But here’s the dirty little secret: Mr. Gruber was exposing something sordid yet completely commonplace about how Congress makes policy of all types: Legislators frequently game policy to fit the sometimes arbitrary conventions by which the Congressional Budget Office evaluates laws and the public debates them.
In the case of the Affordable Care Act, that meant structuring the law so that the money Americans must pay the Internal Revenue Service if they fail to obtain health insurance under the law’s mandate is a penalty, not a tax. (The Supreme Court held that, though not a tax, the penalties were constitutional because they were an exercise of Congress’s taxing authority, which is the kind of distinction only a lawyer could come up with). That’s the reason the financial assistance the health law gives people to buy insurance is structured as a tax credit, not a direct payment, which would probably be simpler and more efficient.
And as Sarah Kliff notes at Vox, it is also why the law was structured to expand insurance coverage three years after passage. That way its cost estimate by the C.B.O. was kept under $1 trillion during the first decade after enactment. One trillion was the highest number that Democratic leaders thought was politically feasible.
This kind of gamesmanship is very much a bipartisan affair.
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