Replies to post #266725 on Tornado Alley (PROG)

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Fact Check: Trump’s Critiques of the Affordable Care Act

"Populism and the Politics of Health"

By LINDA QIU MARCH 13, 2017


President Trump meeting on Monday morning with Americans he described as “victims” of the Affordable
Care Act. Credit Stephen Crowley/The New York Times

WASHINGTON — President Trump blamed the news media on Monday morning for “making Obamacare look so good” as he spoke at a listening session with nine people he characterized as “victims” of the health care law .. http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html?inline=nyt-classifier .

Mr. Trump repeated his declaration that “Obamacare is a disaster” — a sentiment echoed more specifically by White House and cabinet officials in the past few days.

While it is undeniable that the law has not been universally beneficial, many of the criticisms from Mr. Trump and his team are cherry-picked or misleading.
Mr. Trump pointed to high premium increases.

“You represent the millions of American who have seen their Obamacare premiums increase by double digits and even triple digits.”

This needs context. In 2017, premiums for the benchmark plan increased by 22 percent .. https://aspe.hhs.gov/system/files/pdf/212721/2017MarketplaceLandscapeBrief.pdf .. on average across the states that use the federal marketplace or have their own exchanges, according to the Department of Health and Human Services. Some places had higher increases (116 percent in Arizona, the only state with a triple-digit increase) and some lower (9 percent in Wyoming).

That’s much higher than the 7 percent increase in 2016 and 3 percent increase in 2015, but looking at premium increases alone does not fully capture what people are paying.

About 84 percent of enrollees qualify for tax credits that help blunt the costs in 2017, meaning the government picks up the tab for any increase. Factoring in this financial assistance, a 40-year-old nonsmoker making $30,000 would see no change, or even a slight reduction, for the benchmark plan in all but two states, the Kaiser Family Foundation estimated .. http://kff.org/health-reform/issue-brief/2017-premium-changes-and-insurer-participation-in-the-affordable-care-acts-health-insurance-marketplaces/ .

Mr. Trump criticized the law for having little impact on the number of insured.

“First of all, it covers very few people.”

False. About 20 million have gained insurance under the act. The uninsured rate fell to 10.9 percent .. http://www.gallup.com/poll/201641/uninsured-rate-holds-low-fourth-quarter.aspx .. at the end of last year, according to Gallup, compared with 17.1 percent at the end of 2013. Analysis from the Commonwealth Fund concluded .. http://www.commonwealthfund.org/publications/issue-briefs/2016/dec/aca-declining-uninsured-rate .. that the Affordable Care Act was responsible for a majority of the decline.

Mr. Trump suggested millions are unsatisfied with the Affordable Care Act or lost health care because of it.

“Millions of people had great health care that they loved. Now when you start deducting those millions of people from the so-called people who are happy, you have a very small number of people that are happy.”

This is misleading. Researchers at the Urban Institute estimated .. http://healthaffairs.org/blog/2014/03/03/how-many-nongroup-policies-were-canceled-estimates-from-december-2013/ .. that roughly 2.6 million people reported in 2013 that their plans were being canceled because of noncompliance with the A.C.A. But half of these people were eligible for Medicaid .. http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicaid/index.html?inline=nyt-classifier .. or subsidized insurance plans. A 2014 study from the RAND corporation, a nonprofit think tank, concluded .. http://www.rand.org/content/dam/rand/pubs/research_reports/RR600/RR656/RAND_RR656.pdf .. that fewer than one million people, not “millions,” ended up with no insurance at all.

Most polls also contradict Mr. Trump’s claim that there is a “very small number of people that are happy.” A majority of enrollees reported satisfaction with the health care law in three national surveys, though some expressed concern with lack of choice and affordability, according to a September 2016 Government Accountability Office .. http://www.gao.gov/assets/680/679673.pdf .. review. (The outlier is Black Book Market Research, a public opinion research company based in Florida, which found just 22 percent of enrollees .. https://blackbookmarketresearch.newswire.com/news/obamacare-satisfaction-plunges-as-insurers-focus-on-cutting-costs-and-18902747 .. were satisfied.)

Tom Price, the secretary of health and human services, suggested the Affordable Care Act has forced workers to take on multiple jobs.

“You hear people’s lives that have been affected in remarkably adverse ways that sometimes you don’t think about as it relates to health care — whether it’s businesses that haven’t been able to survive, or individuals who need to take three, four, five jobs.”

This is misleading. The Affordable Care Act mandated that businesses with more than 50 employees are required to offer health insurance .. http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/index.html?inline=nyt-classifier .. to employees who work 30 hours or more per week, or pay a penalty. Though there are certainly some anecdotes of employers reducing hours to get around the mandate, studies have been unable to find .. https://www.aei.org/wp-content/uploads/2015/08/aca_pre-publication_version.pdf .. much evidence .. http://content.healthaffairs.org/content/35/1/119.abstract .. of a widespread shift to part-time employment.

Mr. Price argued that Medicaid, not the Affordable Care Act, is the leading driver of more coverage.

“Well, in fact the number of individuals who actually got coverage through the exchange who didn’t have coverage before, or who weren’t eligible for Medicaid before is relatively small. So we’ve turned things upside down completely for three or four or five million individuals.”

This is misleading. Out of the 20 million people who have gained insurance under the law, about 14.5 million received coverage .. http://kff.org/health-reform/state-indicator/medicaid-expansion-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D .. through Medicaid, 3.3 million of whom were previously eligible.

A majority of these Medicaid enrollments, 11.2 million, occurred because of the Affordable Care Act’s expansion of the health care program. The health care law raised the eligibility cutoff to adults under 65 who made less than 138 percent of the poverty line.

Sean Spicer, the White House press secretary, claimed the Affordable Care Act has caused increases in private employer-based insurance as well.

“We went in to solve a problem that a small fraction of Americans had and we upended the entire system forcing premiums to go up and choice to go down for everybody.”

This is misleading. Health costs for employer-sponsored plans have risen in the years since the law was implemented. Independent estimates for the rate of increase hover in the 3 percent .. http://kff.org/health-costs/press-release/average-annual-workplace-family-health-premiums-rise-modest-3-to-18142-in-2016-more-workers-enroll-in-high-deductible-plans-with-savings-option-over-past-two-years/ .. to 4 percent .. http://www.commonwealthfund.org/publications/press-releases/2016/oct/slowdown-in-employer-insurance-cost-growth .. range.

But this trend was occurring in the years before the Affordable Care Act as well. The Kaiser Family Foundation estimates that premiums increased by 20 percent from 2011 to 2016, compared to 31 percent from 2006 to 2011 and 63 percent from 2001 to 2006.

https://www.nytimes.com/2017/03/13/us/politics/fact-check-trump-obamacare-health-care.html?_r=0