BY PETER SUDERMAN
Obamacare turns five years old this week, and to mark the occasion, President Obama took after critics of the health law, noting their ongoing opposition while briefly laying out the reasons he believes it to be a success. “It’s time to embrace reality,” he said, according to The Hill.
The president ticked off a string of points in support of the law: an additional 16 million insured, 50,000 fewer preventable deaths, slow growth in health premium costs, and lower deficit projections as a result.
The law, he said, is “working even better than expected.”
One could reasonably quibble with much of this, because not all of the points President Obama cited are clearly or fully attributable to Obamacare.
Health spending growth, for example, is indeed down, and this is driving much of the decline in the deficit, but at least a sizable portion of the decline—perhaps most of it—can be attributed to the recession. One study in Health Affairs last year concluded that about 70 percent of the health spending slowdown is a result of the economy, not any structural changes to health care delivery. Obamacare may be due some credit, but not too much.
Similarly, it’s true that a government report estimated that between 2010 and 2013, deaths from “hospital-acquired conditions” were reduced by about 50,000. But it’s hard to fully pin this on Obamacare when the report states up front that “the precise causes of the decline in patient harm are not fully understood.”
Meanwhile, the 16 million insured figure comes from a March report by the Department of Health and Human Services, and it is a total of those who gained coverage through Obamacare’s exchanges, Medicaid, employment, and the individual market place, which means it’s not wholly attributable to the law. And it tallies those who signed up for coverage rather than those “effectuated enrollment”—those who have already paid their premiums. The actual number is probably not too far off from what President Obama stated, but, once again, Obamacare isn’t the entire story here.
So Obama is overstating the case, and, of course, leaving out points against the law.
For example: About half of the people who received subsidies through the law last year will have to pay them back through their taxes this year, according to a Kaiser Family Foundation study this week. On average, those who owe will have to pay a little more than a quarter of their subsidy back. A few will have to pay back the entire subsidy.
On the flip side, a little less than half will end up getting money back, but even that will be complicated by the fact that the federal government and California, which runs the biggest state exchange, sent out nearly a million tax forms related to the health law with incorrect information, leading the administration to ask many to delay filing their taxes as a result. California has already issued 120,000 correct tax forms, but there are still “tens of thousands” who haven’t gotten updated forms, according to the L.A. Times.
Beyond that, there are additional questions about whether the Internal Revenue Service is even equipped to handle all the new paperwork required by the law. According to the Chicago Tribune, roughly a quarter of tax filers will have extra filing requirements due to the health law.
And then there are the poll numbers for the law, which is still unpopular, just as it has been throughout the five years it has been law. Polls differ on the exact contours of public opinion about the law, but all the polls in the Real Clear Politics opinion survey show that oppositions outweighs support by at least seven points; on average, the opposition is 10.5 points higher than the support.
If the law is truly working so well for so many people, if it is, as Obama has now taken to saying, working better than expected or anticipated, then why does it remain so stubbornly unpopular?
When the law was being debated in Congress, many supporters of the law argued that it would grow popular once it passed. When that didn’t happen, Obamacare backers insisted that it polled poorly because the major benefits had yet to kick in. When the major benefits kicked in, they argued that the botched launch of the exchanges was killing support.
These excuses no longer work. The coverage expansion has arrived, and while the precise numbers aren’t clear, there’s no denying that far more people are covered now than two years ago. The exchanges are still incomplete on the back end, but the consumer-facing part of the system works well enough. The health insurance subsidies have arrived, and are being doled out to millions, and so have the insurance rules restricting insurers from charging or denying coverage based on preexisting conditions.
Obamacare’s major benefits have gone into effect and had time to work their way through the system—and yet the law remains widely disliked. Obama’s message about the law, meanwhile, remains the same as always: It’s great, and people should stop resisting and recognize how great it is.
After five years, in other words, President Obama has not changed his message, even in the face of consistent broad public opposition, even as the various theories for why it remains unpopular have fallen away. Obamacare is simply not well liked. This is the political reality—and President Obama still refuses to embrace it.
Buried deep inside the latest CBO budget outlook report there is some shocking (by which I mean not shocking to anyone who has been paying attention) information on the effects of ObamaCare. You can forget about all the promises that were made by the administration and their Democrat allies during the debate… they were lying clearly inaccurate in their estimates. So how bad is it? The Daily Mail came out with the first report.
It will cost the federal government – taxpayers, that is – $50,000 for every person who gets health insurance under the Obamacare law, the Congressional Budget Office revealed on Monday.
The number comes from figures buried in a 15-page section of the nonpartisan organization’s new ten-year budget outlook.
The best-case scenario described by the CBO would result in ‘between 24 million and 27 million’ fewer Americans being uninsured in 2025, compared to the year before the Affordable Care Act took effect.
Pulling that off will cost Uncle Sam about $1.35 trillion – or $50,000 per head.
If you want to read the report yourself, it’s tucked away back in Appendix B of the document. (.pdf format) The total bill over ten years is closing in on the two trillion mark, and the various taxes and fees imposed under Obamacare are only going to make up for $643B of it. So I guess we really did have to pass the bill to find out what was in it.
At this point it is worth asking if maybe the entire fight could have been avoided without crafting such an elaborate system. Assume for arguments’ sake that the Democrats were going to win on the general subject of having some form of massive government program for health insurance. Assume further that the insurance industry was going to agree to go along with some new government mandates about having to cover pre-existing conditions and older children living at home, etc. in exchange for an assurance that they would have a bunch of new customers paying them. At that point, the bill could have been chopped down to about ten pages in length.
The plan is covering 27 million people with estimates of that growing by 25% over the next decade. A mid-range quality health care plan through most employers – including the employer contribution – can be had for roughly $5,400 per year. That works out to a little less than 150 billion dollars to just buy all of those people a health plan under the old system and the insurers would have been thrilled. The crippled, complicated government web site could have been stripped down to just ask how much you make each year and, based on that, issue you a voucher for a health insurance plan from a company that covers your area. We wouldn’t have liked it, but it would have come in at one heck of a cheaper rate and the debate would be over.
Rather than an exit question, we’ll just close with an observation. You were lied to. Again.
Did Obama just blame Republicans?
BY PAIGE WINFIELD CUNNINGHAM
President Obama slammed Republicans Wednesday for continuing to war against his signature healthcare law five years in.
“It’s working, despite countless attempts to repeal, undermine, defund and defame this law,” Obama said in a speech commemorating the Affordable Care Act’s anniversary of passage.
“We’ve made our share of mistakes since we passed this law, but we also know beyond a shred of doubt the law has worked,” he said. “Deficits have been slashed, lives have been saved.”
It’s been half a decade since Democrats in Congress passed the healthcare law and it remains arguably the most controversial piece of legislation passed during Obama’s tenure. Democrats spent this week touting its provisions extending coverage to millions of Americans, while Republicans aired their many ongoing complaints about the law.
There’s one thing members of both parties agree on: Major reforms are still needed in how healthcare is delivered and paid for.
Obama focused on that common ground in the first part of his speech, announcing a network of healthcare providers, payers, advocates and localities his administration is trying to bring together to share ideas on how to improve the quality and cost of care. More than 2,800 organizations — including seven of the country’s 10 biggest insurers — have signed on to the network so far, officials said.
But he also addressed the continuing disputes over the law that Republicans have focused on for years.
He reminded Republicans that some of the ideas behind the Affordable Care Act — most notably its individual mandate to buy coverage — were once supported by some conservatives, although its Medicaid expansion and some other big parts of the law stem more from liberal thought.
“The Affordable Care Act pretty much was their plan before I adopted it,” he said.
While the law has extended health coverage to millions of Americans — and no serious experts dispute that — Republicans charge that it’s still causing more problems than it’s solving.
But Obama sharply criticized the GOP for trying to undermine the law but failing to introduce their own comprehensive alternative. Republicans have introduced many separate bills aimed at reforming healthcare, but have been unable to unite behind one big plan.
And the president condemned the proposed GOP budget the House is voting on this week, which would repeal the entire healthcare law and cost millions of Americans federally subsidized health plans they’ve purchased in the law’s new insurance marketplaces.
“For folks who are basing their entire political agenda on repealing the law, you gotta explain how kicking people off their health insurance is supposed to make us more free,” Obama said.