On 3/12/15, Steve Benen wrote for msnbc.com, “GOP senator: ‘Stop celebrating’ good Obamacare news,” an article that simply perpetuates myths about Obamacare's good[?] news, in what I suppose is a politically motivated attempt to discredit Republicans (http://www.msnbc.com/rachel-maddow-show/gop-senator-stop-celebrating-good-obamacare-news).
On 3/12/15, Mr. Benen, plays the obedient stooge writes: "'Obamacare’ is working better than expected on practically every front, from increased enrollments to lower costs, from expanded coverage to increased competition.”
Well, if he’s willing to put his credibility on the line with that little sentence, let’s take the bait.
INCREASED ENROLLMENTS COMPARED TO WHAT? Certainly not from projections of the Congressional Budget Office which confirms LOWER enrollments than they formerly projected.
In March, the CBO decided to EXCUSE the lower enrollments by going back to before the enactment of Obamacare to REDUCE HOW MANY PEOPLE WERE UNINSURED TO BEGIN WITH and in March disclosed that because the CBO “…decreased the estimate of the number of people who had no health insurance at all,” (CBO, publication 49973, page 22) they could reduce the number of people who needed health insurance in the first place so that would reduce how many people would enroll in Obamacare. Bottom line, were they misleading before Obamacare to get buy-into the law or are they misleading now to excuse lower enrollment?
LOWER COSTS FOR THE FEDERAL GOVERNMENT? First, the costs we’re talking about are those to the Federal government in running Obamacare. BUT, sorry Steve, the CBO tells us they can’t calculate the full budgetary impact of the law, only the health insurance coverage only provisions.
CBO Publication 49892, 1/15/15, page 1, “…estimates address only the insurance coverage provisions of the ACA and do not reflect all of the act’s budgetary effects…because the provisions of the ACA that do not relate directly to health insurance coverage generally modified existing federal programs (such as Medicare) or made various changes to the tax code, determining what would have happened since the enactment of the ACA had the law not been in effect is becoming increasingly difficult.”
LOWER COSTS TO THE FEDERAL GOVERNMENT, WHY, STEVE? Here Mr. Benen takes two pieces of BAD news, LOWER ENROLLMENT THAN ANTICIPATED AND MORE PEOPLE SELECTING BRONZE PLANS THAN ANTICIPATED (which saves money on cost-sharing subsidies which are only available to silver and better plans) to try to create his myth of “GOOD” News.
According to the Congressional Budget Office, it lowered anticipated costs for health insurance coverage only provisions of Obamacare because: “Lower estimated enrollment in coverage obtained through the exchanges in every year accounts for the majority of the $28 billion reduction in the estimated cost of premium assistance tax credits,” (CBO, Pub. 49892,page 11). Got that, Steve? The biggest contributor to savings of the $28 billion is because of LOWER ENROLLMENT.
The CBO also explains some government savings attributed to the fact that people EVEN WITH PREMIUM ASSISTANCE ARE TRYING TO SAVE MONEY by purchasing more bronze plans (rather than silver) than they predicted:
“…more people will forgo those subsidies by choosing to enroll in a bronze plan instead of a silver plan…the agencies expect that some people purchasing coverage through exchanges solely to comply with the individual mandate will be focused on minimizing their premium payments and thus will continue to choose bronze plans.’”(CBO, Pub. 49892, page 13).
Oh yeah, and then of course there’s the newest excuse for lower enrollment…the restatement of how many people were uninsured to begin with, fewer people uninsured, fewer people needed to get coverage. “…[S]lightly lower estimate of the number of people who will gain insurance coverage because of the ACA,” (CBO, Pub. 49973, page 19).
Steve then mentions “expanded coverage” which we can only suppose refers to Medicaid expansion which came in way over projected spending costs for the federal government in January according to the CBO because “…the estimated proportion of Medicaid enrollees who were newly eligible under the ACA was larger than expected,” (CBO, Pub. 49892, page 11) which meant that “For 2015 and beyond, the agencies currently expect that roughly 70 percent of the people who will receive Medicaid coverage because of the ACA will be newly eligible for the program” (CBO, Pub. 49892, page 13) and “Federal costs per Medicaid enrollee are much higher for those who are newly eligible than for those who were previously eligible because the federal government pays a larger share of the costs for newly eligible enrollees,” (CBO, Pub. 49892, page 14).
Of course in March, going back to the excuse that there were fewer people uninsured than we were told before Obamacare therefore there are fewer people who needed to get health insurance, the CBO uses this same reasoning to determine “savings” in costs on Medicaid because there were fewer people who hadn’t signed up for Medicaid who were eligible before Obamacare than they thought:
“Because Medicaid enrollment before the coverage expansion under the ACA turned out to be higher than CBO and JCT anticipated, the pool of people who would have been eligible for Medicaid but not enrolled in the program before the ACA expansion is now estimated to be smaller…” (CBO, Pub. 49973, page 22).
And, come on Steve, that last claim about increased “competition”? Turns out those slower INCREASES in costs of premiums which you brag about are considered differently by the federal government.
The CBO stated in January: “Another notable influence on the downward revision to projected federal costs is the slowdown in the growth of health care costs that has been experienced by private insurers…Although views differ on how much of the slowdown is attributable to the recession and its aftermath and how much to other factors…” CBO, Pub. 49892, page 15.
In March, the CBO confirmed that “The 2013 results reinforced a trend of relatively slow growth that had begun some years earlier…” CBO, Pub. 49973, page 19 that would be SOME YEARS BEFORE 2013, BEFORE EXCHANGES, Steve.
And let’s not forget that those “savings” aren’t going to be so great according to the March CBO report that predicts an 8.5 percent INCREASE in the costs of silver plans on exchanges because the government won’t be making up for shortfalls to insurance companies through reinsurance payments and because the overly narrow networks and low provider reimbursement rates are NOT, in the opinion of the government, sustainable.
The CBO states that for the years 2016-2018 the cost of silver plans on the exchanges is expected to rise “…at an average rate of 8.5 percent per year… for two reasons: Reinsurance payments that the government makes to insurance plans whose enrollees incur particularly high costs for medical care will be phased out over the next two years, placing upward pressure on exchange premiums [AND] Plans initially offered through the exchanges appeared to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than do employment-based plans. CBO and JCT anticipate that many plans will not be able to sustain such low provider payment rates or such narrow networks over the next few years, placing upward pressure on exchange premiums.” (CBO, Pub. 49973, page 22).
Increased premiums (and therefore premium subsidy payments) because private insurance plans sold through exchanges are predicted to go up 8.5 percent because government payouts to insurers (reinsurance) and because the government can’t sustain its narrow networks of providers and the low dollars they pay them really doesn’t resemble any sort of “competition” does it Mr. Benen?
