Says health insurance premiums will rise under the national health care law. -- Americans for Prosperity on July 7, 2013, in a television ad
The conservative organization that spent more than $33 million in the last election to defeat President Barack Obama and other Democrats has turned its sights to undermining support for the Affordable Care Act, otherwise known as Obamacare. The group, Americans for Prosperity, launched a television ad in Ohio and Florida.
In the ad, Julie, a pregnant mother, talks about her concerns about the national health care law. Julie says:
Two years ago, my son Caleb began having seizures. The medical care he received meant the world to me. Now? I’m paying more attention.
And I have some questions about Obamacare.
If we can’t pick our own doctor, how do I know my family’s going to get the care they need?
And what am I getting in exchange for higher premiums and a smaller paycheck?
Can I really trust the folks in Washington with my family’s health care?
In this fact check, we focus on Julie’s question, “What am I getting in exchange for higher premiums?” That line presents higher premiums as a certainty. Whether that’s true in Julie’s case and anyone else’s depends on several key factors: age, income and, perhaps most important, how they get their insurance today.
We asked Levi Russell, spokesman for Americans for Prosperity, whether Julie’s current insurance is through the large-group, small-group or individual markets. We got no details. Russell said, “Julie’s questions about the impact of Obamacare are universal, which is why we’ve chosen not to get into details on her particular insurance coverage.”
But if Julie is the Every Woman, then her conviction that her premiums will go up is a sweeping statement that needs to be put in the context of the different markets.
Cori Uccello, senior health fellow at the American Academy of Actuaries, said many factors will shape how people like Julie fare under the Affordable Care Act. The best thing would be if she gets her insurance through a large employer.
“If they’re in the large-group market, they wouldn’t pay more in premiums,” Uccello said.
We contacted the Insurance Commission in Washington state. They run that state’s exchange, the online shopping tool for small-group and individual plans. Spokeswoman Stephanie Marquis said they will post their final rates in about two weeks. If Julie lives in Washington and is insured under a small-group plan, Marquis says she would do pretty well.
“It’s likely the rates will stay close to the same,” Marquis said.
Employers provide most of the insurance in this country. About 60 percent of everyone under 65 is covered through either a large-group or small-group plan, according to the Employee Benefits Research Institute, an independent think tank. Statistically, if Julie has insurance today, it’s most likely in one of those markets, and the ad should not assume that her rates will rise.
About 22 percent of people under 65 are with a government program. The individual market represents the smallest slice, about 7 percent.
In citing support for the claim that premiums will go up, Russell focused on the individual market. Russell also pointed to a Wall Street Journal article.
The WSJ looked only at the individual market. It used the proposals from insurance companies that want to participate in the exchanges of eight states.
The WSJ found that, “Healthy consumers could see insurance rates double or even triple when they look for individual coverage under the federal health law later this year, while the premiums paid by sicker people are set to become more affordable.”
This could be considered a split decision for the AFP ad. If Julie has a child with a medical history, and buys her insurance with no help from an employer, the article suggests she might do well under the health care law. On the other hand, if she were young and with a very healthy family, she might pay more.
Some states, such as Oregon, have seen companies lower their rates after they first submitted them. And other studies analyzed similar data but reached different conclusions.
Experts have always expected younger workers in the individual market to pay more. The Congressional Budget Office said the price tag for this sort of health insurance plan was likely to go up by 10 to 13 percent.
However, the CBO noted that a significant number of the people getting their insurance this way would have incomes low enough to qualify for tax credits. The Kaiser Family Foundation estimated these tax credits would help about 80 percent of them, although even with that subsidy, many in this group would still see rate hikes.
The WSJ article did not take the tax credits into account.
Our ruling
While most states have yet to announce their final rates, every expert we spoke to agreed that some people will pay more.
The message a casual viewer would take from the ad is that everyone’s rates are going up. But that’s not true, based on what experts told us. The AFP ad cherry-picks the facts and draws a conclusion beyond what the evidence supports, but it will prove accurate for some people.
We rate the statement Half True.
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