The War of the Charts

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In 2009, Rep. Kevin Brady made the rounds at Fox TV, ABC News and The Drudge Report as a newly minted internet star. The source of the Texas Republican’s fame was a stunningly impenetrable graphic created by his staff—65 boxes in six garish colors, interlinked in uncountable ways. The title: “Organizational Chart of the House Democrats’ Health Plan.” Within hours, it was available for purchase on a T-shirt with the caption, “Where is MY doctor?”

The infographic wasn’t exactly explanatory. In fact, it was perhaps the most confusing visual aid ever circulated within the walls of Congress. And to Brady that was perfect. He even tried to send the chart to his constituents as a piece of official mail—before House Democrats blocked it, alleging it was inaccurate.

The war against Obamacare was waged many ways: in words, in lobbying, in ads. But one of the strangest and most imaginative was the war of infographics. The Brady chart was one of a handful of visuals specifically designed as propaganda to scare people about the scope and complexity of a terrifying new law. Democrats, for their part, waged a counterwar, with their own snarky infographics showing just how grim Republican alternatives were.

Five years after Obamacare passed, as his presidency enters its final stages, we tracked down the charts’ creators to get a view of one of the strangest skirmishes in the health care wars—and how the system looks to them now.

Brady managed to top his original chart in June 2010, when he and then-Sen. Sam Brownback (R-Kan.) set out to create a new representation of the Affordable Care Act after it was signed into law. They approached the Joint Economic Committee, a congressional advisory board, to “illustrate how Obamacare would turn the nation’s health care system into a tangled web of mandates, regulations, and top-down bureaucracy,” says Brady spokesperson Lauren Aronson. The chart the committee produced was even more impressively Byzantine than the first. (They’re both easily found by Googling “complicated chart” or just “bad infographic.”) Brady was so pleased with the result that, for the next five years, he would continue to use the same infographic, pasted on a poster-board prop, in his anti-Obamacare soliloquies on the House floor.

The chart was created by Lydia Mashburn, an economist who led a team in distilling the law into a mess of “159 federal agencies, commissions and bureaucracies in between you and your physician,” as Brady described it on the House floor in February 2015. She worked under the direction of Brady, who was chair of the Joint Economic Committee at the time. She takes issue with the notion that the chart is a partisan document, calling it as “accurate a reflection of what we found in the bill as possible” — and not just accurate, but even somewhat simplified, the product of “hours and hours spent to reduce unnecessary complexity.”

In 2012, Twila Brase, a former ER nurse and head of an anti-Obamacare advocacy group, took a stab at condensing the 234,000-word bill—about a third of the King James Bible—into a single diagram. Sen. John Barrasso (R-Wyo.) began citing her visual of the bill, called the “Obamacare Machine,” which depicts a six-step system for health care exchanges with arrows shooting from every state in a map of the U.S. and a federal “hub” for data transfers hovering above. The diagram evokes a “War of the Worlds” alien incinerating every state exchange with heat rays. “‘A picture is worth a thousand words’ is particularly true in policy,” says Brase, president of the Citizens’ Council for Health Freedom.

Are they good graphic designs? Well, in a sense. We sent Brase and Mashburn’s graphics to Jennifer Palilonis, a design professor at Ball State University, to ask what she thought: “Poorly designed, difficult to follow and incredibly daunting,” she appraised. “I would have given [them] an F.” Which is exactly the point. Without squinting to make out the fine print amid labyrinths of lines, the message of the infographics still reads loud and clear: “Chaos,” says Gerald Kominski, another health care law expert at the UCLA Fielding School of Public Health.

Jill Horwitz, a health care expert at UCLA Law, was unable to confirm how accurately the Republican diagrams depict the bill: “I can’t even read the damn thing,” she says of Mashburn’s chart. However, she adds, the chart is indeed inaccurate in its suggestion that the ACA brings unprecedented complications to Americans’ health care, extending “its tentacles into your private life in a way that didn’t exist before.” If comparable charts were created for the private sector, Kominski points out, with 7 million employers buying insurance from several thousand insurers in a large market, they would look “equally confusing and bureaucratic.”

While the Republicans schemed to make the ACA look absurdly complex, the Democrats worked to dumb down Republican alternatives, which, until last month, did not exist in a viable form. In 2009, Rep. Alan Grayson (D-Fla.) took to the House with a boiled-down explanation of the Republican alternative, which spokesperson Tina Dupuy says drew inspiration from Jonathan Swift’s 1729 “Modest Proposal.” The three-poster-board props read: “The Republicans’ healthcare plan: 1. Don’t get sick. 2. And if you do get sick… 3. DIE QUICKLY.” The C-SPAN footage has attracted over half a million views.

In the battle for the title of most meme-worthy health care charts, neither Democrats nor Republicans have surrendered. Looking back on the debate, Grayson claims his infographic allowed him to “shift the narrative away from the GOP’s unwarranted attacks on the ACA, and direct it toward the absence of any better alternative.” And Brady says his team created enduring images that “shocked the public and framed the public debate on Obamacare” — to this day, he continues to see the charts hanging in doctor’s offices.

William Gray, a former C-SPAN producer and the creator of a Tumblr account compiling thousands of congressional floor charts, considers the political attack graphic a peculiar art form of its own. The goal of a congressional floor chart is not really to illuminate, he says, but to convince people they understand something just enough to know it’s bad. In his four years studying floor charts, however, never has he seen as many gimmicks as in the Obamacare debate. “There’s an irony in both parties wasting taxpayer dollars on needlessly complex political props to point out waste and complexity in government,” he says.

Nicole Narea