Supreme Court rul­ing on the Af­ford­able Care Act launches a raft of fluffer­nut­ter

The Washington Post Sunday - - POLITICS & THE NATION - GLENN KESSLER glenn.kessler@wash­post.com

Mo­ments af­ter the Supreme Court up­held a key pro­vi­sion of the Af­ford­able Care Act, a.k.a. Oba­macare, our in­box be­gan to be flooded with state­ments from politi­cians ei­ther con­demn­ing or prais­ing the 6-to-3 rul­ing. These e-mails were then fol­lowed by queries from read­ers ask­ing for an ex­pla­na­tion of the fig­ures spouted in those state­ments.

Here’s a guide to some of the rhetoric, much of which we have cov­ered in the past. As is our prac­tice with such round-ups, we do not award Pinoc­chios.

Bush got these num­bers from a re­cently re­leased Con­gres­sional Bud­get Of­fice re­port that looked at the im­pact of re­peal­ing the law.

The CBO es­ti­mated that from 2016 to 2025, the law would re­quire $1.7 tril­lion in out­lays (spend­ing) while rais­ing rev­enue (taxes) of $1.2 tril­lion. But the CBO also cal­cu­lated that the law pays for it­self— and re­duces the fed­eral deficit over the 10-year pe­riod— be­cause the taxes, $800 bil­lion in sav­ings from Medi­care and other pro­vi­sions ex­ceed the $1.7 tril­lion price tag.

All told, the lawis pro­jected to re­duce the deficit by more than $350 bil­lion— some­thing that Bush does not men­tion.

Boehner em­pha­sizes in­creased health costs, a claim also as­serted by Bush. But there are many­ways ei­ther side can spin this.

Ob­vi­ously, the cost of health care gen­er­ally goes up ev­ery year, though the rate of in­crease has slowed dra­mat­i­cally in re­cent years. Democrats stress this, but at this point it’s hard to give most of the credit to the health-care law. (We once gave Pres­i­dent Obama Three Pinoc­chios for mak­ing this claim too em­phat­i­cally.)

At the same time, Repub­li­cans are be­ing disin­gen­u­ous for as­sum­ing the lawwas go­ing to re­sult in an ac­tual de­crease in costs. In their de­fense, they point to Pinocchio-laden state­ments made by Obama dur­ing the 2008 pres­i­den­tial cam­paign, which we will ex­plore be­low.

In this quote, Perry is re­ly­ing on one very stale talk­ing point and one ex­ag­ger­ated one.

The “nearly 5 mil­lion peo­ple los­ing their health plans” comes from an As­so­ci­ated Press count in 2013 of the num­ber of peo­ple who re­ceived no­ti­fi­ca­tions that their old poli­cies were no longer valid un­der the law be­cause they did not meet cer­tain stan­dards. (Re­call that Obama had fa­mously— and falsely — promised that if peo­ple liked their plans, they could keep them.)

Other es­ti­mates of the num­ber of af­fected peo­ple were lower. More­over, a large per­cent­age of the peo­ple whose old plans were can­celed were au­to­mat­i­cally moved to new­plans of­fered by the same in­sur­ance com­pa­nies.

On top of that, the White House or­dered an ad­min­is­tra­tive fix that, depend­ing on the ac­tions of in­di­vid­ual states, al­lowed as many as 2.3 mil­lion peo­ple with “can­celed plans” to sim­ply stay on their old plans for at least another year. (Then the White House ex­tended that dead­line to 2016.) The ad­min­is­tra­tion also an­nounced a new cat­a­strophic ex­emp­tion to fill any re­main­ing gaps in cov­er­age— es­ti­mated to af­fect as many as 500,000 peo­ple.

So the num­ber of peo­ple “los­ing a plan” is far less than 5 mil­lion.

As for pre­mium in­creases of more than 50 per­cent, Perry is re­ly­ing on a con­ser­va­tive anal­y­sis of the in­di­vid­ual mar­ket that com­pares pre-law plans with fewer ben­e­fits to cur­rent law plans. The Kaiser Fam­ily Foun­da­tion in June re­leased an early anal­y­sis of plans in 10 states plus the Dis­trict of Columbia and found that, on av­er­age, the cost of a bench­mark sil­ver plan would be 4.4 per­cent higher in 2016.

That’s about a 10th of the fig­ure touted by Perry. More­over, it is worth re­call­ing that be­fore 2010, when the lawwas ap­proved by Congress, pre­mium in­creases in the in­di­vid­ual mar­ket were about 10 per­cent each year.

This is an ap­ples and or­anges com­par­i­son, com­bined with a mis­char­ac­ter­i­za­tion.

Obama in 2008 said that a health-care over­haul would re­sult in fam­ily sav­ings of $2,500, com­pared with an­tic­i­pated in­creases in premi­ums. In other words, he was not promis­ing a cut in premi­ums, as Cruz claimed. Still, it was a foolish pledge, for which Obama re­ceived Two Pinoc­chios be­cause it was based on a se­ries of shaky as­sump­tions.

Af­ter the Af­ford­able Care Act was im­ple­mented, the White House amended the pledge to a sav­ings of $2,000 by 2019.

In the mean­time, the av­er­age pre­mium for em­ploy­er­spon­sored plans has in­creased by about $3,000 from 2010 to 2014, ac­cord­ing to the Kaiser Fam­ily Foun­da­tion. But that’s a goodnews story, be­cause the rate of in­crease in premi­ums has slowed sig­nif­i­cantly.

We have pre­vi­ously pro­vided a lengthy ex­pla­na­tion of this $1,800 fig­ure, which is de­rived from the same Kaiser study from which Cruz ob­tained his “$3,000” fig­ure. But in this case the White House fo­cused on what premi­ums would have been if they had con­tin­ued on the same path of pre­mium growth from 2000 to 2010.

When we ex­am­ined this in depth, the pres­i­dent earned Two Pinoc­chios for two key rea­sons. First, he had called it a “tax cut” of $1,800, when it’s un­clear how much of this money ends up in an em­ployee’s pocket. The “you’re still pay­ing” lan­guage has the same prob­lem. For all one knows, em­ploy­ers are pock­et­ing the sav­ings.

More­over, Obama ap­pears to be at­tribut­ing the en­tire slow­down in cost in­creases to the Af­ford­able Care Act— and the jury is still out on that. The slow­down in health-care costs has to be viewed in con­text— as the eco­nomic growth and price in­fla­tion in gen­eral was lower in the af­ter­math of the Great Re­ces­sion. (Health-care costs slowed around the globe, even in coun­tries with no changes in health-care laws.)

Thus, at­tribut­ing the full $1,800 in sav­ings to the lawis a stretch.

“This fa­tally flawed law im­poses jobkilling man­dates, causes spend­ing in Washington to sky­rocket by $1.7 tril­lion, raises taxes by $1 tril­lion and drives up healthcare costs.”

— For­mer Florida gover­nor Jeb Bush (R)

“Oba­macare is fun­da­men­tally bro­ken, in­creas­ing healthcare costs for mil­lions of Amer­i­cans.”

— House Speaker John A. Boehner (R-Ohio)

“With in­di­vid­ual premi­ums up more than 50 per­cent and nearly 5 mil­lion peo­ple los­ing their health plans, Amer­i­cans de­serve bet­ter than what we’re get­ting with Oba­macare.”

— For­mer Texas gover­nor Rick Perry (R)

“Pres­i­dent Obama promised the av­er­age fam­ily’s health in­sur­ance premi­ums would drop $2,500 un­der Oba­macare. In ac­tu­al­ity, the av­er­age fam­ily’s premi­ums have risen $3,000.”

— Sen. Ted Cruz (R-Tex.)

“If your fam­ily gets in­sur­ance through your job— so you’re not us­ing the Af­ford­able Care Act— you’re still pay­ing about $1,800 less per year on av­er­age than you would be if we hadn’t done any­thing.”

— Pres­i­dent Obama

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