Politics of the ACA; also, There’s Three Kinds of Lies

There’s three kinds of lies: lies, damn lies, and statistics.

Numbers are easy to manipulate.  You can fairly easily tell technical truths while obscuring the actual truth, or, at least, over-simplifying complex issues.  Pundits and politicians do it all the time.

Unless, of course, you’re just lying.

Unless you live under a rock (and it would have to be a very remote rock), you have heard the accusations that millions of Americans had their insurance policies cancelled (or have been notified of the same) since the implementation of Affordable Care Act.

This is, technically, the truth.

What that number fails to reflect is the number of policies that:

• Would have been cancelled regardless, as happens every single year.
• Were lost due to some factor outside of the ACA, such as lose of job.
• Were replaced by another policy, even if the new policy was cheaper or better, even if the policy was replaced by the same company, and even if that replacement was automatic.
• Were so bad that the policy holder could have still easily been bankrupted by a major medical event.

50 to 75 percent of individually purchased insurance will be cancelled

The 50% to 75% numbers were put forth in an NBC article and have since been quoted as more evidence of the failure of the ACA.

I wouldn’t be surprised if those numbers were correct.  “Individually purchased insurance” is generally terrible, take great advantage of people who have no other access to health care.  This is not the insurance you get through your employer, who pays part of your premium.  This is insurance where you pay 100% of premiums, which generally covers fairly minimal things.

Ah, statistics…and the hope that readers don’t realize what “individually purchased insurance” really is.

“The United States has seen ‘a net loss of people with health insurance’ because of Obamacare” -John Boehner

This is not statistical manipulation.  This one is just a lie…or utter ignorance, take your pick.  As Boehner further explains:

“When you look at the 6 million Americans who’ve lost their policies, and (government officials) claim 4.2 million who’ve signed up — I don’t know how many have actually paid for it — that would indicate to me a net loss of people with health insurance. And I actually do believe that to be the case.” (source)

But, as already stated, losing a policy in no way equates to being without insurance. Lots of people who lost a policy got another one through various means, frequently without a cost increase or at least getting much more value for their buck.

As further explanation:

“According to [Boehner], there were 6 million people told their policies were canceled because they didn’t meet the health law’s minimum benefits and coverage. And the administration announced that through February, 4.2 million had purchased insurance through the state and federal marketplaces. (A few days after Boehner spoke, the administration announced enrollment through the marketplace surpassed 5 million.)” (source)

Comparing those two specific numbers makes no sense.  Many of the people who lost insurance got different insurance outside outside the Marketplace. Seriously, these numbers are meaningless in the context of net loss of coverage, which was Boehner’s message.

Lies, damn lies, and statistics.

The Cherry Pick

Boehner’s not nearly the worst when it comes to working numbers that sound like they support you.  MyGovCost.Org (and other sources) have posted by state where over 2,000,000 policies have been cancelled due to the ACA.

First, this suffers from some of the above problems: it doesn’t weigh how many of these policies were replaced, much less how many uninsured people gained insurance.

However, there’s a much grosser issue here: it only displays a handful of states, and even there only handfuls of sources.  The numbers for Alabama, for example, only cover numbers reported by Blue Cross.  Updated numbers include the state of Wisconsin, noting “Madison only.”  Here, a single city (and not even the largest) represents an entire state, and a handful of states (13 in the original article, with addendums that eventually add another 4, then another 10) are meant to represent the entire country.

That’s. Not. How. Statistics. Work.

“If you like your plan, you can keep your plan” – Barack Obama

Ok, that line was bullshit.  Clearly, some people were going to lose their plans.  The point of the line was the government wasn’t going to dictate where you go for insurance, but that doesn’t negate the fact that the sentence as said was complete nonsense.

Dealing (And Not Dealing) With a Broken Insurance System

A major point of the ACA was to start reigning in out-of-control insurance companies.  Until now, there has been very little competition in the health insurance world.  Either you:

• Buy the one option offered by your employer
• Buy individually purchased insurance, which almost universally suck, or
• you go without.

That means insurance companies can continually hike prices and limit coverage without being in danger of losing many customers.

The ACA offers competition.  You can now choose to buy your employer’s insurance or buy one of many policies offered through the ACA Marketplace (I personally had access to 84 different policies).

Those who harp most about Obama’s lie have often done nothing to address the problem the ACA imperfectly approaches.

These critics include Republican politicians who did not vote for ObamaCare; these are Republican governors who refuse to set up exchanges to reach their own citizens; these are people oppose expanding Medicaid to help poor people getting better health care; these are people who have never put any proposal on the table as an alternative fix for the nation’s costly health care system that leaves tens of millions with inadequate medical coverage and tens of millions more totally uninsured. (source, which, incidentally, is an opinion piece on Fox News)

Don’t believe this is anything but political

The ACA wasn’t meant to operate on its own.  States were given the option of running their own Marketplaces, and they were given federal funding to expand Medicaid coverage to those too poor to qualify for subsidies under the ACA.

Guess which states took advantage of those options?

Among the 22 states (plus D.C.) that are running their own exchanges or partnering with the federal government to do so, Democrats control the legislatures of 17 and hold 18 governorships (or mayorship in the case of D.C.). Among the 27 federal-default states, all but two have Republican governors and 23 have GOP-controlled legislatures. (Pew Research)

My own governor, Scott Walker, has repeatedly, actively and vocally rejected the ACA.  In 2012, he refused $37 million in grants to investigate implementation of a state-managed marketplace.   He turned down millions of dollars in federal aid by not expanding Medicaid.  In fact, tens of thousands of people got kicked off Medicaid in the name of “less dependence on government, and more dependence on individual hard work.” (source)

Because, you know, people are only poor because they refuse to work hard.

As an Aside: It’s worth noting the U.S. Bureau of Labor Statistics recently ranked job growth in Wisconsin:

• 9th out of 10 Midwestern states
• 35th out of 50 for private sector jobs
• 32nd out of 50 in total job growth (The Cap Times)

We’re also 48th out of 50 for new business start up (Politifact)

Walker and I clearly disagree on our understanding of the slogan “Moving Wisconsin Forward.”

On the bright side, that’s a nice increase from being dead last in job growth in 2011. (Politiscoop)

But I digress.

The Insurance Coverage Gap

One big potential problem with the ACA is the insurance coverage gap.  There is a minimum income necessary to qualify for ACA subsidies.  The reason is that the truly poverty stricken should be on Medicaid.  However, Medicaid is run by the state, and in many states the maximum income for Medicaid is lower than the minimum income from ACA subsidies.

You may wish to compare the above map with this one:

Of the 29 states currently led by Republican governors, 21 have delayed or refused (as indicated by the fist map), and eight have not.

There’s also four states with Democratic governors that have refused.

It’s not a perfect correlation.  Most issues aren’t.  But it’s an ugly and obvious slant.

The ACA isn’t our problem.  Politics and unchecked insurance companies are the problem.

Even More Reading:

• The Truth About Those Cancelled Health Plans

• The GOP claim that more Americans have lost insurance than gained it under Obamacare