Blast from the Past: Campaign Rhetoric vs. Policy Reality, a study in irony

Shoutout to James Medlock for digging up this relic from the 2008 Presidential primariy race: A lit piece from then-Senator Barack Obama's campaign slamming then-Senator Hillary Clinton over her insistence on her proposed healthcare policy bill including an Individual Mandate Penalty. How many Republican talking points can you spot below?

There's a lot going on here. For starters, the couple on the first page are basically 2008 versions of "Harry & Louise"...it's a white, middle-age, middle-class suburban couple poring over their finances. Considering that the 1993 "Hillarycare" proposal was destroyed in large part due to the health insurance lobby's successful series of Harry & Louise "there's got to be a better way" ads, Obama using this same tactic had to sting.

Second, the "...even if you can't afford it" slam is included no fewer than five times. I'm pretty sure Hillary's 2008 primary campaign proposal included some sort of affordability waiver (the final version of the ACA lets you off the hook if the lowest-price ACA-compliant policy costs more than 8.3% of your household income), in which case the "even if you can't afford it" attack was either false or at least disingenuous depending on your point of view. I don't recall the exact details of Hillary's 2008 proposal, however, so it's possible that it didn't include such a waiver (or if it did, that it was set at a higher threshold than Obama's).

After the primary was over and Obama won the general election and became President, of course, he eventually conceded Hillary's point and the version of the ACA which actually passed did include a coverage mandate requirement/penalty after all. In fact, this makes the zeroing out of the ACA individual mandate penalty by the GOP in December 2017 incredibly ironic, since in doing so, they actually made the ACA more like the original version of "Obamacare" in the process.

Here's another nice catch by Akaash Kolluri: The flyer above is also the one which infuriated Hillary Clinton and led to her infamous "Shame on you, Barack Obama!" line at this rally on February 23, 2008:

My point in posting this isn't to relitigate the 2008 primary or the 2016 primary between Hillary and Bernie. I'm simply pointing out that once again, actual legislation usually ends up quite different from the original concept...and that's not necessarily a bad thing.

Both Obama and Hillary's 2008 healthcare proposals during the primary likely went through several drafts along the way. Obama's proposal went through changes between the primary and the general election. The House and Senate versions which eventually passed went through further changes in the various committees and the full Congressional votes, as well as each other...and the final version which was actually signed by Obama in March 2010 was different still.

Even then, the law as implemented went through further changes, including things like the HHS Dept. issuing a "grandmother" extension of non-ACA compliant policies after the "you can keep it" backlash; SCOTUS ruling that Medicaid expansion had to be optional for states, the Risk Corridor Massacre, Trump cutting off CSR payments, the repeal of the mandate penalty itself and so on.

Some of the changes along the way improved the law; most made it worse. Some were done reluctantly in order to get it to pass; others were done deliberately in an attempt to sabotage its effectiveness.

My larger point, as I noted a few weeks back, is that when debating healthcare policy differences (or any other topic, really), it's important to remember that not every difference of opinion is based on malice or evil intent. Virtually ALL Democrats agree that universal, quality, affordable healthcare coverage is the goal. The main differences are about how to achieve it.