An ad from the U.S. Chamber of Commerce criticizes Rep. Kathy Hochul (D-NY) for supporting the Affordable Care Act, listing a series of negative things “we know about Obamacare.” Those bits of supposed knowledge, however, are badly misinformed. Despite the ad’s allegations, the health care law does not “kill jobs,” does not “cut” Medicare benefits, and lowers deficits by more than $200 billion over a decade. Unfortunately, such dishonest attacks have become standard for the Chamber, which took mountains of money from health insurers to fight against reform.
GOP Argument That Obamacare Will “Kill Jobs” Has Been Debunked
FactCheck.org: “Job-Killing” Claim Is “Health-Care Hooey.” FromFactCheck.org: “The exaggerated Republican claim that the new health care law ‘kills jobs’ was high on our list of the ‘Whoppers of 2011.’ But the facts haven’t stopped Republicans and their allies from making the ‘job-killing’ claim a major theme of their campaign 2012 TV ads. […] All of this is health-care hooey, aimed at exploiting public concern over continuing high unemployment, with little basis in fact. As we’ve said before (a few times), experts project that the law will cause a small loss of low-wage jobs — and also some gains in better-paid jobs in the health care and insurance industries. It’s also expected that more workers will decide to retire earlier, or work fewer hours, when they no longer need employer-sponsored insurance and can obtain it on their own with help from federal subsidies. But that just means fewer people willing to work — and it will free up jobs for those who want them. If anything, that could reduce the jobless rate.” [FactCheck.org, 2/21/12]
- AP: Republicans Misuse CBO Statistics To Support “Job-Killing” Claim About Health Care Overhaul. From the Associated Press: “A recent report by House GOP leaders says ‘independent analyses have determined that the health care law will cause significant job losses for the U.S. economy.’ It cites 650,000 lost jobs as Exhibit A, and the nonpartisan Congressional Budget Office as the source of the analysis behind that estimate. But the budget office, which referees the costs and consequences of legislation, never produced that number. What CBO actually said is that the impact of the health care law on supply and demand for labor would be small. Most of the lost jobs would come from people who no longer have to work, or can downshift to less demanding employment, because insurance will be available outside the job. ‘The legislation, on net, will reduce the amount of labor used in the economy by a small amount — roughly half a percent— primarily by reducing the amount of labor that workers choose to supply,’ budget office number crunchers said in a report last year.” [Associated Press via USA Today, 1/24/10]
Affordable Care Act Savings Do Not “Cut” Medicare Benefits
Affordable Care Act Reduces Future Medicare Spending, But “Does Not Cut That Money From The Program.” According to PolitiFact: “The legislation aims to slow projected spending on Medicare by more than $500 billion over a 10-year period, but it does not cut that money from the program. Medicare spending will increase over that time frame.” [PolitiFact.com, 6/28/12]
GOP Plan Kept Most Of The Savings In The Affordable Care Act. According to the Washington Post’s Glenn Kessler: “First of all, under the health care bill, Medicare spending continues to go up year after year. The health care bill tries to identify ways to save money, and so the $500 billion figure comes from the difference over 10 years between anticipated Medicare spending (what is known as ‘the baseline’) and the changes the law makes to reduce spending. […] The savings actually are wrung from health-care providers, not Medicare beneficiaries. These spending reductions presumably would be a good thing, since virtually everyone agrees that Medicare spending is out of control. In the House Republican budget, lawmakers repealed the Obama health care law but retained all but $10 billion of the nearly $500 billion in Medicare savings, suggesting the actual policies enacted to achieve these spending reductions were not that objectionable to GOP lawmakers.” [WashingtonPost.com, 6/15/11, emphasis added]
Affordable Care Act Reduces The Deficit
CBO: The Affordable Care Act Will Reduce Deficits By Over $200 Billion From 2012-2021. According to Congressional Budget Office Director Douglas Elmendorf’s testimony before the House on March 30, 2011: “CBO and JCT’s most recent comprehensive estimate of the budgetary impact of PPACA and the Reconciliation Act was in relation to an estimate prepared for H.R. 2, the Repealing the Job-Killing Health Care Law Act, as passed by the House of Representatives on January 19, 2011. H.R. 2 would repeal the health care provisions of those laws. CBO and JCT estimated that repealing PPACA and the health-related provisions of the Reconciliation Act would produce a net increase in federal deficits of $210 billion over the 2012–2021 period as a result of changes in direct spending and revenues. Reversing the sign of the estimate released in February provides an approximate estimate of the impact over that period of enacting those provisions. Therefore, CBO and JCT effectively estimated in February that PPACA and the health-related provisions of the Reconciliation Act will produce a net decrease in federal deficits of $210 billion over the 2012–2021 period as a result of changes in direct spending and revenues.” [“CBO’s Analysis of the Major Health Care Legislation Enacted in March 2010,” CBO.gov, 3/30/11]
“Nearly $2 Trillion” Claim Refers To Gross Cost And Does Not Account For Savings
March 2012: CBO Estimates ACA “Provisions Related To Insurance Coverage” Will Have “Gross Cost” Of $1.762 Trillion. According to a Congressional Budget Office report titled “Updated Estimates for the Insurance Coverage Provisions of the Affordable Care Act”: “This report also presents estimates through fiscal year 2022, because the baseline projection period now extends through that additional year. The ACA’s provisions related to insurance coverage are now projected to have a net cost of $1,252 billion over the 2012–2022 period (see Table 2, following the text); that amount represents a gross cost to the federal government of $1,762 billion, offset in part by $510 billion in receipts and other budgetary effects (primarily revenues from penalties and other sources).” [CBO.gov, March 2012, emphasis added]
- July 2012: CBO’s Updated Estimate For Gross Cost Of ACA Insurance Coverage Provisions Is $1.683 Trillion. According to a Congressional Budget Office Report titled “Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision”: “CBO and JCT now estimate that the insurance coverage provisions of the ACA will have a net cost of $1,168 billion over the 2012–2022 period—compared with $1,252 billion projected in March 2012 for that 11-year period. That net cost reflects the following: Gross costs of $1,683 billion for Medicaid, CHIP, tax credits, and other subsidies for the purchase of health insurance through the newly established exchanges (and related costs), and tax credits for small employers. […] Those gross costs are offset in part by $515 billion in receipts from penalty payments, the new excise tax on high-premium insurance plans, and other budgetary effects (mostly increases in tax revenues stemming from changes in employer-provided insurance coverage).” [CBO.gov, July 2012, internal citations removed]
- July 2012 Report Affirmed Projection That ACA Will Reduce Deficits. According to a Congressional Budget Office Report titled “Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision”: “CBO and JCT have not updated their estimate of the overall budgetary impact of the ACA; previously, they estimated that the law would, on net, reduce budget deficits.” [CBO.gov, July 2012]
Chamber Distorts CBO Expectations To Fearmonger On Lost Coverage
The ad cites the CBO on March 15, 2012, to support the claim that Obamacare “could disrupt coverage for millions.”
Up To 30 Million People Are Expected To Gain Coverage Through The Affordable Care Act. From the Congressional Budget Office: “CBO and JCT now estimate that the ACA, in comparison with prior law before the enactment of the ACA, will reduce the number of nonelderly people without health insurance coverage by 14 million in 2014 and by 29 million or 30 million in the latter part of the coming decade, leaving 30 million nonelderly residents uninsured by the end of the period. … The share of legal nonelderly residents with insurance is projected to rise from 82 percent in 2012 to 92 percent by 2022. According to the current estimates, from 2016 on, between 23 million and 25 million people will receive coverage through the exchanges, and 10 million to 11 million additional people will be enrolled in Medicaid and CHIP as a result of the ACA. Between 4 million and 6 million fewer people are estimated to have coverage through an employer, compared with coverage in the absence of the ACA. That number did not change significantly as a result of the Court’s decision.” [CBO.gov, July 2012]
Affordable Care Act Projected To Cause Small Reduction In Employer-Based Coverage, But Could Also Increase Such Coverage. From the Congressional Budget Office: “CBO and JCT continue to expect that the ACA will lead to a small reduction in employment-based health insurance. […] In CBO and JCT’s judgment, a sharp decline in employment-based health insurance as a result of the ACA is unlikely and, if it occurred, would not dramatically increase the cost of the ACA. […] As reflected in CBO’s latest baseline projections, the two agencies now anticipate that, because of the ACA, about 3 million to 5 million fewer people, on net, will obtain coverage through their employer each year from 2019 through 2022 than would have been the case under prior law. […] In the four alternative scenarios examined, the ACA changes the number of people who will obtain health insurance coverage through their employer in 2019 by an amount that ranges from a reduction of 20 million to a gain of 3 million relative to what would have occurred otherwise. According to the CBO’s July update, the number of people expected to lose employer-based coverage “did not change significantly,” and is now estimated at between “4 million and 6 million fewer people.” [CBO.gov, 3/15/12; CBO.gov, July 2012]
“Law Could Just As Well Increase” Workplace Coverage By 3 Million; 20 Million Figure Is Worst-Case Scenario. From The Hill‘s report on the March 15 CBO report: “As many as 20 million Americans could lose their employer-provided coverage because of President Obama’s healthcare reform law, the nonpartisan Congressional Budget Office said in a new report Thursday. The figure represents the worst-case scenario, CBO says, and the law could just as well increase the number of people with employer-based coverage by 3 million in 2019. The best estimate, subject to a ‘tremendous amount of uncertainty,’ is that about 3 million to 5 million fewer people will obtain coverage through their employer each year from 2019 through 2022.” [The Hill, 3/15/12]
CBO: Other Analyses Consistent With Our Best-Guess Scenario. From the CBO report cited by the Chamber: ” Other analysts who have carefully modeled the nation’s existing health insurance system and the changes in incentives for employers to offer insurance coverage created by the ACA have reached conclusions similar to those of CBO and JCT or have predicted smaller declines (or even gains) in employment-based coverage owing to the law. Surveys of employers regarding their plans for offering health insurance coverage in the future have uncertain value and offer conflicting findings.” [CBO.gov, 3/15/12]
CBO: Similar Massachusetts Reforms Have Led To Increase In Employer-Provided Coverage. From the CBO report cited by the Chamber: “One piece of evidence that may be relevant is the experience in Massachusetts, where employment-based health insurance coverage appears to have increased since that state’s reforms, which are similar but not identical to those in the ACA, were implemented.” [CBO.gov, 3/15/12]
Plans In The Insurance Market Are Already Unstable, Causing Eroding Coverage And Higher Premiums. According to Time: “Still, while many employer-based plans will be snared in the regulatory net of the Patient Protection and Affordable Care Act, many of those with this coverage could actually stand to benefit. The new regulations, after all, are designed to protect consumers. If job-based plans have to change — and are not dropped by employers — they will do so in ways that limit what workers have to pay out of pocket and what insurers can refuse to cover. […] Plus, it’s not as though the employer-based insurance market is reliable and stable in its current form. Most employees don’t have any control over the structure of their health insurance. As a result, coverage has been steadily eroding in the past decade, with premium costs for workers increasing 131% from 1999 to 2009, even as the actuarial value of those plans, on average, decreased.” [Time, 6/24/10]
Health Insurers Poured Money Into Chamber To Attack Reform
Health Insurance Industry Gave Chamber Over $100 Million To Fight Health Care Reform. From the National Journal:“The nation’s leading health insurance industry group gave more than $100 million to help fuel the U.S. Chamber of Commerce’s 2009 and 2010 efforts to defeat President Obama’s signature health care reform law, National Journal’s Influence Alley has learned. During the final push to kill the bill before its March 2010 passage, America’s Health Insurance Plans gave the chamber $16.2 million. With the $86.2 million the insurers funneled to the business lobbying powerhouse in 2009, AHIP sent the chamber a total of $102.4 million during the health care reform debate, a number that has not been reported before now. The backchannel spending allowed insurers to publicly stake out a pro-reform position while privately funding the leading anti-reform lobbying group in Washington. The chamber spent tens of millions of dollars bankrolling efforts to kill health care reform.” [NationalJournal.com, 6/13/12]
[NARRATOR:] What do we know about Obamacare? We know Kathy Hochul supports Obamacare. We know Obamacare will kill jobs and could disrupt health care coverage for millions. We know Obamacare will cut Medicare by $500 billion. And we know Obamacare will cost nearly $2 trillion. So why does Kathy Hochul still support Obamacare? Does she know something we don’t know? Call Kathy Hochul. Ask her if she still supports Obamacare? [U.S. Chamber of Commerce via YouTube, 5/10/12]