Introduction

House Budget Committee Chairman Rep. Paul Ryan, R-Wis. listens as Congressional Budget Office (CBO) Director Douglas Elmendorf testifies on Capitol Hill in Washington, February 2014, before the committee. Adding fresh fuel to the political fight over “Obamacare,” Republican lawmakers have seized on a Congressional Budget Office report that predicts nationwide job losses because of the health care program. J. Scott Applewhite/AP

If you’re curious about what I used to do as a PR guy for the health insurance industry, how I often took facts and figures and twisted them to advance a specific political or financial agenda, take a look at the behavior of some members of Congress last week.

Like I used to do, they took numbers in a report from a government agency — in this case the nonpartisan Congressional Budget Office — and twisted their meaning to suggest something never intended by the report’s authors. Like I used to do, they misled the public with statistics to advance their team’s ultimate agenda, which, of course, is to win votes in November. And if getting people to vote against their own best interests means making comments that not only are dishonest but also contradict what they’ve said previously, so be it.

I have to wonder if, also like my former me, they have trouble sleeping at night.

At issue is a section of the CBO’s 10-year budget and economic outlook, which was released last Tuesday. The agency’s economists updated their previous estimates that 800,000 fewer Americans might be working in 2017 because of the Affordable Care Act than would have been the case if Congress had not passed the law. The economists now believe that the number might actually be closer to 2 million and maybe 2.5 million by 2024.

The CBO never suggested that those jobs would be “lost” or that hundreds of thousands or millions of people would be laid off because of Obamacare. Rather, the law is expected to reduce the labor participation rate, meaning that many people will choose of their own free will not to stay in jobs because they need the health insurance.

Over the years, both Democrats and Republicans have pledged to support efforts to eliminate what has come to be known as “job lock,” a phenomenon unique to the U.S. employer-based health insurance system. What “job lock” means is that people stay in jobs they often hate, usually at big corporations, out of fear that they might not be able to find affordable coverage if they quit, even to take a job at a smaller company.

For decades, big employers that provide health coverage in this country have had an advantage over smaller employers that can’t afford to offer subsidized benefits. They’ve been able to attract workers who might prefer to work for a small business — or start a business of their own — but decide against it solely because of health insurance.

And in a system like ours in which millions of people every year lose their health insurance when they get laid off, big employers to a large extent have been the ultimate deciders when it comes to who will be able to keep their health insurance and who will lose it.

As a consequence, most of us with employer-based coverage have always been just one layoff away from joining the ranks of the uninsured. Millions of us join those ranks every year because our employers decide our services are no longer needed.

As Rep. Paul Ryan of Wisconsin, the 2012 GOP vice-presidential nominee, said during the Congressional debate on health care reform in 2009, “the key question that ought to be addressed in any health care reform legislation, is are we going to continue job lock, or are we going to allow individuals more choice and portability to fit the 21st century workforce?”

The Affordable Care Act, by changing the health insurance marketplace to make it more consumer-friendly and a little less insurance company-friendly, essentially does exactly what Ryan said should be health reform’s most important goal: it ends job lock.

But last week, after the CBO report was released, Ryan — surprise! — changed his tune. He suggested that Obamacare was encouraging people “not to get on the ladder of life, to begin working, getting the dignity of work, getting more opportunities, rising the income, joining the middle class.”

Republican Sen. Lindsay Graham of South Carolina tweeted: “Obamacare will cost our nation about 2.5 million jobs and increase the deficit by $1 trillion.”

The next day, CBO director Doug Elmendorf said in testimony before the House Budget Committee, which Ryan chairs, that Obamacare critics were misrepresenting the data.

“The reason we don’t use the term ‘lost jobs’ is there is a critical difference between people who like to work and can’t find a job — or have a job that’s lost for reasons beyond their control — and people who choose not to work,” he said.

Despite Elmendorf’s clarification, and the Obama administration’s efforts to set the record straight, we can expect the spin to continue. Don’t be surprised to see campaign ads later this year saying that Obamacare will cost 2.5 million jobs, with the CBO cited as the source.

And you can expect millions of Americans to be influenced by the intentional misrepresentation of facts and figures during the next election. But don’t expect those politicians purposely twisting the record to lose any sleep over it.