Far from Disaster, ObamaCare Expands Coverage, Saves Money

“…the disaster that’s been Obamacare…”

So says a Republican Congressman on NPR this morning. That hyperbole matches the language Senator Mike Rounds uses about the Affordable Care Act, conjuring Titanic imagery when he says, “This ship is sinking,” or Speaker Paul Ryan’s false claim that the ACA is in a “death spiral,” or Speaker Ryan’s alt-reality commentary this week at VP-Elect Roy Batty‘s side:

We know that things are only getting worse under Obamacare. This is about people paying higher premiums every year and feeling powerless to stop it. It’s about families paying deductibles that are so high, it doesn’t even feel like you have health insurance in the first place. And in many parts of the country, as you’ve all heard, even if you want to look for better coverage, you are stuck with one option.

One choice is not a choice—it’s a monopoly. The health care system has been ruined—dismantled—under Obamacare [Speaker Paul Ryan, press conference, 2017.01.04].

With Republicans in charge and Democrats possibly unable to stop a repeal of the Affordable Care Act, it’s easy to retreat from the ACA debate and let Republicans own the real disaster that will follow. But even if we can’t peel away three Republicans to stymie the Trump wing’s plan to blow up the ACA and the deficit, we can still point out that Rounds and Ryan are lying about the ACA. It has made health insurance and health care in the United States better.

The Los Angeles Times promotes a storm of analysis from Washington University health policy analyst Timothy McBride, who Tweets chart after chart showing the Affordable Care Act is working like gangbusters. Take a look:

Lots more Americans have health insurance than they did before the ACA.

More adults have insurance, and more kids.

Low-income, middle-income, high-income—more Americans across the spectrum got insurance under the ACA. The gains were slightly better for the poorest Americans, the folks who need the most help.

The uninsured rate dropped across income and racial groups.

As more people got insurance, more people could choose to go see the doctor instead of letting cost keep them from seeking treatment.

Fewer parents had to make the wrenching choice between saving money and taking their children to the doctor.

Fewer patients came to hospitals without insurance or other means to pay their bills, meaning hospitals ate fewer costs—i.e., hospitals passed fewer unpaid bills on to insurers and the rest of us. But notice, dummies (yeah, I’m looking at you, Al): the states that really cashed in on that ACA advantage were those who expanded Medicaid.

We spent $3.2 trillion on health care in 2015. That’s still more money per person than any other country spends. But even with more Americans seeing the doctor (or maybe because more people were seeing the doctor!), we spent a good $200 billion less than we were projected to spend pre-ACA.

Per-person health care spending grew at markedly slower annual rates than they did in the decade before Obamacare. For Medicare recipients, per-person spending actually decreased (except for prescription drugs, which we can go back and talk to George W. Bush about).

Premiums for employer-based health insurance rose 5.6% a year in the decade before the ACA. Workers were seeing their contributions rise 7.2% a year. Because the ACA lowered the number of uninsured people whose costs ended up passed on to policyholders, employer-based insurance premiums grew at only 3.1% a year post-passage of Obamacare. At that rate, a worker making a $1,000 monthly contribution toward family coverage from her employer would be paying $1,238 a month in 2017. At the pre-ACA 7.2% annual rate, that same worker would be contributing $1,627 a month for the same policy. Over ten years, Obamacare saves the typical employer-insured worker $37,000.

Dr. McBride exhorts us to “Tell the whole story” on the Affordable Care Act. In this case, the whole story is that Mike Rounds, Paul Ryan, and Donald Trump are about to kill a program that has insured more Americans and saved us a lot of money. The only people for whom the Affordable Care Act has been a disaster are the Republicans who can’t stand the fact that Obamacare (which probably would have been the same plan a President Romney would have passed) was and is a good program that should be expanded, not killed, and certainly not replaced with the status quo ante.

19 Responses to Far from Disaster, ObamaCare Expands Coverage, Saves Money

  1. Donald Pay

    Looking at it from a strictly Republican partisan perspective, Obamacare has been a disaster—for them. If Obamacare is such an abject failure, then let’s put the blame where it belongs. The most hated portion of Obamacare, the mandate to purchase health insurance, was a conservative idea that, as always, was a Republican sop to the health care insurance industry. I’m old enough to remember that mandatory health insurance purchases for individuals was the Heritage Foundation alternative to Hilary Clinton’s 1990s approach to health care reform. That plan was adopted by the Republican Party, and was only abandoned when Obama suggested it as the major part of his plan.

    I happen to agree that that portions of Obamacare have problems. It was always dependent on faulty assumptions about the ability of “the marketplace” to keep health care costs low. But those problems can be fixed.

    Of course Republicans will retort: our plan didn’t have some of the marketplace reforms that Obama put in to make sure insurance companies weren’t screwing you when you went in for your prostate exam. True. Republicans would have left in place scam insurance plans that guaranteed nothing except that the insured would be bankrupt at the end of that prostate exam. Republicans seem to think cutting regulation and selling insurance across state lines is some magic solution. All that gets you is scam insurance.

    All the other parts of Obamacare seem to be working well, and are supported by most of the public, as Republicans will find out pretty soon if they are dumb enough to repeal them. And, repealing will explode the deficit, something those scamming Republicans already figured out because they have gone back to the Cheney idea that deficits don’t matter now that Obama is reducing the deficit. Yup, repeal Obamacare, explode the deficit. Republicans never cared about deficits when they wanted to go to war against somebody. With Cheney it was a faked war against Saddam. With Trump it is a real war against America.

    Impeach Trump.

  2. Jerry K. Sweeney

    “Although it has received little attention, a full repeal of Obamacare would eliminate Medicare benefits created by the law. Among other things, it improved Medicare’s financial outlook by slowing the growth of spending and clamped down on fraud, waste and excessive payments. It also enabled tens of millions of Medicare beneficiaries to get free preventive services such as flu shots and screenings for cancer and diabetes. And between 2010 and 2015, nearly 11 million Medicare beneficiaries saved $20.8 billion on prescription drugs—an average of $1,945 per person — because of the gradual closing of the coverage gap known as the doughnut hole.”


  3. Having Mike Rounds declare Obamacare a disaster is like Colonel Sanders saying fried chicken is a disaster. Fisher Rounds has done very very well with Obamacare with incentive trips taken all over the world with its sales. A better question to Mike Rounds is how much did your agency’s grow in the last 6 years? How many more sales were achieved by the individual mandate on insurance? Ask him to explain how the old grandfathered plans were able to stay affordable for those that would not qualify for a subsidy. Without answering those questions, then Rounds is just like the twitter king, full of nothing but lies.

  4. Porter Lansing

    It’s easy to forget now, but the status quo prior to passage of the Affordable Care Act was not good. Forty million Americans had no insurance, and could be bankrupted by an unexpected illness or accident. Millions more could not get new insurance because of preexisting conditions. Children could only stay on their parents’ insurance until they turned 21.
    This system was bad for workers, often locking them into their jobs. It was bad for hospitals, which lost millions upon millions of dollars in uncompensated care. It was bad for the insured, who paid higher prices to make up the costs of caring for the uninsured. It was bad for the uninsured, who could be ruined by bills they could never hope to pay. Mostly, it was the insurance companies who benefited.
    The Affordable Care Act still has some problems. The exchange markets are not functioning as well as they should, for example, leading to some hefty premium increases this year. Costs, especially for prescription drugs, continue to skyrocket.
    But the law is not nearly the disaster its opponents are trying to paint it as. Even as Republicans go full steam ahead on their repeal efforts, 8.8 million people signed up for insurance plans on the federal exchange, a new record. Its cost-containment measures, inadequate as they were, have had some success in lowering the rate of health care inflation.
    Fantasy thinking about health care — that we can have lower prices, better care, more choice and no mandates — permeates the Republican critique of Obamacare. Republicans are doing their best to disguise this reality under the cloak of liberty, deregulation and consumer choice, but the economic and political trade-offs cannot be avoided

  5. Ye gads, Don is unhinged completely in his rage against the truth with the proof of the Russian military efforts to get him elected. This man is out of his mind, literally. Republicans need to take care of this before we find ourselves in serious world trouble. Mental illness is a very serious matter.

  6. mike from iowa

    Wingnuts lie- people die. That has ever been the way in my life. Now it is even worser. And it will get worser than worser.

  7. Come on dont be so hard on slick Mike didnt he do a great job with eb-5 he knows very little about this. just like he does his senate job. so quit being so hard on him.

  8. Timothy McBride has some good statistics there and I encourage anyone that despises Obamacare to look at them.
    The whole healthcare reform debacle has never been focused enough on cost containment. Why do we spend the most in the world on healthcare per person and how can we slow that down? I still place most of the blame on health insurance companies. They are after their own business interests, that’s it. They choose not to help contain costs and to buy our politicians (except for a few good ones like Bernie Sanders).
    I would think Republicans would love the record profits of recent years that big health insurance has reeked in since Obamacare.

  9. I get so weary of the lies that the GOP tells about the ACA. (and the South Dakota media provides our threesome a big platform to spread their propaganda)

    One of the unreported/under reported “fact” of the huge rising premiums this year is the “risk corridors”. When the ACA was passed, insurance companies knew that insuring many more “sick” people would more than likely create financial loss for them. However, as a team effort, everyone knew that it would be bumpy for a few years as America started getting Americans healthier. So, as part of the law, to assist insurance companies to help cover their losses, was for funding to be provided to help cover those “risk corridors”. In 2015, Congress actually cut this funding. No dollars for the risk corridors. So, what did insurance companies do without this funding? Of course! Passed the loss onto consumers – thus, the rise in premiums.

    GOP CREATED the rise in premiums. This part of the story should have gotten more legs, and I wish the Dems had been more vocal about this. To explain the whole story. But really a moot point now with what the GOP is trying to do.

    If you are interested, here is a story from Dec 2015 about the pulled funding to cover the risk corridors.


  10. That is a massively big blogging, Mr. H. So big, in fact, with so many confusing little postings from the Face Book that I could not bear to attempt to read it all. It is even too much to page the down through. Probably your biggest blogging ever.

  11. Porter Lansing

    Perfect , Dana P. Under reported nationally. UNreported in red states. Hear it now. Marco Rubio’s bill to eiminate risk corridors is why everyone’s pament went up. SchweinHundt!

  12. mike from iowa

    I believe Ryan admitted to withholding funds to force premiums to go way up. They held onto over 2.5 billion bucks.


    Despicably, disgusting, deplorables.

  13. It takes more than 140 characters to reform health care. Unfortunately, it’s easier for Trump, Rounds, et al. to tell catchy lies in 140 characters than it is for us to refute them with detailed facts and data. I proceed unbowed.

    However, as penance for my lengthy retorts, I offer the following repeal-and-replace plan:

    The Affordable Care Act is repealed.

    All American citizens are eligible for Medicare.

    85 characters. How’s that, Grudz?

  14. Porter Lansing

    You know that’s where USA is headed. Medicare Part E. E is for everyone. It’s said that every nasty, dark cloud has a silver lining and just maybe if Republicans are allowed to put their name on it and claim the rewards of voter approval for it, we might see national healthcare. Who cares who gets the credit as long as we all get cheaper and better services. Buying things we all need as a group is cheaper. It saved Europe after everything was destroyed by Nazi bombs and Allied tanks and it still works today. We both saw “Who Do We Invade Next” and the truth was pretty undeniable.

  15. Of course the republicans opposed the Affordable Care Act. It was conceived by a republican think-tank, the Heritage Foundation. It was enacted by a popular republican governor in a blue state (Romney), and it was sponsored by a black president. What is not to oppose here, republicans?!

  16. mike from iowa

    Obama didn’t call the ACA “Obamacare”. That was a derogatory name slapped on it to make it easier to mock. When wingnuts finally figured out it was working, they shifted into overdrive trying to repeal a success for Obama and Dems.

    Porter, can you point out the silver lining in this wingnut cluster**** dark cloud?

  17. Darin Larson

    Cory, if Republicans were smart, they would do just as you suggest by enacting Medicare for all. Then they could further tweak it with the power of Medicare to enable the medical services market to compete to serve patients at the lowest cost. Imagine Sanford and Avera bidding against each other to serve all the medical needs of a group of 25,000 people in a certain coverage area. Patient satisfaction scores would be measured as part of keeping the contract with Medicare. Medicare should also be allowed to negotiate drug pricing. Coverage for all with market force cost controls and reasonably priced drugs would be a panacea.

  18. mike from iowa

    With Medicare for all, they are going to have to RAISE TAXES to save these entitlement programs and wingnuts would prefer letting Putin take control rather than raise a penny in new taxes or old.

  19. The foundation has been set to keep Obamacare in place for at least another 4 years. As Porter says, the silver lining is that it will need to be improved and will happen.

    We saw this very same progression in the 2003 mandate of President Bush’s Medicare Part D. The disaster that followed lasted for a couple of years before Democrats and Republicans worked together to salvage it. I look for the same now that it is clear to see that repealing Obamacare would end healthcare facilities, put doctor’s on a very short leash while making insurance companies obsolete. It could have the potential to make the crash of 2008 seem like just a rainy day.

    Thankfully, it was not up to dimwits like NOem, and Thune to come to grips with this. I do think that Rounds was doing some back channeling to change minds and keep it in place as he has a multi-million dollar agency that depends on health insurance.