Mr. President, Stop Saying Obamacare Is Imploding (Because It’s Not)

2017-08-31T18:15:32+00:00July 10th, 2017|affordable care act, healthcare|

During a CNN focus group of Trump voters last week, one educated, white collar professional said that the Republican congress had to repeal and replace Obamacare because it is “imploding.”  That Trump supporter directly mimicked Trump’s own comments about Obamacare – comments which are patently misleading.  This proves once again the effectiveness of demagogic language (“Obamacare is a disaster!”) shamelessly applied to important policy questions that impact almost every American.

Obamacare is most definitely not imploding, but Trump and the GOP in Congress have convinced an awful lot of people that it is – simply by repeating the same falsehoods on a regular basis. Why does this matter?  It matters because the Senate may vote on its Obamacare repeal and replacement plan within the next couple of weeks.

The GOP’s Better Care Reconciliation Act would deprive 22 million Americans of health coverage over the next ten years and gut Medicaid, hitting the old and the sick unusually hard. As long as Republicans continue to justify repeal with false claims that Obamacare is in a “death spiral,” advocates for the most vulnerable members of our society must continue to call them out.

Both the New York Times and the Washington Post this week found it necessary to debunk misleading Republican claims about Obamacare and the Senate bill to replace it.  The Times entitled its piece, “Five Misleading Republican Claims About Health Care,” while the Post went with “Decoding the White House spin on Obamacare ‘failures.’”  The papers’ fact-checkers had plenty of material to work with.

These and other analyses are crucial to understanding what’s really happening with Obamacare and the GOP repeal and replace legislation:

1) Obamacare is not “imploding” or in a “death spiral.”  Despite recent instability mostly induced by the Trump administration and Congress itself, Obamacare is hardly imploding.  A new study by the Kaiser Family Foundation suggests that Obamacare markets are, in fact, “stabilizing” and “regaining profitability.”  The CBO forecasts that the Obamacare system will remain stable for the foreseeable future – if it is not further undermined.

2) Premiums for Obamacare policies are not generally rising 200-300%.  Though a few states have unfortunately seen triple digit premium hikes, the National Conference of State Legislatures found that average premium increases nationwide were 25% this year.  Because some 84% of enrollees’ premiums are covered by Obamacare subsidies, few feel the effects of the increases.  Their net costs may even decrease.

As the Post’s fact-checkers point out, “Average insurance premiums in the Obamacare marketplace now are about at the level predicted by the Congressional Budget Office for 2017 when it first evaluated the law in 2009.”  In other words, some premium hikes were predictable as the new marketplaces found their footing – and not likely to be repeated every year.

3) Insurers are not abandoning state insurance exchanges in droves.  The Post reports that an average of five insurers participated in each state’s marketplace in 2014, ranging from one to 16 companies per state. According to the Kaiser Family Foundation, the average number of insurers in 2017 is 4.3, ranging from one to 15 companies per state.  Not a huge decline.  Still, “slightly more than 2 million people, mostly in rural areas, don’t have competitive plans to choose from and are seeing premium increases,” writes the Post’s Dana Milbank.  But again, many of those premium hikes are offset by Obamacare subsidies.

4) The Trump administration and Congress could have done a lot more to stabilize Obamacare; instead they undermined it.  Here’s how:

*The administration balked at paying cost-sharing subsidies that would have relieved financial pressure on reluctant insurers.

*President Trump signed an executive order soon after taking office instructing federal agencies not to enforce the Obamacare mandate that all Americans have health insurance, discouraging participation in the exchanges.

*The administration ended public outreach efforts to encourage Americans to sign up for health care.

*In fact, President Obama and the Democrats in Congress asked Republicans to work with them to strengthen Obamacare during the    first six years after the law was passed, only to have the GOP Congress vote to repeal it some 60 times.

5) The President and his allies in Congress have spooked the insurance markets.  They have sown tremendous uncertainty about Obamacare’s future with their attempts to repeal the law and harsh rhetoric, spooking insurance companies and potential customers.  The former chief marketing officer for HealthCare.gov estimated that Trump’s rhetoric alone has deterred nearly 500,000 people from signing up this year.

Furthermore, the Post reports that figures the White House uses to smear Obamacare are often based on comparisons of the insurance markets from before the law took effect and today.  Such apples-to-oranges comparisons are misleading and not useful.

Meanwhile, the Republicans have employed similar demagoguery to promote their own repeal and replace legislation.  The Times found several GOP claims about the Senate healthcare bill to be factually dubious, including assertions that the legislation does not “pull the rug from anyone currently covered by Obamacare” – and that the bill “reduces taxes on the middle class” when, in fact, the top 1% of earners reap most of the benefits.  The cruel truth is that some 22 million Americans would lose health coverage under the GOP bill over the next ten years, including 15 million Medicaid beneficiaries – many of whom are needy seniors who rely on the program to pay for long-term care.  We must not allow the clever manipulation of language by those who would destroy Obamacare to hurt so many millions.