Today is the Affordable Care Act’s fifth birthday. For five years, most of the GOP legislators have been making predictions about the law’s leading the entire country to wrack and ruin. The following dozen failed predictions show how all these people have been wrong:
Failed Prediction #1 – Americans won’t enroll in the ACA: The demand was so great that the website sometimes crashed from the heavy usage. About 8 million people signed up for private insurance coverage in 2014, and the number rose to 11.4 million in 2015. While it was hard to sign up for health care on the exchanges last year, it was harder to be uninsured or underinsured.
Failed Prediction #2 – The ACA won’t meet its enrollment goals: In its first two years, enrollment totals exceeded preliminary projections.
Failed Prediction #3 – Insurers will want no part of the ACA system: Many insurers see the ACA as a major growth opportunity that lets them expand in the individual market.
Failed Prediction #4 – The ACA will cause the economy to suffer and kill jobs: In one press conference, House Speaker John Boehner (R-OH) used the phrase “job-killing” an average of every two minutes while talking about the ACA. Yet the U.S. has had 59 consecutive months of job growth since October 2010, the longest stretch of time in history. National data also shows no indication of employers hiring people under 30 hours a week to avoid the ACA insurance mandate. The average length of the work-week, which dropped during the recession, recently matched pre-2010 levels. Using interviews with major U.S. employers, Bloomberg found that the law “is putting such a small dent in the profits of U.S. companies that many refer to its impact as “not material” or “not significant.” It decided that “the biggest entitlement legislation in a generation is causing barely a ripple in corporate America.”
Failed Prediction #5 – People who enrolled wouldn’t pay their premiums: Again the GOP was wrong. Five months into last year, over 91% of the 8 million consumers who enrolled through an ACA exchange marketplace paid their premiums.
Failed Prediction #6: People would see exorbitant premiums: Those who qualify for tax credits through the insurance exchange pay an average of $82 per month for premiums—one-fourth of the expenditure without financial help. More people who changed from individual insurance to exchanges have lower premiums.
Failed Prediction #7 – Premiums will shoot up next year: State-by-state information shows that more insurers coming to the market are pressuring prices to go down. In 2015, premiums for the ACA’s mid-level plans rose by an average of 2 percent. In 48 major cities, prices for these benchmark plans actually fell by 0.2 percent, compared to the 10-percent increases before the ACA.
Failed Prediction #8 – The ACA helps only those with coverage: Republicans are wrong.
Failed Prediction #9 – The ACA will lead to a “net loss” on overall coverage: Boehner argued that fewer people had health insurance after the health law’s insurance expansion than prior to it, but the uninsured rate has dropped by one-fourth. In Minnesota it’s gone down by 40 percent, and in some cities the number will shrink by 60 percent in cities with expanded Medicaid. People who would not get subsidies still got the same insurance plans by going to an insurance broker. Boehner also ignored the expansion of 9.1 million enrollees on Medicaid.
Failed Prediction #10 – The ACA will lead to higher deficits and a weaker fiscal footing for the nation: The GOP, the party that actually raises the deficit, told the country that “Obamacare” would “bankrupt” the country. In April 2014, the Congressional Budget Office reduced its budget forecast by $100 billion, less than it expected to spend during the first projection in January 2010. The CBO reduced its 10-year estimate of ACA cost by 20 percent and its Medicaid costs attributable to the law by 8 percent, partly because people with health insurance no longer rely on the emergency room for health care.
Failed Prediction #11 – Americans will end up hating the coverage they receive through the ACA: A new Gallup poll shows that 71 percent find their coverage through exchanges to be good or excellent, and another 19 percent said the coverage was fair. Only 9 percent gave it a poor rating.
Failed Prediction #12 – “Obamacare” will mostly sign up people who already have insurance: A Kaiser Family Foundation survey finds that 57 percent of enrollees previously lacked insurance.
More failed projections: there is no “death spiral,” or “death panels,” or “rate shock.” Not one prediction has lived up to scrutiny. And not one prominent Republican is willing to admit the failed predictions or even explanations for these mistakes and misjudgments. Instead, they’re still busy trying to repeal the law.
Facts will not change the minds of many in opposition, as Jonathan Chait pointed out:
“Suppose you strongly objected to the idea that your city should own a bunch of buildings where people can go borrow books for free. (Some people do!) If you couldn’t persuade a majority of fellow citizens of your conceptual objections to libraries, you might try arguing that the library scheme was doomed to collapse in cost overruns, or that nobody would ever use them, or that shelves of heavy books would be routinely toppling over and killing small children. But the fact is that running buildings where people can check out books, and running exchanges where people can purchase basic health insurance packages, are both things that governments can do.”
One GOP complaint is that “Obamacare” helps only the poor. It is true that the poorest people get free Medicaid, and those up to an income of $94,000 a year for a family of four can get tax credits. People who receive insurance from their employees are having their coverage paid by “other people’s money.”
Employer-sponsored insurance get tax deductions, giving the largest benefits to those who earn the most money as compared to the ACA which gives the most to those who earn the least. For example, newly-announced presidential candidate Sen. Ted Cruz’s (R-TX) premiums, up to $40,000 for the year for his family, were paid by his wife’s employer, Goldman Sachs. Cruz will be shopping for health insurance because his wife has taken an unpaid leave while he runs for president.
Sen. John Barrasso (R-WY) may have summarized the GOP complaints with this comment on the floor of the Senate: “It’s time for the White House to stop celebrating [the ACA] and start thinking about the people.” Huh?
What’s ahead for the Affordable Care Act? After voting dozens of time to repeal the ACA, the GOP is trying to pass a budget that would double the uninsured rate and eliminate $1 trillion in tax revenue that pays for the law. Republicans have no plan to help the millions of families losing affordable medical care if they succeed. Rep. Paul Ryan (R-WI) has only one suggestion: he urged state lawmakers to stop state insurance exchanges if the Supreme Court rules that this as a requirement for the ACA. That’s what he told state legislators last week during a conference call organized by the conservative think tank Foundation for Government Accountability.
If the Supreme Court were to rule for mandated state exchanges, subsidies in the mostly blue states would continue while millions of consumers in GOP-run states would go without. Michigan and Ohio are intending to set up the exchanges that Ryan warns against because no one should do what the White House wants, even if it puts constituents in jeopardy.
Missouri is a prime example of problems with GOP legislators. GOP legislators have threatened to filibuster any Medicaid expansion bill and Bob Onder, a new state senator, has proposed a bill to keep an insurance company from selling policies in the state if it accepts federal subsidies sold on the federal health exchange. The state refuses to accept billions of federal dollars to offer Medicaid coverage to approximately 300,000 uninsured residents. Onder said, “To expand Medicaid would only put further stress on a system that’s already strained,” Onder said. A single mother with two children must make less than $3,700 to get Medicaid, and rural hospitals are facing either huge cutbacks or closure because the state refuses Medicaid expansion.
The GOP-led legislature, however, has passed a bill to insure cows in the state. It would subsidize up to 70 percent of farmers’ premium payments for dairy insurance. The House passed it by 110 to 49, and the Senate did better at 31-2. Rep. Jeremy LaFaver (D-MO) called it the “Affordable Cow Act” because insurance subsidies for cows are fine but “not for people.”
Maybe some day, Republicans will figure out that “Obamacare” should be called “GOP Cares.”