Fact vs. Fiction: Is Obamacare Working?

In the seemingly endless back and forth, both sides are claiming victory (or their opponent’s defeat) when it comes to Obamacare. But with midterm elections riding on it, is the Affordable Care Act actually working?

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By Chris Hoenig

Fact vs. Fiction: is Obamacare Working?

Photo by Shutterstock

With midterm elections fast approaching and the fate of the House and Senate hanging in the balance, Republicans are banking on Americans’ disapproval of Obamacare to win seats.

As an election issue, “facts” about the Affordable Care Act and its success have been thrown about by politicians more than a football in the hands of Peyton Manning. But what is true and what is not?

1. One-third of Obamacare enrollees aren’t paying their premiums.

The newest claim from Republicans, this statistic comes courtesy of a House Energy & Commerce Committee report, citing data from insurance providers in the federal healthcare exchange.

VERDICT: Clever wording in the survey and an attempt to make incomplete data sound like the final word. The survey from the Energy & Commerce Committee—which has a 30-24 Republican majority—asked insurance companies only to provide raw data on the number of enrollees who had already paid their first-month premiums as of April 15.

The catch: Affordable Care Act enrollments surged significantly in late March, meaning millions of Americans—upward of 40 percent of all Obamacare enrollees—who had enrolled after March 15 still had time before their premiums were due (you get 30 days after enrolling to pay your first month’s premium). It’s not that one-third aren’t paying, or that one-third face late fees because they haven’t paid on time … it’s that people whose premiums aren’t due yet—people who have a proven history of waiting until things are due to take care of them—haven’t paid.

2. Nobody is signing up.

With all the website glitches, both on the English and Spanish healthcare.gov sites, arguments have been made that the Obama administration would not get the enrollment numbers it was looking for—and that it needed in order to make the overhaul successful and sustainable.

Pretty soon, however, states that had accepted funding to expand Medicaid and had set up insurance exchanges began to see strong growth in Affordable Care Act coverage. This growth remained limited, though, by politics: More than half the states, nearly all of which were run by Republican governors, had opted not to take part in the Medicaid expansion.

VERDICT: President Obama announced last month that 8 million Americans have signed up for insurance through the Affordable Care Act, beating the administration’s goal. ACASignups.net estimates that the number, including people who took advantage of a grace period due to high traffic on healthcare.gov on the signup cutoff date of March 31, sits around 8.14 million.

Officials are still working through a backlog of Medicaid enrollees—some of whom are stuck because states that did not accept expansion money have not set up computer networks that are compatible with the federal government’s. Still, more than 11 million Americans have qualified for Medicaid coverage for this year.

3. Young, healthy Americans won’t sign up.

In order to sustain the law, young, healthy Americans need to sign up for coverage. The low expenses that insurance companies have to pay out for them help keep premiums affordable for older enrollees who use their insurance more.

Early enrollment figures were not encouraging, though the Obama administration maintained that it expected the younger demographic to sign up later in the enrollment period.

VERDICT: Of the more than 8 million enrollees, 28 percent are 18 to 34 years old.

“This thing is working,” President Obama said in announcing enrollment numbers, which pointed to the late increase among younger Americans that the administration was expecting. “The Affordable Care Act is covering more people at less cost than most people would have predicted a few months ago.”

Still, analysts say an increase in the number of young people getting insurance—as high as 40 percent of the newly insured—is needed to guarantee that there won’t be large spikes in premiums next year.

“In an ideal world, you’d want to get as close to that as possible,” said Larry Levitt, a Senior Vice President at the Kaiser Family Foundation. “But what is important is what the insurance companies expected, and this is what they expected.”

4. The Affordable Care Act isn’t affordable and will cost people their coverage.

This has been a staple of the anti-Obamacare movement from day one; the focus of floor speeches in the lawmaking chambers at both the state and federal level; and the centerpiece of attack ads on television, radio and in print.

VERDICT: The Obama administration made some changes to the law to allow people receiving bare-bones coverage to keep it after some people began losing their plans, which were considered too basic under the new law.

In unveiling their latest enrollment numbers, the Obama administration is touting that 129 million Americans, including 17 million children, will be able to get or keep coverage despite having a pre-existing condition. Another 105 million no longer have to worry about a lifetime cap on spending, and 3 million young adults picked up insurance through their parents’ plans.

In New York, officials released data showing premium rates in the Empire State dropping by more than 50 percent. Overall, the nonpartisan Congressional Budget Office (CBO) estimates that premiums will come in as much as 15 percent below initial forecasts.

As for the attack ads, most have been proven false. In ads that ran in Louisiana, the residents that were having their insurance plans cancelled because of Obamacare turned out to be paid actors.

Even worse was an ad featuring a Michigan woman who had been diagnosed with leukemia. In the TV spot, she claims that her insurance was cancelled because of Obamacare, and now ”the out-of-pocket costs are so high, it’s unaffordable. If I do not receive my medication, I will die.” The only catch was that Julie Boonstra was lied to by anti-Obamacare activists. Not only could she stay with her oncologist, but she could actually save nearly $8,000.

PolitiFact, a fact-checking service from the Tampa Bay Times, has found several other Obamacare lies, including the statement from Senator Rand Paul that “for every Kentuckian that has enrolled in Obamacare, 40 have been dropped from their coverage.” That claim was found to be mathematically impossible.

5. Nobody wants Obamacare, everyone wants it repealed.

Another focus of attack ads is that no health-loving American wants Obamacare, and voters nationwide think it should be repealed. Along those lines, the House of Representatives has voted at least 50 times to repeal the law since it went into effect four years ago.

VERDICT: The attack ads do have some credibility in one area: Approval ratings for the Affordable Care Act still average only around 41 percent. Hard numbers are always difficult to nail down; any poll’s results are really skewed based on who is asking, how the questions are worded and the demographics of who is answering. One poll shows support as low as 26 percent, while another says that Americans are actually in favor of the overhaul by a 49 percent to 48 percent tally. The average of the major polls works out to a 41 percent approval, 52 percent disapproval rating.

But one thing the polls show clear agreement on: Americans don’t want Obamacare repealed and healthcare reform started over from scratch. Only about 30 percent of those surveyed say Congress should repeal or repeal and replace the law, and support for repeal is falling even among Republicans. Of the 53 percent of Americans that disapprove of the law in a recent Pew study, a vast majority (more than a 3-2 margin) believes Congress should make it work as well as possible (only 19 percent said the law should fail).

One possible reason for the discrepancy between disapproval and repeal: A recent CNN poll found that 12 percent say they disapproved of the Affordable Care Act because it was not liberal enough. When combined with those that already approve of the law, roughly half of those surveyed think Obamacare is fine or should go even further and only 39 percent disapprove because it is too liberal.

6. Obamacare is bad for America.

This is the main overall theme of opposition to the law, going all the way back to the campaigning days of its infancy, before it was even voted on by Congress.

VERDICT: If keeping the economy from contracting is a good thing, then the Affordable Care Act has certainly been a success. Analysts say that without the growth in healthcare spending, the GDP would have shrunk by 1 percent in the first quarter of 2014, instead of posting the 0.1 percent growth that it did.

More importantly, early data show that the main purpose of the Affordable Care Act—to affordably insure uninsured Americans—has worked, with the number of uninsured Americans dropping by anywhere from 4–10 million.

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20 comments


  • Thank you, Chris, for breaking it down. Your article should be required reading for every naysayer of the ACA. I was always fortunate to have insurance through my employer, but I have so many friends who are now able to afford healthcare coverage. They include a young man with diabetes who was kicked from his mom’s policy and had to pay for his insulin out of pocket because he couldn’t get coverage for his pre-existing condition. Now both he and his mother have affordable health care plans through the ACA and he doesn’t have to worry about dying because he can’t get his insulin.

    I might actually be one of those people who doesn’t think the law is progressive enough and I would not want it repealed at all.

    • Only a hyper-partisan fool would defend this Obamacare mess, which is why nearly all Democrats running this year are avoiding talking about it.

      Health insurance should be like car insurance and should kick in when there are major problems. Can you imagine what an oil change would cost if it was covered under your auto insurance? You don’t bill your car insurance for oil changes or little scratches in your car’s paint job.

      Also – unlike the gov website, auto insurance sites actually work! I pay $24/month for car insurance at Insurance Panda. With healthcare dot gov, it takes me hours to get an unaffordable BS rate. Who can afford $600/month insurance?

      All in the plan. Problems at the end so more can say they tried but couldn’t so now anyone can get an extension, further helping enrollment numbers. Add this to the 38 changes made to the law since passage, the joke continues. But, it’s the law of the land and cannot be changed!

    • Anthony Cannon

      I’m glad everyone is on their high horse complimenting the health care law. Let me know what happens when you get advanes cancer, forcing my insurance I had over 30 years retiring from the city of
      Chicago raising my costs over 400 per month admittedly cause obama home state of Illinois having too many new sign ups pushing me and my wife, elderly and sick to the exchanges. This forces insurance change still raised my premium to keep the same doctors, while multiple times I have been misled by agents on healthcare exchanges that medical supply companies and second opinion clinics like the mayo clinic have forced me to pay for products not in network that used to be on my old policy, costing me more Money and stress when I’m fighting advanced cancer, let me know how great this is at that time in you or a loved ones life.

    • thats all well and good for everyone that doesn’t have to fight now every year my husband who is self employed and has always had individual health care is fighting every year to find a plan we can afford I don’t think that 450.00 a month is affordable when our prior year plan was 215.00 you can read all your statistic but live it and you will see ACA sucks

  • Michael Cummings

    You’re drinking the Koolaid! Approval rating around (?) 41%, disapproval is a majority of Americans at almost 60%!

    • Really? I don’t disapprove and nobody asked me. The message here is more Americans approve than the Republicans would have us think and thereare people not included in any survey – like me.

  • Valerie Heath-Harrison

    My daughter is one of those who has fallen into the limbo created by a Republican governor who won’t accept Medicaid expansion. This governor is trying to work a deal with the feds to use the Medicaid dollars so that low-income people can use the subsidies to buy private insurance on the exchange. Talk about lining the pockets of private industry at the expense of taxpayers — it is an outrage! And in the meantime, my daughter, who is a single mother with 3 children and has myriad health problems keeps sinking further into debt due to ongoing medical costs to treat her conditions. Not to mention she is treated like a third-class citizen by the health care providers because she has no insurance and cannot afford to buy private insurance.

    Step aside, governor, and let the law take effect as it was intended to! This whole issue makes my blood boil. Holding needed health care hostage because of politics. Do the right thing, already. Single payer system all the way around!

  • Valerie Heath-Harrison

    Michael Cummings. You are wrong. I agree with Michelle in that the law did not go far enough and is not liberal enough. And I am not the only one I know who feels this way in one of the most conservative states in the union.

  • I wish people would stop calling it “Obamacare” and start referring to it by it’s actual title: Affordable Care Act.

    • Luke Visconti

      This person has made several posts mocking diversity, so the takeaway from this comment is the Koch brothers are concerned that their focus on Obamacare is likely to backfire in November. Luke Visconti, CEO, DiversityInc

  • The ACA is working with all the HCR laws that were implemented. It is not working if you are a Republican, like me. It is working whether you are a Republican or Democrat. The basis of the implementation was to encourage people to get their preventive checkups to prevent and detect illnesses so they could live a better physical quality of life. By having the insurance companies to pay the full amount of these services, it was to encourage people to go the doctors. The next implementation was to make it lawful for all American citizens to get insurance based on their financial ability to pay for it. But, if they can’t pay the full amount, they now have some financial assistance; some don’t have to pay anything without feeling that they are on welfare. The healthier people are, the healthier their neighbors are. What I mean by this is, the persons next to you are not sharing as many diseases because they are going to the doctors more for their treatment which they couldn’t afford in the past.

    • Luke Visconti

      We have a crisis in our nation—our workforce is aging. After World War II, we had eight workers per retiree. Now we have four workers per retiree; by 2025 we’ll have three workers per retiree. If we don’t get people to work, we are doomed to a slow and endless decline. You can’t go to work if your child is running a 104-degree temperature and you don’t have access to a doctor. It’s that simple. Luke Visconti, CEO, DiversityInc

  • The fact that 8 million people signed up is really not a victory. They HAD to or face penalties. Really everyone! Please just stop with the partisan politics. I am getting really sick of it. Obama has poor approval ratings like it or not and has had many failures as the leader of our country as well as victories. We need to stop with the mud slinging and really try to work together as a country to fix the issues that we have. The more name calling and acrimonious banter that there is the worse everyone gets and in the end it breeds more hatred. If you are truly interested in a better country and everyone being treated well. Start with yourself and the way you treat people who do not share your views. We are getting dangerously close to fascism in this country and it is disgusting.

    • His approvings ratings are poor based on fox news! What is the current unemployment rate 5.9
      ACA is working because Healthcare prices are going down, because people are getting checkups which keep the premiums down, in which Insurance companies do not like, that is why we should not have Doctors and Lawyers serving as congressman or senators. I am sure they did not mention that on the news, the fact is the more people see their doctors and gat healthy insurance compaines cannot over charge for health care. “In all your getting get Understanding.”

      • Greg put the Koolaid down. I played the game last year and found my wife who has one kidney a policy thru Anthem for $351 a month, after the subsidy, it had a $750 deductable and a $1600 out of pocket cap and her PCP was in the network. We were informed by Anthem that her premium will now be $797 a month and her deductable is now $4000 a year. The total yearly increase in premiums is $5352 and the increase in the dedutable is $3250 for a total increase of her health care cost being $8602. Her insurance cost is now 18% of our income and our taxes are 18% which leaves us 64% of our income to live on. Thank you POTUS!!

  • ObamaCare aka ACA (let’s face it folks after Republicans have tried to repeal for that what…? We are at 50 now, it’s never going to be known as ACA . They won’t let it!!) … I digress!

    It’s here, people are going to be able to see the significance of it once all of the hick-ups are worked out. Stop doing the Fox News and move on to more coherent topics like um, School Killings?

    American living in France. It’s embarrassing to see French News pick-up on “another” school killing from the States! Show us what you are really made of!

  • I believe Obama Care was developed with good intentions, but I think it would have been much easier to lower the requirements in applying for Medicaid and raise taxes to compensate for it. Because that is essentially what is being done. People that don’t work or meet certain income requirements could receive Medicaid, with or without a spend-down. So with Obama Care, those that make above a certain amount, will end up paying, while others don’t pay a dime. It’s the same as, those that don’t work, don’t pay taxes, and those that do work, pay to support those that don’t work. The problem with changing the requirements and raising taxes, Obama would have never been elected into office. I think it is basic math. And another problem arises when people can’t afford to pay their premiums. Do you pay your car note so you could keep your car and get to work? Or do you pay Obama Care and have your vehicle repossessed? I am a homeowner and the price of heating oil is through the roof. I think it’s a no brainer!

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