Peter Suderman:
Obamacare turns five years old this week, and to mark the occasion, President Obama took after critics of the health law, noting their ongoing opposition while briefly laying out the reasons he believes it to be a success. “It’s time to embrace reality,” he said, according to The Hill.
The president ticked off a string of points in support of the law: an additional 16 million insured, 50,000 fewer preventable deaths, slow growth in health premium costs, and lower deficit projections as a result.
The law, he said, is “working even better than expected.”
One could reasonably quibble with much of this, because not all of the points President Obama cited are clearly or fully attributable to Obamacare.
Health spending growth, for example, is indeed down, and this is driving much of the decline in the deficit, but at least a sizable portion of the decline—perhaps most of it—can be attributed to the recession. One study in Health Affairs last year concluded that about 70 percent of the health spending slowdown is a result of the economy, not any structural changes to health care delivery. Obamacare may be due some credit, but not too much.
Similarly, it’s true that a government report estimated that between 2010 and 2013, deaths from “hospital-acquired conditions” were reduced by about 50,000. But it’s hard to fully pin this on Obamacare when the report states up front that “the precise causes of the decline in patient harm are not fully understood.”
Meanwhile, the 16 million insured figure comes from a March report by the Department of Health and Human Services, and it is a total of those who gained coverage through Obamacare’s exchanges, Medicaid, employment, and the individual market place, which means it’s not wholly attributable to the law. And it tallies those who signed up for coverage rather than those “effectuated enrollment”—those who have already paid their premiums. The actual number is probably not too far off from what President Obama stated, but, once again, Obamacare isn’t the entire story here.
So Obama is overstating the case, and, of course, leaving out points against the law.
For example: About half of the people who received subsidies through the law last year will have to pay them back through their taxes this year, according to a Kaiser Family Foundation study this week. On average, those who owe will have to pay a little more than a quarter of their subsidy back. A few will have to pay back the entire subsidy.
On the flip side, a little less than half will end up getting money back, but even that will be complicated by the fact that the federal government and California, which runs the biggest state exchange, sent out nearly a million tax forms related to the health law with incorrect information, leading the administration to ask many to delay filing their taxes as a result. California has already issued 120,000 correct tax forms, but there are still “tens of thousands” who haven’t gotten updated forms, according to the L.A. Times.
Beyond that, there are additional questions about whether the Internal Revenue Service is even equipped to handle all the new paperwork required by the law. According to the Chicago Tribune, roughly a quarter of tax filers will have extra filing requirements due to the health law.
