I can’t believe the 7.1 million people who signed up for Obamacare didn’t want this GOP healthcare alternative pic.twitter.com/goHz8uGrms
— Travon Free (@Travon) April 1, 2014
When the Congressional Budget Office predicted in 2010 that 7 million Americans would sign up for health insurance in the Affordable Care Act’s first open enrollment period, this prediction wasn’t meant to be a goal.
But as every element of the law became politicized, that’s what it became. And as the website floundered, stumbled and — at times — seemed positively unfixable, it looked like a nearly impossible goal. Even the CBO revised its prediction to 6 million.
Now that this number has been reached, what do we know for sure?
The New Republic‘s Jonathan Cohn put it best when he said, “The signup figures may not show that Obamacare works well. But they show that Obamacare works.” We don’t know if we have the 51 viable individual markets the law intended to create, but signs point to it being possible.
Still, Republicans will keep attacking the law — because, you know… elections — but their arguments will become even more absurd.
Here are the five worst arguments that will never, ever die — and why they should.
It Can’t Be 7,000,000!
The unskewer is back!
Who could have predicted that Obamacare signups would surge as the deadline approached?
Um, everyone who paid attention to Romneycare’s initial rollout and the skyrocketing numbers that Charles Gaba was reporting at ACASignups.net
Suddenly, people from the same party that accused the Obama administration of making up jobs numbers was arguing that the administration had fudged its statistics to meet the goal it had set for itself.
In reality, the 7 million goal is the smallest one this law needs to meet.
“The [CBO] expects enrollment though the insurance exchanges to more than triple by the end of 2016, to 22 million,” The Week‘s Adrianna McIntyre writes. “Total enrollment is expected to level out at 24 million to 25 million in 2017.”
But given that enrollments are verifiable and forging the number would result in a scandal bigger than the flubbed launch of HealthCare.gov, Republicans have retreated to another talking point…
Some People Won’t Pay!
Republicans have discovered a shocking fact of private insurance in the last few weeks: Sometimes people who sign up for it don’t pay.
Armed with this detail, they’ve been pointing out that of the 7 million who have picked a plan, about 15 to 20 percent won’t pay. This will affect the law’s viability, but it’s also an inevitability of a system that keeps the private insurance market alive.
If Republicans want a plan where paying isn’t optional, they could join the rest of the industrialized nations around the world with single payer, which deducts the costs of care directly from paychecks… the way Medicare already does.
Photo: Taber Andrew Bain via Flickr
Only A Few Million Uninsured Are Covered!
Republicans like to take the 7 million number and deduct those who won’t pay and those who were only replacing canceled plans, and come up with just a million or so people gaining coverage.
To do this, they ignore that in many states, people have been allowed to keep their canceled plans. Then there’s the 4.71 – 6.49 million Americans who have gained coverage through Medicaid expansion, plus the up to 4 million who have gotten coverage directly through insurers. And of course, they don’t want to count the millions of people up to age 26 still on their parents’ plans, thanks to the law.
Medicaid enrollment will continue all year and anyone who loses a job, gets married, graduates or moves can still get covered through HealthCare.gov.
The CBO estimates that 13 million uninsured Americans will gain coverage this year and that’s more than one and a half times the 7.9 million fewer Americans who had health insurance after eight years of George W. Bush.
Additionally, tens of millions now have improved plans with free preventive care and no lifetime caps, along with consumer protection that requires insurers to justify that they are spending at least 80 percent of their premiums on actual care.
Graph: Charles Gaba via ACASignups.net
It Doesn’t Cover Everyone!
This is another Republican argument that makes it seem as if the GOP alternative to the current version of health care reform had been single payer.
Obamacare was designed to drastically reduce the number of uninsured Americans, not to cover everyone. If Republicans have a plan where no one has to pay and everyone is covered, they should offer it today. I’d imagine that quite a few Democrats would happily go along with it.
The ACA was a compromise built on top of a compromise, and with a 60-vote Senate, it’s a miracle it exists at all. If coming up with a plan to transform our broken health care system were easy, the GOP would have passed one of its own at some point during the three years they’ve controlled the House.
The GOP isn’t just moving the goalposts here. It’s building new ones.
Photo: ProgressOhio via Flickr
We Shouldn’t Be Forced To Pay For Other People’s/Our Own Health Care
Fact: We already pay for each other’s health care. But we do it through taxes, lost productivity and the highest health care costs in the world.
Even if the GOP wants to repeal the law that mandates hospitals not turn any sick patient away — The Emergency Medical Treatment and Active Labor Act (EMTALA), or as I like to call it, Reagancare, since the Gipper signed it — we’ll still be paying for each other’s care, and not just because most of us will end up on Medicare or Medicaid at some point in our lives. The mandate means that we’re responsible for a small chunk of the millions of dollars we may cost our fellow Americans over our lifetimes.
Republicans dispute the notion that “we’re all in this together,” but there’s a metric that proves that point over and over that they love — Gross Domestic Product.
For the privilege of having the 25th best health care system in the world, we pay 17.9 percent of our GDP on health care, the highest in the world. Reducing that percentage to about 12 percent — what Switzerland and the Netherlands devote to care — would transform our economy, President Bill Clinton noted last year.
“The difference between 17.9 percent and 12 percent is $1 trillion a year,” he said. “A trillion dollars that could go to pay raises, or to hire new employees or to make investments that would make our economy grow faster or to provide more capital to start small businesses or to expand others or to support diversifying and strengthening agriculture. You name it. A trillion dollars is a lot of money to spot our competitors in a highly competitive global economy.”
We know how to reduce what we spend on health insurance and it starts with insuring as many people as possible. Obamacare has done more to reach that goal than anything the government has done in generations.
Photo: cometstarmoon via Flickr