Dispatches and Debunkery from the Trenches of the Obamacare Debate

I spent several hours of my Saturday debating conservatives about Obamacare on Facebook. It turned out to be a case study in both the efficacy of Republican and Fox News misinformation, but also in just how fantastically pissed off some people are about the idea of a law that helps Americans to acquire affordable healthcare.
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I spent several hours of my Saturday debating conservatives about Obamacare on Facebook. It turned out to be a case study in both the efficacy of Republican and Fox News misinformation, but also in just how fantastically pissed off some people are about the idea of a law that helps Americans to acquire affordable healthcare.
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My dearest friends are always warning me to stop being baiting into political shovel fights on social media. And while I've somewhat restrained my natural compulsion to do so, I simply can't help it. It's what I do. If there's someone who's marketing in crapola online, I can't help but to respond. There's a classic online cartoon illustrating a stick figure pounding away on a computer and a voice out-of-frame begs the figure to come to bed. The character replies, "I can't! Someone is wrong on the internet!"

I'm that guy.

Case in point, I spent several hours of my Saturday debating conservatives about Obamacare on Facebook, and I regret nothing. It turned out to be a case study in both the efficacy of Republican and Fox News misinformation, but also in just how fantastically pissed off some people are about the idea of a law that helps Americans to acquire affordable healthcare.

A former colleague and friend of mine from when we both wrote for AOL's now-defunct WalletPop website posted what I thought was a joke about Obamacare -- I'm not sure whether it was a joke since it involved Ann Coulter, and so much of what she says is a joke even when she's trying to be serious. Either way, via a tag, I was asked to respond. So I jumped in head first by describing my health insurance situation and concluded that Obamacare is not only good policy but it's also good politics, based upon the fact that I and millions of others would gladly use our bodies as human shields against anyone who tries to repeal the law. A lot of us vote.

That's when the insanity began. Repeatedly debunked myths aside, I get the sense that many Obamacare opponents don't even know what the hell it is.

Out of the gate, someone replied: "This is [about] many people suffering in order to pay for the health care of the relatively few people who couldn't get insurance."

I really have no idea what this means (hence my reply: "Nonsense."). This guy appears to have been suggesting that "many people" are either paying higher taxes or egregiously higher premiums in order to pay for "the relatively few people" without insurance. Well, no. There's no hard evidence showing widespread suffering from higher premiums or anything else due to the law. He also seems to forget that health insurance wasn't a panacea before the law when you could be dropped just after being diagnosed with an illness or, after paying thousands in premiums, told that your medical treatment won't be covered because you reached an annual or lifetime limit on benefits.

This guy seemed to be opposed to the wildly popular section of the law forcing insurers to accept people with pre-existing conditions because, he wrote, it causes "suffering" in others. If this was really his point, he's definitely in the extreme minority here since 78 percent of Republicans support this aspect of the law -- again, that's among Republicans.

Another commenter complained, "Under Obamacare, my adult daughter's health insurance policy premiums virtually double and she gets less coverage than she had before."

Of course there's no real way to verify this statement, but it sounds eerily similar to the dozens upon dozens of alleged and subsequently debunked "horror stories" we've been hearing about since October. He neither clarified what his daughter was paying before and what it covered nor did he elaborate on what her Obamacare policy options were.

But let's take this guy at his word. Later in the thread, he praised "so many other people who were responsible enough to maintain their own health insurance or look for an employer who would provide that benefit."

Interesting. Okay, then why didn't his daughter, who was evidently not responsible enough to keep her health insurance, follow her father's advice to get job -- to "look for an employer who would provide that benefit?" Odd. Is it me or does it sound like some Obamacare opponents are desperately looking for something to complain about no matter what happens?

Anyway -- and this is an important point that's so often (and deliberately) overlooked -- there's no requirement in the law mandating that you buy insurance through Obamacare, be it the exchanges or Healthcare.gov. This guy's daughter or anyone else, for that matter, can go directly to a health insurance company's website and sign up. Sure, the Healthcare.gov website and several of the exchange websites were initially flummoxed, but that shouldn't have prevented new customers from visiting the websites of insurers in their state.

According to a study by the Rand Corp., 9.5 million Americans signed up for new policies without using either the exchanges or Healthcare.gov. Add that to 7.1 million sign-ups via the exchanges, 4.5 million via expanded Medicaid coverage and 2 million kids under the 26-year-old threshold for staying on their parents' policy. Incidentally, most of the people who signed up directly through insurance companies were previously insured.

In the face of the good news regarding the new enrollments, someone in the thread had the balls to ask me, "Hey Bob, if this is SO much better for the masses then why haven't people been signing up for it by the droves?"

Funny. At the end of the law's first several months of being fully implemented, upwards of 23 million Americans have purchased new insurance policies, according to the Rand Corp. study. If that doesn't constitute "by the droves," I don't know what does.

When I challenged the "by the droves" remark with the Rand numbers, a different commenter replied, "And I'm sure the threat of financial penalty also had nothing to do with that." Yeah, perhaps, but what about he financial penalties involved in getting sick or injured without insurance? Those penalties, including bankruptcy or physical harm caused by lack of treatment, are a hell of a lot greater than the tax penalty for not signing up, I assure you. Perhaps being a responsible member of society, not to mention making sure you're covered in case of illness or injury, is a smart move.

Next up, another commenter wrote: "And for the supposed 10 million who signed up.... there were at least 10 million who got dropped from their insurance for no net gain."

That's also terribly wrong. The Rand study showed: "Fewer than a million people who had health plans in 2013 are now uninsured because their plans were canceled for not meeting new standards set by the law."

My colleague jumped in with a remark that I found to be incredibly misinformed. He suggested that Obamacare manifests "higher costs than before for young healthy people who aren't poor." In other words, younger people are paying higher premiums in order to pay for everyone else.

Let's go to the Kaiser Family Foundation's premium calculator.

--A 21-year-old earning $25,000 living in Phoenix, Arizona can get a Bronze plan for $122 per month. That's 5.8 percent of his/her annual income.

--Now, my colleague specifically cited young people "who aren't poor." So let's re-calculate. Same state, age 21, income $100,000. Bronze plan: $132 per month. 1.59 percent of annual income. And this is a state (AZ) without an exchange. Bump the salary up to $200,000 at the premium remains the same. Why? Because income has nothing to do with the calculation of the premium.

--Let's compare that to someone who's 19 years older. A 40-year-old with the same income, $25,000, in the same state would pay 5.61 percent of his/her annual income in Bronze plan premiums. So my colleague is technically correct... by 0.2 percent or (shock, horror) $6 more per month for the older enrollee.

--While we're here, what about a family of four earning $200,000 annually, also living in Phoenix? $370 per month for a Silver plan or just 2.2 percent of annual income. By the way, if this family wants to expand with another child, pre- and post-natal care is covered for free under the law. Or if this family chooses to remain a family of four, contraception is covered free-of-charge as well. Because Obama clearly hates families.

Back to my colleague's point, young people are being encouraged to sign up not because of their premiums but because they don't get sick as often, which mitigates the risk of enrolling older, riskier people. It's called "risk pooling," and it's how insurance companies of all varieties have always operated.

The upshot in all of this is that the Republicans have done a better job at misinforming the public than the Democrats have done in properly informing Americans, not just about the law and the options that go along with it, but more broadly about how insurance works. It's a gap that spawned my Facebook debate on Saturday and, I'm sure, thousands of others, be they in social media corners or around dinner tables.

This law, which admittedly was almost entirely based upon proposals by the conservative Heritage Foundation and prominent Republicans like Bob Dole and Chuck Grassley, isn't perfect. Indeed, there was a bipartisan vote last week to pass an improvement to a part of the law regarding deductibles and small business group policies. The amendment passed and the president signed it. And even though the Republicans both sponsored the amendment and voted for it while publicly vowing to entirely repeal the law, you won't hear a damn thing about this improvement from them. Obviously.

Needless to say, we'll surely see more amendments and fixes to Obamacare. But in and of itself, this law is absolutely benefiting millions of Americans. In that regard, it ought to be defended just as tenaciously as it's been attacked. As a beneficiary of Obamacare, I intend to be just as vigorous in defending the law as I was in supporting its passage back in 2009 and 2010. If that means spending half a Saturday correcting people who are "wrong on the internet," so be it. It's the least I can do.