It would be a genuine challenge to identify a more obsequious group of water-carriers for the Obama agenda than the (hilariously inept) “explanatory journalism” team at Vox. One of their ongoing projects is “Voxplaining” to Americans how Obamacare is, in fact, working quite well — regardless of what the vulgar right-wing liars might be asserting. Though I spent a great deal of time refuting one such effort last fall, I once again feel compelled to rise on behalf of Obamacare opponents to puncture Vox’s latest pseudo-factual exercise in ideological self-congratulation. Last week, blogger Sarah Kliff, who has done some good work as a journalist on the healthcare beat, published a piece crowing that the so-called “Affordable” Care Act has been vindicated by outcomes. Setting aside problems with her approach — selecting uniquely hyperbolic predictions to “rebut,” and treating shorthand critiques as granular objections, for instance — let’s examine the eight “myths” she purports to refute:
(1) Nobody wants to buy Obamacare: Of course it’s true that many people wanted to, and did, obtain coverage through Obamacare — both on the exchanges, and through the law’s Medicaid expansion. Millions of those who enrolled through the exchanges, however, had little choice in the matter. They’ve been stripped of their existing, preferred coverage, and forced to purchase new, compliant plans. This represents a glaring violation of one of the law’s central pledges. The fact that these people were legally required to buy Obamacare is not evidence that they wanted to do so. Kliff also mentions that it’s “much worse” to be uninsured than insured. Empirical data shows that this statement is (tragically and counter-intuitively) not necessarily true, at least for those who are now covered under Medicaid.
(2) Obamacare will “never” meet its enrollment goal: The administration’s shortfall in sign-ups has, indeed, been a familiar refrain among the law’s critics. Perhaps that’s because Obamacare sign-ups did fail to meet the White House’s public projections during the 2013-2014 open enrollment period. The administration significantly inflated their stats in several ways to hide this fact. (Kliff acknowledges one recently-revealed form of malfeasance, moving the goalposts to celebrate how Obamacare “didn’t completely miss” its targets). The nonpartisan Congressional Budget Office also downgraded enrollment projections for 2015 by millions of people. At the behest of Democrats on the Hill, the White House has now added an unscheduled, on-the-fly enrollment period later this year. Finally on this point, I repeat: It’s very strange to boast that millions have signed up for insurance due to a law that legally requires them to sign up for insurance. That’s not a meaningful achievement.
(3) Obamacare will wreak havoc on the economy: Silly conservatives have insisted all along that Obamacare would hurt the economy and kill jobs, Kliff sighs, eagerly noting that job and economic growth has continued on an upward trajectory since the law passed. She generously concedes that the healthcare law does not deserve “all” of the credit for this great news, but look at all these charts showing job growth since 2010! The US economy’s historically slow, plodding recovery finally has most arrows pointed in the right direction, but a strong case can be made that these positive trends have emerged despite Obamacare’s impact — and have likely been slowed down by it. CBO’s 2014 fiscal assessment determined that Obamacare will reduce overall full-time American employment by the equivalent of 2.5 million workers over the next ten years. The report stated that employment gains will “be smaller than [they] would have in the absence of the ACA.” CBO cited the law’s work disincentives as a “central factor in slowing economic growth,” both now and in the future. Many fewer full-time workers, slower growth. Does that count as “havoc”?
(4) The website will never work: In an especially unfortunate bit of timing for Kliff (and the president, who’d just assured his nodding supporters at Vox that Healthcare.gov was working “flawlessly“), this particular football spike was quickly exposed as…premature. Within days of publication, a spate of errors and glitches introduced fresh headaches for hundreds of thousands of Obamacare consumers. It was also revealed that bugs in the system are blocking newborn infants from being added to coverage. Furthermore, H&R block estimates that a majority of Obamacare subsidy recipients will be forced to pay back at least a portion of their taxpayer-funded assistance, due to miscalculations and incorrect income estimates. These problems are widespread because Healthcare.gov’s so-called “back end,” which is supposed to streamline the process of reconciling this type of data, remains incomplete. It was supposed to be fully built by late 2013. It’s now 2015. It’s also worth pointing out that taxpayers have spent more than $2 billion on the federal website. For $2 billion, that site really should be working “flawlessly.” It’s not. Still.
(5) Only people who had coverage are signing up: Yes, some of Obamacare’s enrollees were previously uninsured. But millions of them were not. There’s a debate over how many “new enrollees” touted by the Obama administration already had coverage prior to their plans getting canceled, but every estimate shows it’s a substantial percentage. The White House cannot reasonably celebrate these millions of coerced enrollments as “new.” Conservative healthcare wonk Avik Roy runs the numbers and concludes that only about five million of the administration’s claimed 11.4 million exchange enrollees previously lacked coverage. Kliff offers an array of estimates on this front, the best of which (by far) comes from…the Obama administration, which she’s already admitted has been caught cooking the books.
(6) Obamacare would cause a net-loss of insurance: This “prediction” only applied to very limited period of time, in the midst of the infamous 2013-2014 enrollment meltdown. Most people conceded that eventually, more people would have insurance than would not. Once again, the law mandates that people get insurance. Interestingly, two comprehensive government studies released late last year suggested that the ranks of the uninsured had either slightly increased (US Census Bureau), or had been reduced by far fewer people than Obamacare supporters have claimed (Centers for Disease Control). Even on this slam dunk outcome, Obamacare is not an unvarnished success.
(7) Premiums will skyrocket: Americans were promised, over and over again, that Obamacare would substantially reduce everyone’s rates. Instead, premiums have continued to tick up overall, and they have skyrocketed by double digits for many consumers. Kliff and others are reduced to arguing that aggregate premium increases are less steep “than expected,” as if that proves critics wrong. Unless the average family is paying less in premiums ($2,500 less per year, in fact), critics are not wrong. Various healthcare experts also argue that premium hikes have been superficially and temporarily held down by certain price control provisions within the law that will expire in the next few years. They anticipate an additional bout of major rate increases when those gimmicks sunset. Another way Obamacare plans have staved off major premium increases is by severely limiting provider and coverage networks, resulting in major frustration and “access shock” for many “beneficiaries.” Finally, proponents’ fixation on premiums also distracts from the biggest cost-related challenge facing Obamacare consumers: Unaffordable out of-pocket-costs, including huge deductibles and expensive co-pays. Among the tens of millions of Americans who remain uninsured under Obamacare, the number one reason they cite for declining to participate in the new law is lack of affordability.
(8) Obamacare just can’t work: This is a terribly subjective statement to “fact check,” but it’s basically correct nonetheless. Far more Americans say the law has directly harmed their families than helped, Obamacare’s popularity remains significantly underwater, and the law is objectively not working the way it was marketed. Not even close. Kliff cites a study showing that “most” Obamacare consumers have been able to get doctors appointments within two weeks. Even if we take this study at face value, a large minority of consumers also say they’ve had to wait weeks or months — or haven’t been able to see a doctor at all. This study is presented as evidence of the law “working.” Kliff also concedes that there isn’t a lot of data available yet on Obamacare’s promise of cost-curve bending, though many supporters have misleadingly credited the law with the recent slowdown in the rate of over spending increases (which is accurately attributed to the sluggish economy).
Some Obamacare opponents overstated and exaggerated predictions about the law’s deleterious effects. Critics were virtually unanimous, however, in stating that Democrats’ hugely expensive and disruptive policy experiment would fail to deliver on many of the core pledges upon which it was sold to the public. They were unambiguously correct on the whole, and the American people know it. Far from being “debunked,” the anti-Obamacare case has been exonerated by actual outcomes, in remarkable detail and breadth — and no tendentious Voxplanation can change that reality.