After getting hammered on a series of government reports that they felt Republicans unfairly characterized, Democrats are taking the unusual step of responding to another potentially damaging report before the GOP attacks even start.
The report, released late Friday by the Actuary of the Centers for Medicare and Medicaid Services, looks at the impact two provisions of the Affordable Care Act will have on health insurance premiums for small businesses. Republicans requested the report in 2011 when they slipped it into an appropriations bill.
Democrats expect the GOP to seize on a portion of the report that estimates that premiums will go up for most small firms.
“[W]e are estimating that 65 percent of the small firms are expected to experience increases in their premium rates while the remaining 35 percent are anticipated to have rate reductions,” the CMS report reads. “This results in roughly 11 million individuals whose premiums are estimated to be higher as a result of the ACA and about 6 million individuals who are estimated to have lower premiums.”
Those are very scary words for Democrats, and something you could expect to see in a Republican attack ad.
But that passage doesn’t tell the whole picture, says Drew Hammill, a spokesman for House Minority Leader Nancy Pelosi. “This report is the latest instance of House Republicans attempting to peddle half-truths and incomplete data to justify their blind obsession with repealing the Affordable Care Act,” Hammill said in a statement. “The Actuary notes in the report that the findings are incomplete, but Republicans are only interested in what they can use to mislead and deceive Americans about the ACA and its effect on what small businesses will pay for health coverage.”
The staff of Rep. Henry Waxman, the ranking member of the House Energy and Commerce Committee, responded to the report Friday in detail, noting that nowhere does it say that the average premium for small businesses overall will go up. While premiums might go up for some, Waxman’s rebuttal says, they won’t overall, and “[o]n average, the premium decreases would be larger than the premium increase.”
The report’s 65-35 conclusion is based on the assumption that about 65 percent of businesses currently pay below-average prices, while 35 percent pay above average. After Obamacare, all businesses will end up closer to the average.
That disparity comes from the fact that insurance companies used to be able to charge more to companies that employed sick workers, and could also charge more for women. That meant disproportionately higher bills for a minority of companies.
Under Obamacare, however, that’s no longer allowed. Insurance companies can’t discriminate against sick people or women. They can only charge more based on age, geographic area, tobacco use, and whether the policy is for an individual or family.
This change is good, Democrats say, because it will make the marketplace more fair. They also point out that the CMS report itself leaves a lot of wiggle room. “There is a rather large degree of uncertainty associated with this estimate,” the report reads, adding that the real impact “could vary significantly.”
A RAND Corporation study, cited by the new report, analyzed the impact of the entire health law on small businesses’ average premiums and determined that “the effect would be minimal.” The Congressional Budget Office looked at the same question and also concluded that the overall impact would be small, ranging “from an increase of 1 percent to a reduction of 2 percent in 2016.”
Whether their pre-push-back works remains to be seen. In the past two weeks, Democrats have been raked over the coals for two different CBO reports, and had trouble changing the narrative, even when the facts were on their side.