this contributed mightily to Obama’s loss of credibility among his constituents, and evidence that the White House knew Obama’s assurances were empty adds force to what was a serious presidential lapse. But the episode also seems to reflect a broader political attribute of this president that is catching up with him in his second term: he has not always been candid with the American people about his true goals and aims.
Let’s start with the promise that Americans could keep their health plans if they liked them. Back in early November, the Wall Street Journal interviewed more than a dozen administration officials involved in crafting and selling the president’s health plan. What emerged was a picture of a government seeking to finesse the reality, apparently well understood by administration officials at the time, that Obama’s health legislation would obliterate many individual plans, thus forcing those insured persons to seek other options.
The Journal piece describes Obama officials seeking to reconcile that looming reality with the political need to assure Americans that their lives wouldn’t be disrupted by the legislation. As the paper put it, "Officials worried…that delving into details such as the small number of people who might lose insurance could be confusing and would clutter the president’s message." But that "small number" turned out to be 10 million, hardly a politically insignificant figure and certainly not insignificant when weighed against the president’s firm assurance, with the "period" attached at the end.
Even more disturbing is the evidence that the Obama plan’s architects fully intended all along to force those people out of their individual plans and into the subsidized Obamacare exchanges, to bolster the risk pools of the exchanges. A Journal editorial in late October quoted extensively from the "regulatory impact analysis" of the Department of Health and Human Services, published in the Federal Register. This document gives the game away.
HHS made clear that any change whatsoever in any individual plan—even a small copay increase—would trigger a need for the plan to be rewritten in compliance with HHS’s stringent plan requirements. The document speculated that 40 to 67 percent of individual plans wouldn’t make the cut and would thus have to be altered. As HHS explained, it wanted to prevent those individual insurance policies "from being bought and sold as a commodity in commercial transactions." The hallmark of these plans was flexibility—people could craft plans to meet their particular circumstances and budgets.
That’s precisely what HHS wanted to thwart because its philosophy favored "a small number of meaningful choices," as the HHS document put it. It added that allowing the old plans to continue "would have allowed extremely wide variation across plans in the benefits offered" and "would not have assured consumers that they would have coverage for basic benefits."
In other words, HHS wanted to herd people into large insurance pools through a forced conformity to a very small range of options. Then healthy young people, for example, who might want a simple catastrophic plan with high deductibles would be forced into broader insurance pools with more coverage that they really wanted—but with their premium payments going to pay for the insurance of older and less healthy people whose needs were far more expensive.
All this was well understood by Obama and his people throughout the legislative and rules-writing processes, but they finessed it. Obama sought to fool people into thinking his big health program wouldn’t affect them if they didn’t want to be affected. By the time they understood otherwise, it would be too late. That’s a pretty stark disregard of the Lincoln dictum about how democracy works.
And there’s more to come. Grace-Marie Turner, president of the Galen Institute and a leading Obamacare critic, has identified a number of looming results from the president’s legislation. They include:
● big increases in premium costs stemming from the law’s mandates regarding the percentage of average health costs that insurance must cover; those who opt for lower premiums will see whopping new deductibles (the money spent on health care before insurance kicks in). Turner cites a Chicago Tribune study indicating that twenty-one of twenty-two low-cost Illinois exchange plans offered in Cook County have annual deductibles of $4,000 for individuals and $8,000 for families.
● growing incidence of people simply walking away from their health plans because of premium and deductible sticker shock, thus threatening the risk pools for remaining enrollees who are most in need of expensive health care.
● diminishing job creation as companies remain under the fifty-employee floor for applicability and convert full-time employees, who are covered under the law, to part-time employees, who aren’t.
● big penalties for those who come under government scrutiny because they took health-cost subsidies for which they were ineligible, either because their financial circumstances changed in the interim or because they didn’t fully understand the law’s complex requirements.
All of this is in the future, and much of it could further undermine Obama’s political credibility on the issue. By forcing his cherished health plan through Congress in the face of widespread evidence of its unpopularity, he put himself in a political position necessitating that he finesse many of the realities surrounding the legislation. He tried to fool too many people too much of the time. Whether Lincoln’s introductory dictum will apply here as well remains one of the most powerful questions hovering over the Obama presidency in the final three years of his tenure.
Robert W. Merry is political editor of The National Interest and the author of books on American history and foreign policy. His most recent book is Where They Stand: The American Presidents in the Eyes of Voters and Historians.