There was a report on the Affordable Care Act on my local CBS affiliate this morning. The spin was interesting, to say the least. It preceded the CBS This Morning show, which also looked at the ACA sign ups.
Several points were made. While it's too soon to know what the final enrollment numbers look like and how they break down, the last minute surge could not be ignored. Where the report went with it is telling. The gist of it was, Obamacare going forward is still going to fall short of its claims. A 40-60 split between young healthy enrollees and older people was cited as the goal of the exchanges, to ensure there'd be enough healthy people paying into the system to keep rates down. Instead, the report claimed the actual numbers looked more like 25-75, which if true, means rates will be higher than expected.
This was accompanied by another claim, that insurance companies are going to raise rates, because they deliberately priced their plans low to get customers during the initial sign up period of the ACA. To reinforce this message, they played a clip of Katherine Sibelius testifying before Congress that insurance premiums would go up - but not as fast with Obamacare.
The gist of the report was A) not enough young, healthy people have signed up, and B) we're all going to be paying more for health insurance because of Obamacare. (It concluded by saying things would get so bad, within 6 years the government would have to go to single payer!!!)
This is part and parcel of a media message that Obamacare is a failure, a narrative that has been firmly in place since the initial botched roll-out of the ACA website.
When CBS This Morning came on and got around to the ACA story, Charlie Rose and Norah O'Donnell interviewed former Obama White House Chief of Staff Bill Daley. Rose set the the tone of the interview with his very first question.
"Do you believe the President, and do you believe he has it accurate when he says 8 to 10 years from now, the [affordable care act] will be considered a monumental achievement?"
"Believe" has a loaded context, given the repeated Republican messaging that President Obama is a liar who has lied repeatedly about Obamacare (and everything else). Norah O'Donnell followed up by asking Daley what will happen when premium hikes start going out.
Daley was hardly the most enthusiastic supporter of the ACA, but he did make the point that repeal is not going to happen any time soon. However, he also reinforced the narrative the Obamacare is going to be a big problem for Democrats over the next 7 months going into the November elections. And while he mentioned "the negative attitude about the ACA that seems to be out there", he passed up a perfect opportunity to point out where that has come from. Obamacare has been under attack since day one by Republicans, who have fought it every step of the way. Millions of people now have affordable health care despite the efforts of the Republican Party to prevent that from ever happening.
The interview finished up with Rose bobbling a last question, only getting as far as "Badly conceived" before running out of time. One can only speculate where he was going with that.
The narrative playing out here is that Obamacare has failed to get the sign ups it needs most to work, health insurance premiums will be going up, and Obamacare is going to hurt Democrats in November. As long as Democrats passively allow it to go unchallenged, it's going to play out just like that.
And of course, there's one more thing. The moment anyone in the media starts officially reporting that the Affordable Care Act is actually looking like it might actually work, they will immediately be attacked by Republicans and the conservative messaging machine for their 'liberal bias'. So, don't expect the negative narrative to disappear anytime soon. Any mention of Obamacare in the news must always include at least one mention of the problems with it, 'to be fair and balanced.'
It's a given that anything bad related to healthcare will be attributed to Obamacare. Any delay getting a doctor appointment, increase in a co-pay, bad outcome in a hospital, dropping of employer-provided health benefits, premium increases - it's all going to be blamed on the President and the Democrats. And the Mighty Wurlitzer Right Wing Media Machine will be playing that tune on heavy rotation. Not to mention the Koch Brothers.)
Kevin Drum points out the obvious: insurance companies always raise rates, every year.
Bottom line: if we end up seeing double-digit rate increases, it will be business as usual. Insurance companies will all blame it on Obamacare because that's a convenient thing to do, but the truth is that we probably would have seen exactly the same thing even if Barack Obama had never been born. So let's all keep our feet on the ground when the inevitable huge rate increase requests start flowing in. It's mostly an insurance company thing and a healthcare thing, not an Obamacare thing.The news media will certainly blame it on Obamacare. There's several counters to be made, aside from the obvious one that it was going to happen regardless. 1) Everyone now has better insurance whether or not they went through an exchange: no more lifetime caps, no more pre-existing condition denials of coverage, no kids kicked off before they have the chance to enter the job market. 2) Millions of uninsured people who would otherwise be clogging emergency rooms and running up healthcare bills for everyone else will now be able to get preventive care: better health for less money. 3) It will strengthen the economy and create jobs when people are no longer at risk of losing everything if they get sick, and they'll be able to move to better jobs or even start their own business if they don't have to worry about health insurance. 4) It actually helps control costs when more people are in the system to share the load and they can get care that prevents them from becoming sick.
Kevin Drum picks up on another LA Times story about how many uninsured people are now covered - 9.5 million newly insured. The important takeaway here is that despite what stumbles and shortcomings the ACA may have had up till now, the sober truth is that there is no going back without stripping millions of people of healthcare coverage. By 2017, as Drum notes, the ACA will continue to add in people, up to 36 million.
But what do things look like in 2017? The chart on the right shows the latest CBO estimates. By 2017, a total of 36 million Americans will be covered by Obamacare. Of that, 24 million will have private coverage via the exchanges and 12 million will be covered by Medicaid. Those are very big numbers. Even if Republicans improbably manage to get complete control of the government in the 2016 election and eliminate the filibuster so Democrats can't object, they'll still have to contend with this.This is a wave Democrats should prepare to ride, rather than running away from. It's a story they need to get out, because it won't happen as long as the media narrative is all about the failures of Obamacare and not the real difference it is making to millions of Americans.