“…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.