Liberal Values Defending Liberty and Enlightened Thought

Brian Buetler points out that the conservative claims of people not signing up for coverage under the Affordable Care Act are falling apart as we reach the end of the open enrollment period:

Charles Gaba — an ACA supporter and data Hoover — has been documenting the March surge, state by state on his Twitter account and his site, ACAsignups.net. Gaba has the best numbers out there, and has been accurately forecasting official enrollment statistics for weeks. He currently projects total exchange enrollment will hit 6.2 million by the end of the month, not counting enrollment in off-exchange plans, and puts the grand beneficiary total (including Medicaid beneficiaries and “young invincibles” on their parents’ plans) at 11.9-15.6 million as of Saturday. Conservatives are thus, to no one’s surprise, furiously attempting to “un-skew” his figures.

And, as Vanderbilt health policy and med school professor John Graves notes in Health Affairs, turnover is a major hallmark of the insurance market. People who lose or change jobs, and thus become temporarily uninsured, will be eligible for ACA enrollment, even after March 31. Medicaid, isn’t bound by open enrollment. As such, enrollment numbers will continue to grow throughout the election season. Exchange beneficiaries might even reach the elusive 7 million total this year, a few months late, but before the midterms.

He also noted a “glaring error” regarding the Affordable Care Act in a conference call for Michigan Republican Senate candidate Terri Lynn Land. Such errors are quite common whenever Republicans talk about health care. He pointed out that Land’s proposal (an idea commonly promoted by Republicans) could lead to anyone whose coverage lapses being permanently denied insurance coverage.

Just as incorrect and claims about Obamacare are common from Land and other Republican candidates, Glenn Kessler points out that the latest ad from the Koch financed Americans For Prosperity is making more misleading claims:

“Millions of people have lost their health insurance”

We’ve repeatedly written about this claim, most recently when House Speaker John A. Boehner (R-Ohio) incorrectly claimed that so many people have lost insurance that there’s even been “a net loss” of people with insurance. Actually, there has been an increase in the number of people with insurance, though not as much as the Obama administration had hoped.

The Associated Press estimated that nearly 5 million Americans had their insurance canceled, but a large percentage of the people whose old plans were canceled were automatically moved to new plans offered by the same insurance companies. These people may not be happy with their new coverage, but they got a plan without going through HealthCare.gov. Precise figures are not available, as the insurance market is private and fragmented, but insurance company officials say a majority of people could move to new plans they were offered.

The White House last year 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. (In early March, the White House extended that deadline to 2016.) The administration in December also announced a new catastrophic exemption to fill any remaining gaps in coverage — estimated to affect as many as 500,000 people.

In other words, only in a narrow sense have “millions” lost their health insurance.

“Millions of people can’t see their own doctors”

This sweeping statement could just as well describe the world before implementation of the Affordable Care Act. Most Americans get their insurance through their employers, and those plans could be changed at any time. Moreover, when people change jobs, they often also change health plans, which could also force changes in doctors. Of course, most plans do not prevent you from seeing a doctor who is not in a network; instead, your co-pays would be higher.

AFP in the past has run ads that feature people upset at losing their doctors, but this line is misleading because it presumes that everything was perfect before the Affordable Care Act became law.

“Millions are paying more and getting less”

This is another sweeping statement, and the most misleading. (Advocates could argue back that “millions more are paying less and getting more.”)

In terms of premiums, there is a fierce dispute now among policy experts about the impact of the law on the cost of health care. When we previously looked at this issue, after President Obama claimed that the law “has helped the cost of health care grow at its slowest rate in 50 years,” we settled on a “verdict pending.” It’s still difficult to compare premiums from before the law with premiums after the law — or to determine how much the law has to do with health-care costs today.

One big reason why it is difficult to compare premiums, before and after, is because the law mandates a comprehensive package of benefits — benefits that many plans in the individual market previously lacked. That increase in insurance coverage, according to a Congressional Budget Office study in 2009, was expected to boost the premiums of nongroup plans by about 30 percent, but the impact would be negligible for large group plans, which already provided many of those benefits.

But, wait, there’s more: Other factors were expected to reduce premiums in the individual market, so the total difference (before subsidies) was an increase of 10 to 13 percent per person. For people receiving subsidies, the cost of premiums in the individual market would actually decline nearly 60 percent, CBO calculated.

In other words, the insurance premiums may be slightly higher for some — or significantly lower for many — but the plans are also more robust.

So how does AFP justify that people are getting “less”? Levi Russell said the ad is referring to narrower health-care networks. He pointed The Fact Checker to an article in The Wall Street Journal on a McKinsey & Co. report that found that the percentage of plans with “ultranarrow” or “narrow” hospital networks had increased — though that also meant lower premium costs. In fact, many people apparently would happily pay less to get less.

“McKinsey found that nearly two-thirds of about 150,000 consumers surveyed since 2011 said they were willing to trade provider choice to lower their premium costs,” the article said.

Insurance companies have also been going to more restricted panels of physicians for several years, and this likely would have increased with or without the Affordable Care Act. The Affordable Care Act also increases the chances people can keep their own doctor as consumers will have more choices in health care plans, giving them greater opportunity to sign up for a plan which their doctor is in.

Update: Lack Of Information And Misinformation Suppressing Enrollment In Insurance Plans

Cross posted at The Moderate Voice