By Chris Hoenig
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.
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.