Introduction

One of the reasons Americans are still confused about the Affordable Care Act is the ongoing misrepresentation of the law by members of Congress who voted against it. This obfuscation isn’t confined to what the law actually does or doesn’t do, but also to what impact it might have on the federal deficit in years to come, as a vocal critic of the law demonstrated last week.

Jeff Sessions of Alabama, the senior Republican on the Senate Budget Committee, recently asked the nonpartisan Government Accountability Office to look decades into the future and let him know if the reform law will cut the deficit over time, as President Obama says it will.

The GAO got back to Sessions last week with budgetary simulations showing that the ACA will indeed reduce the deficit if it’s implemented as Congress intended.

Probably anticipating that answer, Sessions asked the GAO to do an alternative simulation showing what might happen if the law isn’t implemented as Congress intended. What would happen, in other words, if future lawmakers repeal all of the cost-saving and revenue-generating provisions of the law or phase them out?

It doesn’t take an army of actuaries to figure out that if the parts of the law expanding coverage go forward, but the parts that pay for it or that reduce spending do not, Obamacare will add to the deficit.

Within hours of getting the report, Sessions accused President Obama of misleading the country. Obamacare, he said, will add a whopping $6.2 trillion to the deficit.

What Sessions was doing was engaging in a practice common in politics and propaganda — “statisticulation.” If you haven’t come across that word before, check out How to Lie with Statistics by Darrell Huff, a classic that’s as relevant today as it was when first published in 1954.

“Misinforming people by the use of statistical material,” Huff wrote, “might be called statistical manipulation; in a word: statisticulation.”

Statisticulation is an apt description of what the senator was doing with the GAO report. He was disclosing only the data that would support his assumptions. The truth is that it would take a scenario in which future Congresses repealed or phased out the deficit-reducing sections of the law — or all of them failed completely — for the $6.2 trillion addition to the deficit to be realized. And even if all that happened, that $6.2 trillion, which came from Sessions’ staffs’ calculations, not the GAO report, would be spread out over 75 years. That’s right. Three-quarters of a century.

Sessions did not disclose the GAO simulation showing that Obamacare will lead to a decline in the deficit over the same time frame if it is implemented as Congress intended, with the cost-cutting and revenue-generating provisions intact.

The GAO report stated that, “The primary deficit declined 1.5 percentage points as a share of GDP over the 75-year period in this (GAO’s Baseline Extended) simulation.” But somehow those words didn’t make it into Sessions’s disclosure. He disclosed only the alternative simulation. And he made certain to disclose it several hours before the GAO made the report available to the press and the rest of the world.

As a result, several reporters became accomplices, wittingly or unwittingly, to the Sessions nonsense.

“Obamacare will increase the long-term federal deficit by $6.2 trillion, according to a Government Accountability Office (GAO) report released today,” said the conservative National Review Online. No surprise there.

But there was this from The Hill: “The Senate Budget Committee’s top Republican said a new government report shows that President Obama’s healthcare law will add $6.2 trillion to the deficit over the next 75 years.” The story quoted Sessions as saying that the report “reveals the dramatic falsehoods that were used to push [the bill] to passage.”

It was not until the 5th paragraph that we learned that apparently no one at The Hill had seen the actual report yet: “’The GAO will release its report later Tuesday,’ according to Sessions’s staff.”

Among the few in the media who cried foul was Dr. Aaron E. Carroll, director of the Center for Health Policy and Professionalism Research and associate director of Children’s Health Services Research at Indiana University School of Medicine. He wrote in a post on The Incidental Economist web site that Sessions’s selective disclosure represented “a worst-case-scenario” that would only come to pass “if (1) we left in all the spending, (2) all of the cost control measures utterly failed, and (3) we removed all of the revenue streams/taxes. If you do that, then the bill raises the deficit $6.2 trillion over 75 years.”

Carroll noted, however, that it would take “an actual act of Congress” for that scenario to play out.

“Many of the taxes and cost control measures will only go away if people like Sen. Sessions actually vote to strip them from the ACA,” he wrote. “We won’t see these worrisome results because of the law. We’ll see them if Congress changes it.”

The GAO report noted that even under the most optimistic simulation, the country’s spending on health care is not sustainable over the long haul. More will have to be done in the future. But the ACA, if done right, is a start.