Shortly I’ll get around to an overview look at the first state of the state speech delivered by new Idaho Governor Brad Little. But before I get to that, one allegation contained in it deserves a review.
The context was Little’s statement that “I intend to work with you to implement Medicaid expansion using an Idaho approach,” though he didn’t specify exactly what that would entail.
Then he made this statement, reflecting some of what he said during the recently-concluded campaign:
While making health care available to low-income individuals we should also do what we can to make affordable, accessible, quality health care available to all Idahoans.
An unintended outcome of the Affordable Care Act is that too many people are priced out of health insurance coverage. In the past two years, the number of uninsured Idahoans increased by 125,000 – almost double the gap population. As Idaho continues to enjoy the fastest-growing economy in the nation, the number of insured Idahoans should be increasing not decreasing.
We must pursue strategies that contain health care costs.
My first response when I heard this (and the many comments like it made by many Idaho politicians) was this:
That’s funny. Before the Affordable care Act, I went more than a decade without health insurance; which is to say, without health insurance that would have done me any good. I could have afforded a garbage health insurance policy that would have done me no good, but what would have been the point? A policy like the one I have had since the ACA went into effect was simply out of reach for me then; it would be now but for the subsidies the ACA has provided. (A decade ago, without insurance, I was hospitalized and faced a hospital bill of tens of thousands of dollars, and calculated that if I had been able to afford health insurance then, the premiums would have been so costly that dealing with that massive bill alone was better. Some insurance.) Today and for the last several years I have decent coverage.
My second response was that this isn’t just me. Something like 20 million people have been in the same position and gotten insured thanks to the ACA when they otherwise could not (the best efforts of the Trump Administration and Congress to kill their health insurance options notwithstanding).
Priced out of health care? My policy, which covers has been roughly similar through the ACA years, did bump up in price a couple of years ago, actually dropped a bit this year, but throughout has remained decidedly affordable. The numbers of people using marketplace insurance policies has remained more or less stable, which ought to put paid to the idea that “An unintended outcome of the Affordable Care Act is that too many people are priced out of health insurance coverage.”
The website Factcheck pointed out, “Republicans say the average family health insurance premium has increased by $4,154 under President Obama. That’s right — and it’s a much slower rate of growth than under President George W. Bush. In fact, employer-sponsored premiums have been growing at moderate rates for the past few years. This is a prime example of what we call a “true, but” claim: an assertion that’s technically correct, but changes in meaning or significance once it’s put in context or fully explained.”
And: The RNC’s “fact check” goes on to list more figures from the KFF survey, including the accurate statistic that the average premium for single coverage through employers has gone up 28 percent “under Obama” That’s right again, but much lower than the growth of individual premiums during Bush’s first six years. That increase was 72 percent.”
The situation isn’t great now, for sure. But it’s a massive improvement over what came before it.
That’s the ACA marketplace aspect of the picture, of course – not many other aspects of health care. The Medicaid expansion fix is another element of that. The biggest aspect, not much covered in the talk about insurance, is the cost of health care and its many drivers, and the problem of health cost won’t really really be reined in until that is addressed.
But let’s be clear about this: For tens of millions of Americans, the Affordable Care Act has made the health insurance picture better, not worse. Period.