Let’s Try to Keep Obamacare Anecdotes In Perspective

Examples of how the law impacts Americans are important to the conversation, but need to be observed through a wider lens.

Sen. Lamar Alexander speaks to members of the media at the Capitol October 11, 2013 on Capitol Hill.
National Journal
Sophie Novack
Add to Briefcase
Sophie Novack
Nov. 6, 2013, 9:21 a.m.

The ex­per­i­ence of “mil­lions of Amer­ic­ans” has been thrown back and forth re­cently by both parties as evid­ence of Obama­care’s suc­cess or fail­ure, de­pend­ing on who’s talk­ing.

In Sen­ate hear­ings this week, law­makers piled on spe­cif­ic stor­ies from their con­stitu­ents as em­blem­at­ic of lar­ger im­pacts of the health care law. For Re­pub­lic­ans and Demo­crats, there are two dif­fer­ent “mil­lions of Amer­ic­ans.”

“My late friend Alex Haley used to say: Lamar, if in­stead of mak­ing a speech you just tell a story, some­body might listen to you,” Sen. Lamar Al­ex­an­der, R-Tenn., said Tues­day at a hear­ing of the Sen­ate Com­mit­tee on Health, Edu­ca­tion, Labor, and Pen­sions with Cen­ters for Medi­care and Medi­caid Ser­vices Ad­min­is­trat­or Mar­ilyn Taven­ner.

Re­pub­lic­ans like Al­ex­an­der cited the mil­lions of Amer­ic­ans who are re­ceiv­ing plan can­cel­la­tions from their in­sur­ance com­pan­ies as a shot at Pres­id­ent Obama’s re­peated state­ment that “if you like your plan, you can keep it.”

“I re­cently heard from one of those Ten­nesseans whose policy will be can­celed on Janu­ary 1,” Al­ex­an­der con­tin­ued. “Her name is Emily. She’s 39. She has lupus. She told me: ‘I can­not keep my cur­rent plan be­cause it doesn’t meet the stand­ards of cov­er­age. This alone is a trav­esty,’ she said.”

Demo­crats, on the oth­er hand, are em­phas­iz­ing the mil­lions of Amer­ic­ans who will be newly eli­gible for af­ford­able health cov­er­age for the first time, as a res­ult of Medi­caid ex­pan­sion, premi­um sub­sidies avail­able on the ex­changes, and pro­tec­tions against dis­crim­in­a­tion based on preex­ist­ing con­di­tions or gender. 

“Let me first share with you a story from Michigan that was high­lighted in an art­icle in the L.A. Times that talked about a wo­man named Ju­dith,” Sen. Debbie Stabenow, D-Mich., said Wed­nes­day at a Sen­ate Fin­ance Com­mit­tee hear­ing with Health and Hu­man Ser­vices Sec­ret­ary Kath­leen Se­beli­us.

“She’s 48 years old, works in a de­part­ment store, had an in­sur­ance plan that cost her $65 a month. It was af­ford­able. She thought she had in­sur­ance. Then she was dia­gnosed with can­cer and found out that her plan had a $2,000 an­nu­al lim­it for hos­pit­al ser­vices, which would give her about one day in the hos­pit­al. So she delayed her care. Her can­cer got worse, and she was in a very dif­fi­cult, dif­fi­cult situ­ation.” Stabenow noted that un­der the Af­ford­able Care Act, Ju­dith would not face caps on cov­er­age, high­er rates as a wo­man, or re­jec­tion from in­sur­ance com­pan­ies be­cause of her ill­ness.

Both types of stor­ies are hap­pen­ing across the coun­try, and both are im­port­ant. However, the health care law is far more com­plic­ated than any of these an­ec­dotes in­dic­ate at face value, on their own. Some people will face premi­um in­creases. Oth­ers will see their premi­ums de­crease. Many will be eli­gible or able to af­ford cov­er­age for the first time.

In­sur­ance works by bal­an­cing these changes. To in­crease cov­er­age for mil­lions of people, something’s got to give — some people will pay less, but some people will pay more. In any private mar­ket­place, some health­i­er people end up ef­fect­ively sub­sid­iz­ing cov­er­age for oth­ers if they them­selves don’t end up need­ing med­ic­al care.

However, it’s im­port­ant to re­mem­ber that the num­ber of people who pur­chase in­sur­ance on the in­di­vidu­al mar­ket is re­l­at­ively small. The law will not af­fect the ma­jor­ity of Amer­ic­ans, and the num­ber of the newly in­sured is ac­tu­ally much lar­ger than those los­ing their ex­ist­ing policies.

So yes, some will face high­er premi­ums, while oth­ers will be newly or more com­pre­hens­ively in­sured. These are both key sides of the story to high­light as de­bate over the law’s im­ple­ment­a­tion con­tin­ues. But to get an ac­cur­ate pic­ture, the stor­ies must be re­con­ciled and told to­geth­er.

What We're Following See More »
Is McMullin Building the GOP in Exile?
41 minutes ago

Evan McMullin, the independent conservative candidate who may win his home state of Utah, is quietly planning to turn his candidacy into a broader movement for principled conservatism. He tells BuzzFeed he's "skeptical" that the Republican party can reform itself "within a generation" and that the party's internal "disease" can't be cured via "the existing infrastructure.” The ex-CIA employee and Capitol Hill staffer says, “I have seen and worked with a lot of very courageous people in my time [but] I have seen a remarkable display of cowardice over the last couple of months in our leaders.” McMullin's team has assembled organizations in the 11 states where he's on the ballot, and adviser Rick Wilson says "there’s actually a very vibrant market for our message in the urban northeast and in parts of the south."

Clinton Up 9 in USA Today Poll; Up 3 According to Fox
52 minutes ago

A new USA Today/Suffolk University poll finds Clinton leads Trump by 9 points nationwide, 47% to 38%. A Fox News national poll has Clinton up just three points, 44% to 41% over Trump.

Too Many Potential Enrollees Paying Obamacare Penalties Instead
1 hours ago

One of the main reasons for the recent Obamacare premium hikes is that many potential enrollees have simply decided to pay the tax penalty for remaining uninsured, rather than pay for insurance. More than 8 million people paid the penalty in 2014, and preliminary numbers for 2015 suggest that the number approaches 6 million. "For the young and healthy who are badly needed to make the exchanges work, it is sometimes cheaper to pay the Internal Revenue Service than an insurance company charging large premiums, with huge deductibles."

Cruz: Eight Justices Could Be an Ongoing Situation
3 hours ago

Sen. Ted Cruz (R-TX) said that "there was “precedent” for a Supreme Court with fewer than nine justices—appearing to suggest that the blockade on nominee Merrick Garland could last past the election." Speaking to reporters in Colorado, Cruz said: "I would note, just recently, that Justice Breyer observed that the vacancy is not impacting the ability of the court to do its job. That’s a debate that we are going to have.”

Chaffetz Also Caves, Says He’ll Vote Trump
5 hours ago

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.