Jonathan Gruber appeared on Fox News Sunday this morning and blamed Obamacare’s ongoing problems, including premium spikes and insurers dropping out of the exchanges, on President Trump.
“I think everybody agrees Obamacare has serious problems,” host Chris Wallace said introducing the topic. He then played a clip of President Trump saying this week that Obamacare was “essentially dead.” Wallace then pointed out that premiums went up 24% last year as competition in the marketplaces declined. Finally, Wallace confronted Gruber with the situation in Iowa where the sole remaining insurer in most of the state announced last week that it might pull out completely. If so, this could leave up to 100,000 people with no options for insurance.
“Look, and whose fault is this?” Gruber replied. “Before President Trump was elected there were no counties in America that did not have an insurer,” he said. Gruber continued, “We had a situation under Obamacare where there was a one-time premium increase last year that made up for the fact that insurers massively underpriced in the first two years.
“The problem was fixed. Insurers profits were trending positively. Insurers were saying positive things about their ability to stay in the exchanges and succeed. Then you have a president who comes in, undercuts open enrollment, doesn’t honor the obligations this law makes to insurers and as a result premiums are going up and insurers are exiting. You can look at the quotes from insurers themselves.”
Gruber’s claim about undercutting open enrollment is about cutting some TV ads during the final week and an announcement about waivers for the individual mandate. But both of those changes happened in the final days of January. Enrollment was down by 500,000 this year. So even if Trump hadn’t cut the ads or announced the waiver, at best enrollment would have been closer to last year.
But enrollment is supposed to grow. Last year CBO projected 2017 enrollment would be 15 million. At the end of the year, CBO adjusted that projection downward to 13.8 million, which would represent 9% growth over 2016. Actual enrollment this year was 12.2 million. So, maybe, if Trump hadn’t interfered, enrollment growth might have been 0.0% instead of a decline, but here’s the important point: That’s still a massive failure compared to 9% growth. You can’t blame that huge difference on Trump.
As for Gruber’s claim that Trump didn’t “honor the obligations this law makes to insurers” that’s also not true. Gruber is talking about cost-sharing payments to insurers. It’s true that some insurers have said premiums would go up substantially if these payments were cut. It’s also true that Trump talked about cutting those payments last month. But so far they haven’t been cut. So if insurers are losing money at this point it’s not because of anything Trump did.
And insurers are losing money, contrary to Gruber’s claim that after a one-time adjustment last year all is well. Let’s look at the situation in Iowa in detail. The reason there is only one statewide insurer left in Iowa is because two other large insurers, Aetna and Wellmark, announced they were pulling out of the state last month. Why did they do that? Because they were losing millions. From the Des Moines Register:
Wellmark President John Forsyth said his company’s decision was painful but necessary, because the carrier had lost $90 million over three years covering that group of people.
“We’re an Iowa company, we’re here for Iowans, we want to do the right thing for Iowans, but we can’t allow a small subset to put the broader group in jeopardy,” he said in an interview Monday.
That’s what Wellmark said when it left. Now here’s what Medica, the last statewide insurer, said about why it might leave as well:
Medica Vice President Geoff Bartsh said his company would have continued selling insurance throughout Iowa if Wellmark and Aetna had stayed in the market. But Medica, which lost $1.5 million covering 14,000 Iowans last year, couldn’t afford to take on tens of thousands more from the other two carriers, he said.
“The decision wasn’t, ‘Should we continue?’ It was, ‘Should we be the only game in town?’” Bartsh said in an interview Wednesday.
So, Medica has been losing money on the Iowa exchange and now faces picking up tens of thousands of new customers who were already causing larger insurers to lose millions. That’s nothing like the rosy picture being painted by Jonathan Gruber about how well insurers are doing.
And there’s more evidence that last year’s price hikes were not a one-time thing. This week one of the largest insurers in the mid-Atlantic region requested a 59% premium hike in Maryland and a 35% hike in Virginia. So the idea that all is well with Obamacare (apart from decisions made by President Trump) is not in line with reality. Once again, Jonathan Gruber is lying to people about the law he helped design. Given his track record, that shouldn’t come as much of a surprise.