Facebook Twitter Tumblr Close Skip to main content
A Project of The Annenberg Public Policy Center

‘Cassidycare?’ Come On!

A Democratic TV ad makes some audaciously false claims about Rep. Bill Cassidy, Louisiana Sen. Mary Landrieu’s main Republican opponent:

  • It claims Cassidy once sponsored a bill to set up “government-run health care” in the state. That’s pure invention; Cassidy’s bill did nothing of the sort.
  • And it says he argued for “automatic Obamacare registration,” when he didn’t. Cassidy actually called for repealing the law — and enrolling the uninsured in a scaled-back GOP alternative.

The attack ad began airing June 7. It is sponsored by the Senate Majority PAC, a big-donor super PAC bent on keeping Democrats in control of the U.S. Senate. But from the way the ad slams Obamacare, a viewer might be forgiven for thinking it was the work of the Koch brothers or Karl Rove.

‘Obamacare Lite’?

The narrator says, “Cassidy wrote a plan for Louisiana that’s been called ‘Obamacare lite.’ ” That’s true as far as it goes. One opinion columnist for the Baton Rouge Advocate did call Cassidy’s bill — not very accurately — “Obamacare lite.”  The columnist also predicted — more accurately — that Democrats would use the bill against Cassidy in this year’s U.S. Senate race.

But there’s simply no support for the ad’s claim that “Cassidycare would have created government-run health care in our state, with government bureaucrats making medical decisions.” There’s simply nothing like that in the bill.

The ad refers to S.B. 307, a bill that Cassidy introduced in 2007 when he was a Louisiana state senator — long before “Obamacare” was a word, and even before Obama had announced he would run for president. Cassidy’s bill had one pale similarity to what eventually became the federal Affordable Care Act — it would have set up something called a “Louisiana Health Insurance Exchange” within the state Department of Insurance.

Nothing Like Obamacare

But Cassidy’s state-run exchange would have been nothing like the ACA.

Cassidy’s proposal didn’t include subsidies for low-income people, wouldn’t have required individuals to obtain coverage or have required employers to provide coverage, didn’t set any requirements for what health insurance must cover, and didn’t include any new taxes or fees. And it didn’t include any new regulations on doctors, hospitals or patients, contrary to the ad’s claim that it amounted to “government-run health care.” The ACA, of course, isn’t “government-run health care” either, despite the many times Republicans have tried to brand it as such.

Instead, Cassidy’s proposed exchange would have been a “clearinghouse” for negotiations among parties in the insurance market. The actual language of the rather brief, 22-page bill described the “primary responsibility” of the new exchange as being “to promote and assist such an individual, person, business, state or local government, association and other juridical entity seeking health insurance coverage and any insurer to negotiate and transact a suitable contract or agreement between the parties to provide such coverage.”

It is conceivable — barely — that Cassidy’s bill could eventually have led to something in Louisiana resembling the Massachusetts health care law that then-Gov. Mitt Romney had signed into law the previous year, in 2006. The bill would have required state officials to come up with a set of “reform” proposals to present to the Legislature in 2008, designed to “provide health insurance coverage to each citizen of this state.”

But believing that Cassidy’s bill could have led even to “Romneycare lite” in Louisiana requires a heavy dose of speculation. The bill didn’t specify how the goal of universal coverage should be reached, and the possibility of a mandate for individuals to obtain coverage — the central element of both “Romneycare” and “Obamacare” — wasn’t even among the several ideas the bill would have required state officials to study and evaluate before coming up with their health care plan.

Cassidy’s bill would have required state officials to “[e]valuate demonstrated and verifiable successful reform experience of other states” — presumably including Massachusetts — and it required officials to consider “possible waivers” for Medicaid as one way of funding any proposed changes, as Romney did in Massachusetts. The bill also would have required state officials to “[e]xplore the use of tax credits, vouchers and health insurance premium assistance.”

But exploring, evaluating and studying possibilities is a far cry from proposing anything. And the ideas weren’t limited to elements later adopted by the ACA. One of the means to be studied — the idea of “tax credits” — was soon being embraced by the GOP’s 2008 presidential nominee, Sen. John McCain, as a Republican alternative to the outright subsidies contained in the ACA. Does that make Cassidy’s bill “McCain-care lite.” Of course not.

As it happened, Cassidy’s bill led to nothing. It died quietly in committee without receiving even so much as a public hearing.

A Republican rival to Cassidy, Rob Maness, also pointed to a bill he co-sponsored with another senator in 2008 — S.B. 535 — which would have required group insurance policies for businesses with fewer than 50 employees to cover treatment for mental illness, alcoholism and drug abuse. But that’s hardly comparable to the much broader coverage requirements of the ACA.

Furthermore, Cassidy’s 2008 bill called for a tax credit to offset the added premium costs to businesses (estimated to be between $67 million and $199 million by 2013), and it would not have become effective without such a credit. As it happened, his proposal was defeated on the Senate floor by a vote of 13 to 24.

Cassidy, when rival Republicans brought up the “Cassidycare” allegation, issued a strong rebuttal:

Cassidy: The program I proposed is similar to other Republican programs. It was voluntary, market-based and meant to give people other options. President Obama’s law, passed by Democrats on a party-line vote, is enforced by the IRS, dictates benefits and requires participation under penalty of law. By definition, it’s not market based. To compare one to another is like comparing crony capitalism to capitalism. Anyone who thinks these bills are similar either does not understand their intent or hasn’t read them.

Having read and studied these two bills, we agree that they’re nothing like a “lite” version of the Affordable Care Act.

‘Automatic Obamacare Registration’?

The Senate Majority PAC ad further claims that “Cassidy even said the government should automatically register us in Obamacare if we don’t sign up.” On screen appear the words “automatic Obamacare registration,” as though Cassidy favored dragooning everybody into the exchanges. But that isn’t true either.

The ad refers to remarks that Cassidy made March 20 to the Louisiana Oil and Gas Association. An audio recording of those remarks was obtained by the website Buzzfeed, which posted it March 26. In those remarks, Cassidy does indeed argue for automatically signing up uninsured people — for his own Republican alternative to the ACA.

The recording starts with Cassidy responding to a question, which he summarizes: “If you [Cassidy] don’t like the president’s law, what would you do differently?” And, “What would be my solution?” He answers that by describing an alternative plan in which everyone below a certain income level would receive a health savings account, a policy to cover “catastrophic” costs over a certain amount, and “a pharmacy program.” He adds, “It wouldn’t have all these benefits that we have to pay so much for” under the ACA.

In the recording, Cassidy then turns to “other things I would do,” and argues that the uninsured tend to be unable to grasp the complexities of choosing insurance coverage. Democrats have said this insults uninsured Louisianans, so we’ll quote the relevant portion in full:

Cassidy, March 20: Insurance people they will tell you that they will go to a company and the employer will pay for everything, and there are some people who will not sign up. Turns out, those are my patients. They’re illiterate. I’m not saying that to be mean. I say that in compassion. They cannot read. The idea they’re going to go on the Internet and work through a 16-page document to put in their data and sign up does not reflect an understanding of who is having the hardest time in our economy.

And he concludes, “Instead of saying, listen, you’ve got to log-on, you just make it an opt-out. Everybody’s in, unless you say you don’t want to be.” But “in” to what? Not the ACA, which he would repeal. He went on in the next breath to refer to the “catastrophic” coverage he had mentioned earlier as his alternative.

Cassidy’s Obamacare Attack

Finally, we note that the Democratic ad swipes video of Cassidy from one of his own ads.

Cassidy, who is a gastroenterologist and associate professor of medicine at Louisiana State University, appears in his ad kitted out with white coat and stethoscope. His ad is a standard GOP attack on the Affordable Care Act, expressing opinions and generalities and not much in the way of facts that can be verified or disputed.

He says he voted against the ACA in 2010 because, having read the bill, “it was clear there would be canceled plans, expensive premiums, no guarantee that you could keep your doctor.” He fails to mention that all those things were true before the ACA was passed.

And he calls for replacing the ACA “with a plan that gives the power to you, not the politicians and bureaucrats,” without getting into the fact that — as he noted in his remarks to the oil and gas group — his own plan “wouldn’t have all these benefits that we have to pay so much for” under the ACA.

Democrats can ill afford to lose Landrieu’s seat as they struggle to retain control of the Senate. Cassidy currently holds a slight lead over Landrieu in the polls, according to averages compiled by Real Clear Politics and the Huffington Post Pollster site. And the 538 Blog’s Nate Silver lists Cassidy’s odds of winning in November at 55 percent.

But being behind in the polls is no excuse for making false claims about an opponent’s record. That’s what voters should really find insulting.

— Brooks Jackson, with Carolyn Fante