“Obamacare is imploding” has become the Republicans’ Big Lie; a lie that doesn’t get nearly the disrespect it deserves. Every day, on cable and broadcast news, and in press conferences, Republicans look into the camera and claim that Obamacare is imploding, collapsing, and death spiraling; frequently to either non-responses or the obligatory “uh-huh” in reply. It’s quite a concession on the part of members of the media; allowing Republicans to recast their greatest obsession—repealing Obamacare—as an emergency rescue operation, or even an “act of mercy.”
Republican House Speaker Paul Ryan has repeated The Big Lie over and over again; in media interviews, in his goofy Powerpoint presentation (see, the blue part of the chart are the people with healthcare … the red part are the deadbeats we’re going to toss into the E.R. in order to save the blue people money on their taxes…), and on the House floor.
Donald Trump uses The Big Lie too, in his never-ending campaign rallies and when he does the odd “lyin’ media” interview, mostly on Fox News.
His shouty spokesman, Sean Spicer, deploys The Big Lie in his daily “press briefings” to explain why 24 million people have got to be “freed” from the tyranny of insurance cards.
Tom Price, Trump’s health secretary, and Mick Mulvaney, the director of the Office of Management and Budget, throw out the Big Lie every time they talk about the “three-part repeal and replace” plan Ryan says he cooked up with their help (he called them “the Trump people” in an interview with a skeptical Laura Ingraham on her radio show this week.)
But “Obamacare is imploding” is what you might call in the queenly parlance a damned lie. It’s not even a particularly hard lie to disprove, with the magic of Google, and it’s not clear why so many journalists are responding to this Big Lie with silence, rather than refutation.
Perhaps it’s because healthcare is complicated, and most Americans don’t really understand it, or the ACA. Perhaps it’s because the very real issues some Americans are having with Obamacare, particularly in the individual market, have convinced reporters that the problems with the law are far more extensive than they are. Or maybe the Republican messaging machine has been so thorough that people do believe Obamacare is imploding, including many who work in the media. Though none of that explains why the law is at its most popular since its inception.
So let’s go through this once and for all.
Obamacare is not imploding. Nor is it collapsing. Nor is it a “ticking time bomb” that Obama ordered B613 to set to go off the moment he left office and he and Michelle arrived in New York City looking younger than you.
Don’t believe me? Ask the nonpartisan Congressional Budget Office, which concluded in its report on the Trump-Ryan replacement plan that the “non-group” market, the individual insurance market in which people sign up on state or federal exchanges, “would probably be stable in most areas under either current law or the legislation.” In other words, it can survive whether or not Republicans “repeal and replace” Obamacare, because even when premiums spike, as they did in 2016, in large part because of Republicans in Congress and 19 states actively sabotaging the law, those increases are offset by the federal subsidies people get under Obamacare, which rise as premiums rise, according to people’s incomes. In fact, of the new signups this year, 84 percent were eligible for subsidies which covered 73 percent of the price of their premiums.
So while Republicans really want Obamacare to collapse, and indeed they’ve tried very hard to make it collapse so they could have an excuse to repeal it; the law is not, in fact, collapsing.
Nor is it in a “death spiral” – which actually has a specific meaning, which Politifact defines as “… a cycle where shrinking enrollment leads to a deteriorating risk pool (that is, healthy people leave the plan due to the cost). That leads to higher premiums, which causes enrollment to shrink even further, continuing the cycle.”
Well, that’s not happening, either.
According to The Centers for Medicare and Medicaid Services, the federal government agency that keeps track of these things, 12.2 million people enrolled in health plans during this year’s open enrollment period. That’s less than the 13.8 million people the Department of Health and Human Services projected, but by definition, if millions of people are still signing up for insurance under the ACA, rather than dropping it, Obamacare cannot be in a death spiral.
On the contrary, thanks to Obamacare, roughly 22 million people have gained insurance, between the exchanges andsubsidies, the Medicaid expansion, and those remaining on their parents’ plans. As a result, the uninsured rate is at a record low of below 11 percent. It would be even lower, and the CBO would not have been so wrong in its estimate of how many people would be covered by now, had 28 Republican-led states refused to set up their own exchanges, and had 19 Republican-led states not refused to accept the Medicaid expansion. You’ll recall, they went all the way to the Supreme Court in 2012 to establish the fact that they could keep millions of their own people from accessing Medicaid through Obamacare. Roughly half of those who are uninsured by Republican fiat live in just two states: Texas and Florida.
Ryan himself bragged about the Republican-led congress withholding money from Obamacare’s risk pools in order to help elect a Republican president and cripple the law. When the Trump administration took over, they went so far as to cancel the TV commercials urging people to sign up.
Meanwhile, there’s another lie that Republicans have used to try and sell their “repeal and replace” boondoggle: saying Aetna is one of many insurers pulling out of the Obamacare exchanges because the exchanges don’t work, and the insurers can’t make money. Not true. Aetna did indeed drop out of 11 state exchanges. But a federal judge ruled that they did so because ++ the federal government wouldn’t let them merge with Humana (which then largely dropped out too, after both companies had announced plans to expand their ACA offerings once they combined). The judge also ruled that Aetna lied about why it quit.
It’s no secret that lots of insurance companies hate Obamacare, even though some of them have made quite a bit of money on it. Obamacare prevents them from excluding sick people from coverage; or cutting off the checks when their customer is in mid-treatment because she’s reached her lifetime cap; or charging older people much more than younger ones. Insurers did like the idea of potentially getting a flood of new, young, healthy customers who were required to buy insurance due to the mandate, and many are unhappy that they haven’t gotten more. Meanwhile, the law also made the junk policies they used to sell those younger, healthier customers illegal.
Republicans’ “repeal and replace” plan is a giant gift to those insurers, letting them bring back some of those awful – but profitable – practices; specifically, allowing them to charge older people five times more than younger customers, and restarting the junk policy machine, while also scrapping Obamacare’s limit on how much of their extravagant CEO pay packages insurers can write off on their taxes. As a bonus, Trumpcare would swap out the individual mandate that makes people pay a fine to the IRS if they go uninsured for a fine they pay directly to the insurance company when they do choose to sign up. Ka-ching!
Another lie on offer from the GOP: that Obamacare is driving up health costs. The fact is, Obamacare isn’t doing that. Insurance companies are, by charging more money each year, just like they always have. And statistics show that states that refuse to run their own exchanges have seen the biggest premium hikes.
What we do know is that Trumpcare (or Trump-Ryancare, or whatever it’s being called today) would mean 24 million fewer people with healthcare by 2024. Republicans like Ryan and Price want you to believe that’s because once the individual mandate is gone, 24 million people would deliberately drop their insurance to live a life of healthcare “freedom.” Well, you won’t be surprised to hear, that too is horse puckey. Most of the newly uninsured would lose their insurance by having the Medicaid expansion stripped away or see their subsidies slashed so much that they could no longer afford a policy; all so that Ryan, Trump, Price, Mulvaney and Co. can hand the richest Americans a $600 billion tax cut.
When asked about the horrors that would ensue for the newly uninsured, Ryan and friends make the argument that the only thing that matters is that you have more choices of insurance companies and plans in your market; not that you have enough money to pay for them. The genius of the free market, Ryan gleefully keeps telling interviewers in between lies about Obamacare, is going to make America great again.
And if a few tens of millions of people lose their coverage? Well, freedom.
It’s an ethos not unlike the one that produced a Trump budget that hacks away at everything from mine safety to Big Bird to Meals on Wheels. What you’re seeing in Washington today is exactly what you think you see: a bunch of rich men; modern-day robber barons, giddily drawing up plans to pull off a giant reverse Robin Hood—transferring billions of dollars from the poorest Americans to the richest, just because they can. All that matters is that the wealthy make a profit; and to hell with everyone else.
You want a dose of truth? Donald Trump—the supposed “populist” president; the all-gold everything, New York penthouse-dwelling, Mar-a-Lago every weekend on your dime golf-hopping, wannabe Russian oligarch—is one of them.