The GOP says Obamacare will cancel 80-100 million insurance plans. Nope.

December 5, 2013

I appeared on NBC's "Meet the Press" on Sunday to talk about the state of HealthCare.Gov. Before I came on, Mike Rogers, a Republican congressman from Michigan, delivered his take. Obamacare's effects turned out to be more dire than I'd ever imagined.

"The next go-round on the business side is 80 to 100 million people will get cancellation notices," he said. Challenged by Democrat Chris Van Hollen, Rogers doubled down. "Eighty million people are going to get pink slips," he continued. "Their own estimate. Eighty million."

That's more cancellation notices than the estimates I've seen by a factor of at least 10. I asked Rogers's press secretary where the number came from. Turns out it's not exactly the administration's own estimates. It's a Daily Caller interview with Christopher Conover, a research scholar at Duke University and an adjunct scholar at the American Enterprise Institute.

According to Conover, Rogers, if anything, understated his case: Conover says "at least" 129 million people will lose their coverage by the end of 2014.

How does Conover reach such a startling estimate? By redefining what it means to lose your coverage.

What Conover's talking about here isn't cancellation notices or pink slips, as Rogers says. It's any change to a plan at all. One of the examples he gives is the requirement to cover children up to age 26. Though plans offered by large employers are exempt from most of Obamacare's regulations, they have to abide by that one. And that regulation, popular as it is, costs money. So millions of employer plans expanded to cover older children and, in most cases, raised premiums slightly. According to Conover, all the people in those plans lost their plans because they "no longer have the health plans they used to have."

This isn't how most people define losing their plan. I have family members whose insurance expanded to cover their adult children. They didn't call me complaining that they lost their plan. They called me ecstatic that their plan had improved.

But Conover's original post on this subject, where he explains his methodology in some detail, isn't actually about people losing their plans, at least as most people would understand that event. It's about Obama's rhetoric, which really did go too far. Obama said that "if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have." Conover shows that, in small but real ways, that was flatly untrue. Employer-based insurance, for instance, could no longer include lifetime caps. That's a change in coverage, even if it's minor and even if it's popular.

As Conover wrote to me in an e-mail, "As I tried to emphasize in my piece, the problem with the president’s promise was its unequivocal nature."

But what Rogers said on "Meet the Press" is also flatly untrue. It's simply not the case that 80 to 100 million people are going to get cancellation notices over the next year.

As for Conover's definition of losing your health insurance, it's telling that so many of the people losing their health insurance don't think they've lost their health insurance. Many of them think their health insurance has improved! And small changes to benefits and premiums are common in employer-provided health-care plans.

I guess the wait screen isn't scary enough anymore? (Photo by Karen Bleier/Getty Images)
I guess the wait screen isn't scary enough anymore? (Photo by Karen Bleier/Getty Images)

Some of Conover's data comes from the Kaiser Family Foundation's annual, and invaluable, Health Benefits Survey. So I ran his post by Kaiser's Larry Levitt, who used to manage the survey. "Under this definition, " Levitt replied, "the idea of keeping your plan ceases to be meaningful." He went on to say that "virtually every health plan changed in some way every year -- tweaking benefits, cost-sharing, drug formularies, provider networks, etc."

I asked Levitt whether anything he'd seen in the last few months had led him to believe that Obamacare was making more serious changes to employer-based plans than had previously been thought. "The Affordable Care Act did largely leave the employer market alone," he replied. "The essential benefit regulations don’t apply to large employer plans. There are very, very few requirements that apply to large employer plans."

Obama has taken deserved heat for downplaying the individual-market insurance cancellations that were a predictable and intended consequence of Obamacare. But Republicans are now wildly exaggerating the number of people who will lose their plans in order to spread fear and anxiety about Obamacare.

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Lydia DePillis | December 5, 2013