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Wednesday, August 23, 2017

Speaker of the House Paul Ryan (R-WI) scheduled the vote on the Republican health care bill, the American Health Care Act (AHCA), on the seventh anniversary of the passage of the Affordable Care Act (ACA), also known as Obamacare. Despite seven years of Republicans pledging to repeal and replace the ACA, all they’ve managed to come up with is a bill that is the manifestation of some of the worst myths and baseless critiques that right-wing media leveled against the ACA.

The Republican Party introduced their health care bill earlier this month. The proposed legislation severely cuts Medicaid, reduces tax credits while giving a massive tax cut to the wealthy, and dramatically increases the number of uninsured Americans, effectively erasing the gains made by the ACA. While right-wing media has spent the better part of a decade demonizing the ACA, three of their biggest myths — allegations that the ACA hurts seniors, that Democrats rammed the law through Congress, and the never-ending predictions of a “death spiral” — are actually valid criticisms of the GOP health care law.

The most famous right-wing media myth surrounding the ACA is the death panel — the false allegation that the ACA created a panel of government bureaucrats that would ration health care for the elderly. PolitiFact dubbed the falsehood the “Lie of the Year” in 2009. However, right-wing media figures continued to push the myth for years. The specter of a death panel that might euthanize a grandmother fit into right-wing media’s narrative that the ACA would hurt seniors. Conservative media figures forwarded a variety of lies about how Obamacare was “sticking it to the seniors,” ranging from assertions that the ACA’s medical tax would apply to wheelchairs (it doesn’t) to false allegations that the law eviscerated Medicare by raiding its funding.

In reality, the ACA improved senior care by reducing prescription drug costs for the elderly and extending coverage to key services. The ACA improved access to care by increasing Medicare payments for primary services and instituted crucial protections to improve the “quality and coordination of care.” The health care law also extended the solvency of Medicare by over 10 years, after which “payroll taxes and other revenue will still cover 87 percent of Medicare hospital insurance costs.”

The AHCA, on the other hand, worsens the health care outlook for seniors. The bill loosens the age-rating protections that limit how much insurers can charge seniors, allowing them to discriminate against the elderly by charging them five times more than younger individuals. While allowing insurers to jack up premiums for the elderly, the AHCA also provides substantially less generous tax credits for purchasing health care, likely far below what would be needed to purchase comprehensive coverage. This disproportionately hurts working-class seniors. According to Vox, a 64-year-old who makes $26,500 a year will see “more than a 750 percent increase in premiums from Obamacare to the Republican bill.” As The Atlantic’s Vann Newkirk explained, “proportionally, the group of people that would see the most coverage losses under the AHCA is the population of people aged 50 and older.” And while the ACA increased Medicare’s solvency, the AHCA repeals the Medicare payroll surtax on the wealthy, which will “weaken Medicare’s financial status” by depleting its funding “three years sooner than under current law,” according to the Kaiser Family Foundation. Essentially, despite right-wing media having pushed the image of seniors as one of Obamacare’s main victims, it is actually the Republican health law that actively worsens access to health care while increasing costs for the elderly (just ask the AARP).

Another anti-Obamacare talking point featured conservative media figures decrying the allegedly undemocratic process by which Congress passed the ACA, claiming that Democrats were trying to “ram it down America’s throat.” Right-wing media took then-Speaker of the House Nancy Pelosi’s (D-CA) comment “we have to pass the bill so that you can find out what is in it” at the National Association of Counties out of context, to scandalize the health law as a secretive, closed door deal.

Despite the rampant right-wing smears, the debate over the ACA was “one of the most transparent” in recent history, as Congress debated the legislation for over a year before it was signed into law. The full context of Pelosi’s now notorious speech reveals that her comment was about the need to have conversations about the substance of the ACA outside of the “fog of the controversy,” because negative talking points dominated the discussions of the law.

The clear differences between the legislative processes for the ACA and the GOP health care bill lays bare right-wing media’s hypocrisy. As Politico’s Dan Diamond noted, “in 2009, Dems took 119 days between introducing [the] bill [and] taking a floor vote,” while “in 2017, [the] GOP will do it in 17 days.” The GOP has pledged to hold a vote on the bill in the House on March 23, despite the fact that the CBO has not finished scoring the substantial amendments released this week. Topher Spiro, the Center for American Progress’ Vice President for Health Policy, highlighted the hypocrisy, pointing out “Republicans *literally* have to pass the bill to find out what it does,” since it is highly likely there would be “no CBO score before the vote.” Instead of defending the democratic process they found so dear in 2009, conservative media figures portrayed the AHCA’s passage as inevitable and allowed guests to insist that the Republicans are using “regular order” to normalize the rush to pass the disastrous bill. The hypocritical treatment of these starkly contrasting legislative processes illustrates how right-wing media fealty to democratic norms only exists when it furthers their own narratives.

The third manifestation of conservative hypocrisy on health care stems from right-wing media’s continued predictions over the last seven years about the possible collapse of the Affordable Care Act’s insurance markets into a death spiral. Conservative outlets claimed the law was in a death spiral each time premiums increased, when Aetna withdrew from the exchanges, when they alleged there weren’t enough healthy enrollees, and when some of the co-ops failed. None of these alleged death spirals were real — in fact, the newest CBO report confirms the ACA is not collapsing and will continue to stabilize, despite claims to the contrary.

By eliminating the individual mandate and replacing it with a much weaker “continuous coverage” requirement, the AHCA seriously risks a death spiral because it “could have the unintended consequence of discouraging healthy people from buying coverage.” Whereas the ACA’s individual mandate incentivizes purchasing insurance to avoid a penalty, under the continuous coverage requirement a healthy uninsured individual is likely to wait until they are sick to join the market, massively increasing costs. The Century Foundation outlined how the AHCA could result in a death spiral because coverage losses and cuts in financial assistance will result in few healthy enrollees. Families USA noted that the only way the AHCA creates stable markets is “by making it nearly impossible for older adults and the sick to find affordable coverage, leaving only the healthy or wealthy in the market.” While the predictions of the ACA’s demise have been greatly exaggerated, the Republican health law might actually lead to the death spiral right-wing media have long been hyping.

The false claims right-wing media have made over time about the ACA highlight only a few of the ways in which the AHCA would devastate the American health care system. The AHCA pays for a $600 billion tax cut for the wealthy by cutting Medicaid — the program that provides essential health care for the disabled, the elderly, and low-income communities — by 25 percent. The newest reported proposal to eliminate the ACA’s essential health benefits package will gut access to substance abuse treatment for victims of the opioid epidemic and likely increase costs for women as insurers can drop maternity coverage. By defunding Planned Parenthood, the AHCA will deprive many low-income communities of their only safety-net health center and result in thousands of additional births per year. If the law passes — despite the apparent cancellation of the first scheduled attempt — the AHCA could create the apocalyptic fantasy right-wing media desperately sought to find in the ACA.