10/23/2017
As the debate unfolds
about the bipartisan bill by Senators Lamar Alexander and Patty Murray to
repair the Affordable Care Act marketplaces, the public could be just as
confused as they have been about the ACA's marketplaces. That's why it's
important to debate it in the right context: It's aimed at an urgent problem
affecting a relatively small sliver of the health insurance system, not all of
the ACA and not the entire health system.
The bottom line: It's a limited measure that will never give
conservatives or liberals everything they want.
Data: Kaiser Family
Foundation Health Tracking Poll conducted Oct. 5-10, 2017;
Chart: Chris Canipe / Axios
Reality check: Many people will think it affects their
insurance when, in actuality, it will have no impact on the vast majority of
Americans who get their coverage outside of the relatively small ACA
marketplaces.
The chart based
on our new Kaiser Tracking Poll shows the confusion. Just
23% of the American people know that rising premiums in the ACA marketplaces
affect only people who buy their own insurance. More than seven out of 10
wrongly believe rising premiums in the marketplaces affect everyone or people
who get coverage through their employer.
The public will be
susceptible to spin and misrepresentation against the limited goals of
Alexander-Murray: a bipartisan effort to stabilize the marketplaces by funding
the cost-sharing reduction subsidies, providing more resources for open
enrollment outreach, and expediting state waivers.
President Trump has
added to the confusion. He recently pronounced the ACA "dead",
adding, "there is no such thing as Obamacare anymore." Possibly
that's because he wishes it was dead. More likely, he was referring to the
problems in the ACA marketplaces, which he has exaggerated.
Like thinking your
whole house is falling down when just a part of the foundation needs shoring
up, both he and the American people have an inaccurate picture of where the
marketplaces fit in the ACA and where the ACA fits in the health system.
A few facts:
·
There are just 10
million people enrolled in the ACA marketplaces.
·
The law's larger
Medicaid expansion and consumer protections are popular and working well.
·
The far larger
Medicare and Medicaid programs and employer based health system combined cover
more than 250 million people, and are largely unaffected by developments in the
ACA marketplaces.
·
Premiums for the 155
million people who get coverage through their employers rose a very modest 3% in 2017.
Some conservatives in Congress will hold out
for repeal, and they'll resist any legislation that they view as propping up
Obamacare. But for everyone else, it's important to understand the problem and
get the facts.
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