Skip to Main Content

When Bad Policy Makes Good Politics: Running the Numbers on Health Reform

Online ISBN:
9780190255466
Print ISBN:
9780190255435
Publisher:
Oxford University Press
Book

When Bad Policy Makes Good Politics: Running the Numbers on Health Reform

Robert P. Saldin
Robert P. Saldin

Associate Professor of Political Science

Associate Professor of Political Science, Montana State University
Find on
Published online:
23 March 2017
Published in print:
30 March 2017
Online ISBN:
9780190255466
Print ISBN:
9780190255435
Publisher:
Oxford University Press

Abstract

Since the 1960s, America’s policymaking system has lurched from one in which leaders could simply disparage the concept of budget projections to one in which policymakers manipulate cost estimates. After rounds of good government reforms, the very rules and safeguards put in place to thwart economically unsound legislation now cause chaos by incentivizing the development of flawed, even blatantly unworkable, policies. The pathologies of the new system are illustrated by the CLASS Act and its role in aiding passage of President Barack Obama’s landmark health reform law. CLASS was supposed to address America’s serious problem concerning the availability and affordability of long-term care. A dedicated band of interest group advocates working with Senator Edward Kennedy succeeded in having CLASS become law as part of the Affordable Care Act. But when the Obama administration abandoned the program several months later, CLASS was widely derided as an unviable policy crafted by unrealistic idealists. Yet what appeared to be a naïve proposal was actually a carefully framed policy designed to fit the rules of the game, particularly the cost-projection process of the Congressional Budget Office (CBO). Although CLASS was destined to collapse into a “death spiral” requiring massive government bailouts, the CBO estimated the program would save tens of billions of dollars. These official “savings” made CLASS an attractive add-on to the health reform bill and helped facilitate its passage. Understanding why CLASS was designed in an unworkable manner but nevertheless helped ensure passage of health reform provides insight into how the contemporary policymaking process really functions and highlights its shortcomings.

Contents
Close
This Feature Is Available To Subscribers Only

Sign In or Create an Account

Close

This PDF is available to Subscribers Only

View Article Abstract & Purchase Options

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Close