The Party: Democratic
Top Democrats, including President Obama, have credited the Affordable Care Act for more than 9 million Americans obtaining health insurance. But that’s an exaggerated figure that includes individuals who renewed their existing insurance plans through Medicaid and the Children’s Health Insurance Program. It also includes previously insured individuals who switched to plans offered on the state and federal exchanges.
In early January, Senate Majority Leader Harry Reid said “right now, as we speak, there are 9 million Americans … who have health care that didn’t have it before.” Later that month, in his State of the Union address, President Obama said “because of the Affordable Care Act … more than 9 million Americans have signed up for private health insurance or Medicaid coverage.” And on Feb. 9, Dick Durbin, the second-ranking Democrat in the Senate, increased the figure, saying that “[t]he bottom line is this: 10 million Americans have health insurance today who would not have had it without the Affordable Care Act.”
When Reid made his claim, the 9 million Americans included: 2.1 million who had selected plans on the federal or state insurance marketplaces, or exchanges; 3.9 million who were determined to be eligible for Medicaid and CHIP; and an estimated 3.1 million young adults under the age of 26 who were able to join their parents’ policies as a result of the ACA.
Then, on Jan. 24, the Centers for Medicare & Medicaid Services announced that 3 million people had enrolled in a private health insurance plan through the federal and state-based exchanges since October 2013, and that more than 6.3 million individuals were determined eligible to enroll in Medicaid or CHIP through state agencies and state-based marketplaces in October through December. That’s a total of 9.3 million Americans.
But not all of those people were previously uninsured, as Democrats have claimed or suggested.
In the Jan. 24 blog post, Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services, wrote that the 6.3 million included “both Medicaid and CHIP new eligibility determinations in states that expanded coverage, determinations made on prior law, and in some states, Medicaid renewals and groups not affected by the health care law.” So, the 6.3 million includes some who already had Medicaid or CHIP and were simply renewing. It includes those who would have been eligible for those insurance programs without the law. And it could also include those who had insurance through another source and are now eligible for Medicaid.
Indeed, a Feb. 5 report from Avalere Health, a health care industry consulting firm, estimated that most of the Medicaid and CHIP determinations were not new enrollees due to the law. Avalere estimated that between 1.1 million and 1.8 million enrolled because of the health care law. The firm compared the October through December Medicaid and CHIP numbers from CMS to the average monthly number of applications in July through September 2013.
Some listeners may have gotten the impression from Obama’s speech that the 9 million were all previously uninsured. But Sens. Reid and Durbin claimed outright that all gained insurance because of the health care law. We know that’s not true.
Reid and Durbin, for example, are just two members of Congress who had private insurance through the Federal Employees Health Benefits Program, but were required to switch to an exchange plan as required by the law. The 3 million people who selected exchange plans also include other individuals who were insured but switched to marketplace coverage when their plans were cancelled or their insurers pulled out of the individual insurance market altogether. We don’t know how many, because figures aren’t available.
A Jan. 17 Wall Street Journal article highlighting industry surveys of exchange enrollees said that “[i]nsurers, brokers and consultants estimate at least two-thirds of those consumers previously bought their own coverage or were enrolled in employer-backed plans.”
At some point, the ACA may be responsible for more than 9 million uninsured persons gaining health insurance. The nonpartisan Congressional Budget Office has estimated that in 2014, due to the Affordable Care Act, the number of uninsured would decline by 14 million.
But based on the administration’s most recent figures, we’re not at that point yet.
— D’Angelo Gore
Democrats using this talking point include:
Sen. Harry Reid of Nevada, Jan. 5: [R]ight now, as we speak, there are 9 million Americans … who have health care that didn’t have it before. (Source: Interview on CBS’ “Face the Nation.”)
President Obama, Jan. 28: Already, because of the Affordable Care Act, more than 3 million Americans under age 26 have gained coverage under their parents’ plans. More than 9 million Americans have signed up for private health insurance or Medicaid coverage. (Source: State of the Union address.)
Sen. Dick Durbin of Illinois, Feb. 9: The bottom line is this: 10 million Americans have health insurance today who would not have had it without the Affordable Care Act. Ten million. (Source: Interview on CBS’ “Face the Nation.”)
Rep. Nancy Pelosi of California, Jan. 9: Nine million Americans now have quality health care coverage; 2.1 have enrolled in private coverage; 3.9 on Medicaid so far; 3 million young adults now covered under their parents’ plan. And, of course, the list will continue to grow. (Source: Weekly Press Conference.)
Rep. Sheila Jackson Lee of Texas, Jan. 8: There has been much maligning of the Affordable Care Act. Well, I am here to announce today that close to 9 million people have now been recipients and victors in getting health care. (Source: Congressional Record.)