A Bit of Truth-Telling on Obamacare

by Wendell Potter on November 5th, 2012

The Affordable Care Act’s benefits are hidden beneath the alarmist rhetoric.

Wouldn’t it be great if our candidates had to take a dose of truth serum every morning before hitting the campaign trail? If they did, those of us who will be voting tomorrow wouldn’t be nearly as confused about what Obamacare is and what it isn’t, what it will do and what it won’t.

Since there is no such truth serum requirement, I believe that many of us will actually be voting against our own best interests. Many Americans will vote for candidates who have scared them into believing that Obamacare is a government takeover of health care that it will bankrupt the country while slashing Medicare benefits.

In the event that you or someone you know might benefit from some truth-telling, here, then, are a few things you ought to know before pulling that lever tomorrow:

·         The Affordable Care Act is not a government takeover that has put us on a slippery slope toward socialism, or even toward a single-payer system like the one in the People’s Republic of Canada. In fact, the law actually shores up our uniquely American,  market-based,  multi-payer system now dominated by for-profit insurance corporations.  That is not my favorite part of the law. But if you think insurance companies contribute value to our system, you should know that Obamacare gives them a new lease on life.  Their business practices—which for years have included refusing to sell coverage to people with pre-existing conditions and pricing many other folks out of the system—have actually resulted in an ever-shrinking market. As a consequence, the insurers’ business models are not sustainable. Without a requirement that we all buy coverage from them, insurance companies will be able to grow only by taking market share away from each other and by persuading senior citizens to enroll in their profitable Medicare Advantage plans.

·         The legislation is not going to add trillions to the deficit, even though it will expand Medicaid and provide subsidies to low-income individuals and families to buy private coverage. In fact, the opposite is true, according to the nonpartisan Congressional Budget Office.  In 2010, the CBO estimated that Obamacare would actually reduce the deficit by $214 billion over 10 years, in part by reducing overpayments to private insurers that operate Medicare Advantage plans.  After Republicans who had campaigned against the law regained control of the House after the 2010 elections, they passed legislation to repeal Obamacare in its entirety—despite the fact that the CBO warned that their bill was the one that would increase the deficit—by $240 billion over 10 years. The bill went nowhere in the Senate.

·         The Affordable Care Act will not cut Medicare benefits. On the contrary, because of Obamacare, Medicare is now providing coverage for preventive care, like cancer screenings, for the first time. And the law is also improving the Medicare drug benefit by gradually reducing the amount of money seniors have to pay for medications out of their own pockets. As noted above, the law does reduce payments to insurers and to some health care providers—by an estimated $716 billion over the coming decade—but that money represents savings, not benefit cuts.  One of the reasons the hospital industry endorsed Obamacare is that by bringing more people into coverage, hospitals will not have to provide nearly as much uncompensated care, which hits their bottom lines very hard. So hospitals were quite willing to go along with a reduction in future payments from the government because they know they will more than make up for it by having far fewer uninsured patients.

Here are some things the law will do:

·         It will prohibit insurance companies from refusing to sell coverage to people simply because they have one or more pre-existing conditions.

·         It will also prohibit them from cancelling our coverage when we get sick just to avoid paying for our care.

·         It will prohibit insurers from charging women more than men for comparable coverage and will not allow them to charge older folks more than three times as much as younger folks.

·         It will require them to spend at least 80 percent of what we pay in premiums actually paying claims and improving care.

·         It will allow young adults—who comprise the largest segment of the uninsured—to stay on their parents’ policies until age 26.

·         It will reduce the number of uninsured Americans by at least 30 million if all the states agree to accept federal dollars to expand their Medicaid programs.

That said, Obamacare is not a panacea for all that ails the U.S. health care system. I view it as the end of the beginning of reform. We will have to do more as a nation to bring everyone into coverage, to control costs and to improve the way we deliver care. But Obamacare does not resemble the law that many politicians have spent millions of dollars trying to persuade us it is.  Don’t be fooled into voting against your own best interests tomorrow.

Wendell is a Senior Analyst at The Center for Public Integrity where this first appeared on 11/5/2012.

{ 8 comments… read them below or add one }

Tobey Stein November 8th, 2012 at 6:39 am

Well, the popular vote was close, but thanks to the antiquated electoral college, Obamacare will live on. I’ll drink to that.

Sara November 8th, 2012 at 10:53 am

Thanks, Mr. Potter, as always for a great cogent summary on a topic that seems to need to be reiterated a lot for the American public!

@Tobey, just to be clear, as of the Thursday after the election, nobody is suggesting that Obama didn’t win the popular vote as well! He won it all, right?

Tobey Stein November 8th, 2012 at 9:07 pm

Sara, of course he won the popular vote, but he won it by just 2.5%, then won the electoral vote by 20%. I’m glad he won, but I have my doubts about the use of the electoral college representing the will of the voters. Didn’t W Bush win one time even though he lost the popular vote? What a disaster that was………

Alfred Jordan November 18th, 2012 at 11:20 am

I think that most everything you outline is true about the PPACA. Your comments do not cover :
a host of new taxes
job losses exceeding 150,000 in the insurance industry
small businesses leaving the group insurance market, paying fines rather purchasing coverage
no reductions in insurance premiums
massive increased pharmaceutical expenses
consolidation of insurers into mega national insurers
no mechanism to increase competition to reduce medical expenses
no mechanism to create self-insurance plans for small to medium insurers

In general the PPACA does not solve the underlying issues.

UHC Supporter November 24th, 2012 at 8:15 am

I support universal health care but do not like the ACA. I support some of its provisions such as coverage for dependents up to age 26, no pre-existing exclusions, etc. Unfortunately, I think the main effect of the ACA on the middle-class will be increased taxes. While those who are underinsured will find that they really have no better access to care (i.e. still high premiums, high deductibles, too many out-of-pocket expenses, benefits denied). As a result, I think this will turn many people against universal health care. They will not fully understand that the ACA’s six of one, a half dozen of the other approach to healthcare is NOT universal health care.

Christie J. Fox November 27th, 2012 at 12:30 pm

I heard bits and pieces of Wendell Potter’s talk on a radio station this morning (Nov 27) and he was talking about pre-existing health issues. He said seniors would have to pay 2 to 3 times more for pre-existing health issues. Did he really say that or did I mis-hear. This came as a shock to me so I’m just trying to clarify. tks.

Richard November 27th, 2012 at 2:36 pm

Hi Wendell. Here’s to you! We won! “Obamacare” is thankfully on the horizon. And you — by clarifying its complexities and getting its truth out to the masses — positively played a role in it.

Thank you for your time and expertise. Thank you for your commitment, your diligence.

Thank you for your help.

Pam December 5th, 2012 at 4:44 pm

So, I have to tell you, that as a person who has experienced government healthcare in the past, I am already aware of how incompetent and useless that is and can only guess at how much the taxpayer is paying for such service to the sick that are too poor to buy insurance. Insurance is a ripoff too. There are many extortionists out there all keeping the poor dying to support their own rich lifestyles. Anyway, government healthcare…. ran me and everyone else around in circles, while they ate up more taxpayers money on the sheep that they shuffle in and out. A doctor will spend all of 2 minutes with you. They ask no questions. And they absolutely don’t do a damn thing for the patients. They shuffle… In and out, over and over, until you get sick of being a sheep that feels like it is on it’s way slowly and torturous, to the slaughter house. You want people to believe in the healthcare bill, you best take the government out of the equation. If there’s one thing I know, it is Obama has no problem with spending taxpayer money. He has spent more than Bush did in 8 years, in half the that time. Anyone that doesn’t see the truth about the criminals that infest our government, like a plague should consider yourselves to be one of those sheep. Too bad, no one here believes that. Critical thinking would help you, if you wanted help. Don’t say you weren’t warned. ;)

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