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.