“This is the worst year of all … 2017 is going to be the worst because he’s [former president Barack Obama] gone. He knew that was the year. Let him be out before it implodes.”
— March 15
“It’s a catastrophic situation, and there’s nothing to compare anything to because Obamacare won’t be around for a year or two. It’s gone.”
— March 15
“They also want people to know that Obamacare is dead; it’s a dead health-care plan. It’s not even a health-care plan, frankly.”
— March 17
“I have to tell you that Obamacare is a disaster. It’s failing. … Obamacare will fail. It will fold. It will close up very, very soon if something isn’t done.”
— March 17
Trump’s claims that Obamacare “is failing,” “is dead,” “will close up very, very soon” and “is not even a health-care plan [?]” are simply false.
We have no idea what he’s referring to, but it may be the “death spiral,” which critics say is inevitable for the health-care law. Of course, Republicans are responsible for some of the increased premiums and lack of sign-ups in state exchanges.
For example, Republican lawmakers restricted a key payment mechanism called “risk corridors,” which was intended to help stabilize premiums and protect insurance companies from losses in the initial three years of the law. And within his first week in office, Trump pulled back federally sponsored advertising encouraging people to sign up for health exchanges during the open enrollment period.
Is 2017 the “worst year” because Obama set Obamacare to “implode” after he left office? It’s unclear what Trump is talking about, and the White House did not respond to a request for clarification. (This claim reminds us of Trump’s Four-Pinocchio claim that Obama was trying to delay open enrollment until after the Nov. 8, 2016, election. But federal rules require open enrollment to begin Nov. 1.)
There are some provisions that kicked in after the first few years of the law but none specifically designed to take effect or phase out in 2017 to the detriment of Obamacare. The Cadillac tax on high-cost employer-sponsored group health plans was scheduled to take effect in 2018 but has been pushed to 2020 (and would be pushed to a later date under the GOP replacement bill). A two-year moratorium on the medical-device excise tax, which imposes an effective tax rate of 1.5 percent on some medical-device manufacturers, is set to expire at the end of 2017 (and would be repealed under the GOP bill).
Another program similar to risk corridors is the temporary reinsurance program, also designed to help stabilize individual market premiums during the early years of the law. The program will sunset in 2017 and has contributed to higher premiums in 2017. But those premium increases were reported under Obama’s administration.
“I was in Tennessee — I was just telling the folks — and half of the state has no insurance company, and the other half is going to lose the insurance company.”
— March 17
“I was in Tennessee — we had a tremendous crowd the other night, and they have — half of the state is uncovered. The insurance companies have left, and the other half has one insurance company, and that will probably be bailing out pretty soon also. They’ll have nobody.”
— March 17
This is false. Tennessee is divided into eight geographic areas that insurers use to set their rates. All eight rating areas have at least one insurance carrier, and three of them have two carriers.
Our friends at FactCheck.org looked into this claim in depth and found “it is possible that some parts of the state will be without marketplace coverage next year.” But that’s not the same as Trump claiming half the state has no insurance company.
“I watched Bill Clinton saying, this is the craziest thing I’ve ever seen.”
— March 17
“The governor of Minnesota said that Affordable Care Act — Obamacare — no longer affordable. That’s what he said.”
— March 17
Trump takes both comments out of context and twists their meaning.
Minnesota Gov. Mark Dayton (D) on Oct. 12, 2016, faulted Republicans in Congress for refusing to adjust the law, which he said was the reason individual health insurance was “no longer affordable to increasing numbers of people.”
Dayton added that “the Affordable Care Act has many good features to it, it’s achieved great success in terms of insuring more people — 20 million people across the country — and providing access for people who have preexisting conditions and the like. But it’s got some serious blemishes and serious deficiencies. And we’re going to need both state and federal governments to step in and do what they need to do to remedy these problems.”
Bill Clinton’s remark on Oct. 3 about “the craziest thing I’ve ever seen” did not refer to the Affordable Care Act. Instead, he was talking about the fact that people who did not qualify for insurance subsidies did not have a way to buy into Medicare or Medicaid.
“The people that are getting killed in this deal are small business people and individuals who make just a little too much to get any of these subsidies. Why? Because they’re not organized, they don’t have any bargaining power with insurance companies, and they’re getting whacked,” Clinton said while campaigning in Flint, Mich. “So you’ve got this crazy system where all of a sudden, 25 million more people have health care and then the people that are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It’s the craziest thing in the world.”
Clinton noted that his wife, Democratic presidential nominee Hillary Clinton, had a proposal to deal with the problem by allowing affordable access into Medicare and Medicaid.
“Many of our best and brightest are leaving the medical profession entirely because of Obamacare.”
— March 20
There are anecdotes of some doctors, especially older ones, who are frustrated about adopting electronic health records under Obamacare. But physicians leave the industry for many reasons, mainly aging and burning out. As the baby boomer patient population gets older and has more complex conditions, there is greater demand on physicians and their services.
A 2016 survey of more than 17,000 physicians by Merritt Hawkins for the Physicians Foundation, a nonprofit for professional physicians, found low morale and burnout as key reasons physicians were leaving the industry. Less than one-quarter of physicians gave the Affordable Care Act a positive grade of A or B.
Recent data from the Association of American Medical Colleges shows physicians are actually retiring two years later, said Atul Grover, the group’s executive vice president. Grover said the group has not seen a significant number of physicians leaving the industry because of the law: “There is also no evidence of a declining interest in medicine since the ACA took effect. Applications to medical school are at an all-time high. The real challenge the physician workforce faces is the cap on federal support for graduate medical education established by Congress 20 years ago. As a result, there are not enough residency positions to fill demand.”
“People have been kicked off their plans, and their premiums have increased by double and triple digits. Arizona, up 116 percent.”
— March 20
Premiums increased overall in 2017 — but Trump cherry-picks data from Arizona, the state hit hardest by premium increases. The average increase for the second-lowest-cost silver plan (which is used as the benchmark to calculate government subsidies) is 25 percent. A few states, such as Indiana, will actually see a decrease.
But the majority of enrollees in the marketplace receive government premium subsidies and, in theory, are protected from such premium increases. So who is affected? The people who do not qualify for the tax subsidy. The GOP replacement plan would provide tax subsidies to a broader group of people but often provide less money per person to pay for insurance, so premiums may rise for many, especially the elderly, compared to current law, the CBO said.