Just weeks before the Patient Protection and Affordable Care Act (PPACA)—a.k.a ObamaCare—passed, President Barack Obama urged congressional Democrats to make a final push for the bill, and asked them to schedule a vote as quickly as they could. “From now until then, I will do everything in my power to make the case for reform,” he said.
The bill passed, but the case didn’t take. Since Obama signed the bill into law, its unpopularity has, according to Pollster.com’s multi-poll aggregate, held steady, with roughly 48 percent of the public opposed. Liberal health care activists trying to sell the law and help its supporters in Congress have been forced to backtrack on their messaging—and in some cases, have found that their best strategy is to avoid mentioning the law at all. Now, the Obama administration and its allies are launching a multimillion dollar ad campaign intended to sell the public on the law’s virtues.
The president and his administration, it seems, are still doing everything they can to make the case for reform. The problemn is that so much of that case isn’t likely to pay off. Here are seven empty promises made about ObamaCare:
1. If you like your plan, you can keep your
plan.
In June of 2009, President Obama gave a press conference where he
explained his frequent promise that those who like their health
care plans can keep their health care plans. “What I’m saying is,
the government is not going to make you change plans under health
reform,”
he said. So in order to ensure health plan continuity, the law
included a “grandfathering” provision that allows employers and
insurers to continue offering plans that already exist without
subjecting them to new rules and regulations. But the requirements
that plans must meet in order to keep their grandfathered status
are particularly strict. And in
a draft document laying out grandfathering rules, the
administration admitted that “after some period of time, most plans
will relinquish their grandfathered status.” Meanwhile, the new law
may also
force more than 3 million seniors to switch their Medicare drug
plans, regardless of whether they like them or not.
2. It will put Medicare on better fiscal
footing.
In August 2010, the Obama administration’s Department of Health and
Human Services released a report
claiming that the PPACA would “extend the life of the Medicare
Trust Fund by 12 years.” Later, Obama’s Health and Human Services
Secretary, Kathleen Sebelius, told ABC News that her view is
“supported” by the Congressional Budget Office (CBO). It’s not.
Instead, the CBO said
that “to describe the full amount of HI trust fund savings as both
improving the government’s ability to pay future Medicare benefits
and financing new spending outside of Medicare would essentially
double-count a large share of those savings.” This view is backed
up by Medicare’s top actuary as well, who has
written that “in practice the improved (Medicare hospital
insurance) financing cannot be simultaneously used to finance other
Federal outlays (such as the coverage expansions) and to extend the
trust fund.”
3. It will cost around $900 billion.
In September 2009, Obama
told a joint session of Congress that his health care plan
would cost “around $900 billion over ten years.” The CBO’s final
cost estimate for the law came in at about $950 billion—close
enough to the president’s figure for government work, perhaps—but a
report from the CBO
later estimated that the law will actually require about $115
billion in additional discretionary spending, putting the official
price tag well over $1 trillion.
4. It won’t cut Medicare benefits.
At a 2009 AARP panel, President Obama brushed away the idea that
his health care plan might cut Medicare benefits, telling the
audience that “nobody’s talking about reducing Medicare benefits.”
But
according to the head of the Congressional Budget Office,
thanks to $130 billion in planned cuts to companies that offer
Medicare Advantage plans, the health care law will “reduce the
extra benefits that would be made available to beneficiaries
through Medicare Advantage plans.” Roughly 25 percent of Medicare
recipients use Medicare Advantage plans. One can argue about
whether or not the government should be reducing Medicare benefits,
but it’s simply not true that no one in the program will lose the
benefits they currently have.
5. It will be paid for “mostly” by shifting around money
that we’re already spending.
One of the least popular aspects of the PPACA was its sky high
cost. The president tried to combat this by
saying that, although the bill would cost “about $100 billion
per year,” most of that money would “come from the nearly $2
trillion a year that America already spends on health care.”
Actually, the majority of the money from the bill’s official scored
cost comes from new taxes. According to the CBO,
“the two pieces of legislation [that make up the health care law]
were estimated to increase mandatory outlays by $401 billion and
raise revenues by $525 billion.”
6. It will give consumers more access and greater
choice.
Organizing for America, the successor to Obama’s campaign
organization,
claims that the new health care law will result in “more
choices...for millions of Americans.” But early signs indicate
that, as a result of the law, patients and consumers will have
fewer options for doctors and health insurance. Most experts, for
example,
expect that the health care overhaul will result in a serious
doctor shortage,
particularly amongst primary care phsyicians, meaning many
individuals will have to wait longer for care, and may not get to
see the doctor they want to see. Meanwhile, insurers in some states
are already
cutting back on insurance options.
7. It will bring down the price of
insurance.
Just a few days before the final law passed, Obama
said that “my proposal would bring down the cost of health care
for millions." And health care affordability was so crucial to the
president’s argument that the word made it into the title of the
bill: the Patient Protection and Affordable Care Act. So
will health care costs come down? Not likely. The CBO predicted
that the law will cause average health insurance premium prices to
rise by 10-13 percent. And a recent survey indicates that most
businesses expect insurance prices to rise as a result of the
PPACA. Perhaps Obama meant that the law would “bend the cost curve”
and reduce the growing cost of health care? Even if he did, it
wouldn’t matter; that’s not likely either. In June of 2009, CBO
Director Douglas Elmendorf warned Congress that its proposals would
bend the curve
in the wrong direction. And in a May 2010 presentation
at the Institute of Medicine, Elmendorf declared that in the
CBO’s judgment, “the health legislation enacted earlier this year
does not substantially diminish [the] pressure” of rising health
costs.
Peter Suderman is an associate editor at Reason magazine.








