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Who is Douglas Holtz-Eakin and why is he saying such terrible things about health reform?

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Today, the House Energy and Commerce Committee’s Subcommittee on Health will hold a hearing entitled: Unaffordable: Impact of Obamacare on Americans’ Health Insurance.  (Always nice to know that our elected representatives are keeping an open mind.)

Prominent on the list of witnesses: “Douglas Holtz-Eakin.” Even before reading his testimony, I knew what Holtz-Eakin would say: young, health Americans should brace for “sticker shock.”  Conservatives like Holtz-Eakin tend to stay on script. However stale the rhetoric, they firmly believe that if you repeat a sound-bite often enough, people will believe it.                                     

                                        Who is Douglas Holtz-Eakin?

If you recognize the name, it’s probably because Holtz-Eakin has become a familiar figure in the mainstream media, quoted in the New York Times, writing Op-eds for Reuters and Politico.com, and appearing, not only on Fox Business News, but on CNN and the PBS’ Newshour.

Alternatively, “Holtz-Eakin” may ring a bell because he served as a member of George W. Bush’s Council of Economic Advisers (CEA), and as Director of Bush’s Congressional Budget Office (CBO.)

In a remarkably candid 2011 interview, Holtz Eakin recalled his tour in the Bush administration:

“Going into the summer of 2001, things were getting worse. . . When we first went in and talked to the President, Glenn [Hubbard] and Larry Lindsey said, ‘Mr. President . . . We’re probably not going to run a surplus on budget.  We’re going to run a deficit.”

Bush’s reply: “We’re not going to run a deficit. If you come in here with a deficit, you’re both fired. Go fix it.’”

We ended up running a budget surplus of one billion dollars,” Holtz-Eakin confided, “driven by gimmicks of remarkable proportions.”
Later, Holtz-Eakin served as John McCain’s chief economic adviser during McCain’s ill-fated 2008 presidential campaign. In 2009, Holtz-Eakin consoled himself by founding a conservative think tank, the American Action Foundation (AAF).

These days, Holz-Eakin rarely mentions Bush or McCain. He prefers to be identified as “a former CBO director” as he is on the House subcommittee’s witness list. This makes him sound both neutral and knowledgeable.

This also explains how he has become a .regular source for the mainstream press, and why, when referring to the AAF,  jouranlists don’t always identify it as a “conservative think tank.”

                 The Source for Holtz-Eakin’s Testimony- A Survey of Insurers 

The testimony that Holtz-Eakin gave today is based ,on a report that he wrote for the American Action Reform in January: Insurance Premiums in 2014: A Survey. There, he argues that because the ACA “mandates” insurance and benefits, and “guarantees insurance regardless of health status,” it will force “young, healthy individuals” to subsidize “older, sicker” baby-boomers in the individual and small group Exchanges. Citing an AAF survey of insurance companies, Holtz-Eakin predicts that young Americans will see “dramatic increases” in their premiums.

                        Holtz-Eakin’s Numbers Infiltrate MedPage Today

Not long ago, a story on MedPage Today, an online newsource for clinicians, stopped me in my tracks. It reported that according to an AAF survey, in 2014 premiums for young healthy workers in the individual and small group markets, “will increase by an average of 169%. . . . To put a dollar amount on that,” the reporter continued, “the average monthly premium” in the five cities will  “jump” from $2,047 to “around $5,124.”

Hold on. If monthly premiums rise to $5,000, coverage would cost $60,000 a year!” I emailed the reporter so that he could make a correction before other bloggers picked up the bad numbers.

Then, I looked at the January 2013 AFF report. There, to my astonishment, I found the same eye-popping numbers, neatly arranged in a table headlined: “Impact on Small Group Market: Younger and Healthier Workers.”

“Somebody didn’t proof-read this table,” I thought. “These must be annual, not monthly premiums.”

                                             Readers Tespond

Comments on the MedPage post revealed that others agreed:

“JBH” wrote: “Sure hope those are annual premiums, not monthly.” Others chimed in.

But an EDITOR’s NOTE brushed them off: “Sorry, but those are, in fact, monthly figures.”

Then, another reader commented: “Be forewarned this survey comes from a conservative group that has been guilty of lying, previously. . . .See Factcheck.org” A little Googling soon uncovered a Factcheck piece about AAF headlined: “More Mediscare” .

At this point, I noticed the byline on the AAF report: “Douglas Holtz-Eakin. ” Now, I began to wonder, had the report set out to deliberately mislead readers?

                              Holtz-Eakin Plays Fast and Loose With Numbers

I knew that in the past Think Progress (a liberal blog), had  accused Holtz-Eakin of “Spreading Shoddy Research Defending Tax Breaks for Wealthy Heirs.” 

And not long ago, Paul Krugman called him out for using ”false numbers” in a Reuters Op-ed that outlined a “market-based plan”, for health care reform that supposedly would build on the Affordable Care Act. . Krugman and his co-author, Avis Roy (MItt Romney’s healcare adviser) claimed that their proposal resembled Switzerland’s health care system.

Some liberals were impressed. They thought that Holtz-Eakin and Roy had moved to the center.  “From me, no gloating, no ‘I told you so,’ no smugness,” one of my favorite columists wrote. “Instead, I feel appreciation for common sense overtaking extremism and myopia”

In fact, a close-reading of the Holtz-Eakin/Roy proposal reveals that it would “build” on Obamcare by shrinking the coverage that insurers offer, and slashing the subsidies that would help middle-class Americans afford insurance. It does not build on the ACA; it guts it.

That Holtz-Eakin is able to project a sense of “common sense overtaking extremism” is precisely what makes him so dangerous.

 Ultimately, it was left to Paul Krugman to expose the lies in the Reuter’s Op-ed:  ”the Swiss system is nothing like their description. In particular, they denounce community rating — but Switzerland has community rating!” (Insurers cannot charge people more because they are old or sick.)

Exasperated by some of the praise heaped on the conservative duo, Krugman returned to the subject in a later column:  “Look, I know that we’re supposed to be celebrating people like Holtz-Eakin and Roy for showing more intellectual flexibility than the rest of their party,” Krugman wrote.  “But I guess I find it hard to be encouraged when the supposed show of flexibility leads with grossly false and/or misleading numbers.”

Today Hotz-Eakin had the  opportunity to serve up more pseudo-facts as he testified before the House sub-committee. My favorite moment came when he suggested that when liberal states like New York introduce community rating, and prevent insurers from charging older customers 5 or 6 times more than 20-somethings,  premiums head for the heavens:  “There is anecdotal evidence,” he declared,”of premiums nearing $100,000 in New York.” He was actually suggesting that in New York State  some families pay $100,000 annually for the comprehensive insurance that the ACA mandates.

Anecdotal indeed. I Googled this absurd claim and found that it has been made more than once– but always without a source, and without a link. No wonder Holtz-Eakin decided to call the evidence ”anecdotal.”

Note to Readers: A earlier version of this post appeared on HealthInsurance.org yesterday.  To find out where Holtz-Eakin arrived at the numbers cited in the AAF survey, and what AAF had to say when MedScape sent the reporter back for a follow-up interview, click here and SCROLL DOWN TO “A MedPage Reader Spots a Tell-Tale Footnote.” Please come back here to comment.


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