Senator Ted Cruz speaks to reporters on Wednesday, October 16, 2013, after news emerged that leaders had reached a last-minute agreement to avert a threatened Treasury default and reopen the government. Cruz said he would not try to block the agreement. (AP Photo/J. Scott Applewhite)
Wednesday morning, at the very same moment Senators Harry Reid and Mitch McConnell were on the floor announcing a deal to end the government shutdown and raise the debt ceiling, their colleague from Texas Senator Ted Cruz—one of the key actors in creating this crisis—was delivering a stem-winder to reporters outside the chamber. He blasted the “Washington establishment” and repeatedly lamented the “suffering” Americans felt because of the dreaded Obamacare.
Unfortunately, virtually everything he said about the healthcare law was either directly untrue, highly exaggerated or badly misleading.
Fact-checking Ted Cruz has become old hat at this point—but sadly, not for many mainstream media outlets, who have dutifully reported on the all-encompassing, government-shutting, market-riling debate over Obamacare without actually parsing who is right about the effects of the law.
So this morning’s moment is as useful as any to examine claims that the ACA is so bad, the government almost had to default in order to get rid of it. (You can find Cruz’s full remarks here; we will just excerpt the claims about the ACA.)
CRUZ: The deal that has been cut provides no relief to all the young people coming out of school who can’t find a job because of “Obamacare.” It provides no relief to all the single parents who have been forced into part-time work, struggling to feed their kids on twenty-nine hours a week.
Obamacare is a job-killer: that is an article of faith among many conservatives. Their claims, and particularly the one Cruz is making here, is centered around the employer mandate, which requires businesses with fifty or more full-time employees, defined as those that work more than thirty hours, to provide health insurance or face a penalty. (Incidentally, this is the mandate Obama delayed for one year.)
The theory is that businesses will slash hours or reduce positions to stay under the limits for providing health insurance. (Never mind criticizing the businesses for screwing over their employees in this fashion—it’s naturally the government’s fault for imposing health coverage requirements.) That’s why Cruz is mentioning young adults and single moms—aside from being highly sought-after voting demographics for the GOP, they are also among those most likely to be searching for jobs that straddle the line between part-time and full-time.
But this isn’t actually happening on any significant scale. If it were, one would have seen the number of workers putting in twenty-six to twenty-nine hours increase in 2013, as businesses prepared for the employer mandate before it was delayed. According to a study from the Center on Economic and Policy Priorities, however, the opposite actually happened: there were slightly fewer twenty-six- to twenty-nine-hour workers in 2013 as the mandate date approached. Despite whatever individual examples Republicans may trot out, no significant amount of people are being forced to work less hours because of the ACA.
And what of positions being slashed? That is also not borne out by employment data, which shows private-sector jobs increasing at expected rates. “Health care reform does not appear to be significantly hampering job growth, at least not so far. Job gains are broad based across industries and businesses of all sizes,” Mark Zandi of Moody’s Analytics said earlier this year.
Why is all this? In part, because 94 percent of the businesses that would be affected already give health insurance voluntarily, and also because many of the rest don’t think cutting jobs and cutting hours is a particularly good growth strategy.
CRUZ: It provides no relief to all the hard-working families who are facing skyrocketing health insurance premiums…. President Obama promised the American people “Obamacare” would lower your health insurance premiums. I would venture to say virtually every person across this country has seen exactly the opposite happen, has seen premiums going up and up and up, and everyone who clicks on “Obamacare” and sees the premiums sees the premiums going up and up and up.
This is another article of faith for Tea Party types—that the ACA will skyrocket premiums.
It’s important to note off the bat that the “rate shock” being described would apply only to people buying insurance on the individual market. People who get their insurance through large employers or are on Medicare or Medicaid (i.e., a vast majority of Americans) won’t see a significant change in premiums because of ACA—job-based health insurance cost for single people rose about 5 percent last year, which is the norm.
For people buying on the individual market, through the ACA exchanges, will premiums go up? The short answer is: for some yes, for some no, and there’s usually a significant reason when premiums do go up: much more coverage is being offered. Cruz is wildly overstating his case by saying “virtually every person across this country” has seen higher premiums.
Jonathan Cohn has a comprehensive breakdown of the three major studies that have been done on this so far. What they found: sure, it’s true the “sticker price” of many individual market plans will increase, but that’s because pre-ACA, many of the plans on the individual market offered very sparse coverage and were allowed to exclude people with pre-existing conditions. Since the law beefs up coverage requirements and outlaws pre-existing condition inclusions, the sticker price goes up.
But what will also happen under ACA is that many people will get subsidies to buy health insurance—so relatively few people will actually pay the higher sticker price. The subsidies are offered at the point of purchase, not after the fact, so there isn’t any short-term burden.
In the end, many people will pay less—for example, people who are older or sicker and looking for insurance on the individual market will pay less because the ACA stops insurance companies from charging them more. People with relatively low incomes will also pay less because of the federal subsidies. People with higher incomes (more than four times the federal poverty line) might pay more because they won’t get subsidies, and the young and healthy may as well, because they were benefiting from the health insurance market that existed before, where bare-bones plans that excluded a lot of sick people were offered.
It’s also useful to note that, already, overall, the ACA premiums are less than what was expected when the bill passed.
Cruz could have a real conversation about whether preserving lower prices for the relatively affluent, young and healthy folks on the individual market is worth the extra financial burden for the older, poorer and sicker Americans—but he seems uninterested in doing that. Saying “virtually every person across this country” is seeing higher prices is wildly, wildly overstating his argument. One might even call it a lie.
CRUZ: And [the deal] provides no relief to all the seniors, to all the people with disabilities who are right now getting in the mail notifications from their health insurance companies that they’re losing their health insurance because of “Obamacare.”
Seniors and the disabled are of course on Medicare plans. So what does Cruz mean?
This is another popular Republican myth, one frequently repeated by Senator Marco Rubio, as PolitiFact noted when it flogged him for “oversimplify[ing] matters and put[ting] too much blame on the health care law.”
The short explanation of the flim-flam: since the 1970s, seniors and the disabled have been able to choose between standard Medicare or private plans financed by the government, which has been called “Medicare Advantage” since 2003. Twenty-eight percent of seniors get their coverage through Medicare Advantage now.
The ACA cut $700 billion in excess payments through Medicare Advantage (you may remember that number from the 2012 elections). The idea was to bring the cost of the private plans more in line with the cheaper government plans over time. By tightening the payments, the ACA was challenging the private companies to manage their plans better.
And the thing is, it has worked: Medicare Advantage plans have seen premiums decrease by 10 percent since the ACA was passed, and 28 percent of the plans have been upgraded to a higher star rating since 2010, meaning they are offering better services. Seniors are responding: enrollment in Medicare is at an all-time high, up 30 percent since the ACA was enacted.
Now of course, some (but not many) health insurance companies have elected to dump seniors off their current plan and create a new one more in line with ACA requirements. That’s what Cruz is referring to, and it’s no doubt an inconvenience, but the net effect for Medicare Advantage customers, again, is cheaper plans with more services. The seniors and disabled losing their current Medicare Advantage plan can stay with the new plan being offered by their health insurance company, or chose from another Medicare Advantage plan during open enrollment, or just go on standard Medicare.
It’s not at all the situation being portrayed by Cruz, in which he warns of seniors “losing” their health insurance. He’s once again walking right up to the line of mendacity, and failing to explain what’s actually going on.
CRUZ: People all over this country are losing their health insurance. Fifteen thousand UPS employees got a notification in the mail that they were losing spousal coverage, that their husbands and wives were all losing the health insurance that they wanted and they liked. That is happening all over the country. It’s wrong.
Indeed, UPS said in August that it was ending spousal coverage for 15,000 employees and blamed, in part, the ACA. But Cruz isn’t telling even one-tenth of the story.
Once again, we turn to Jonathan Cohn. Here’s what’s important to understand: first, long before Obama became president, companies were jettisoning spousal coverage plans. That type of dual-coverage was a relic of the days when only one spouse (usually the man) worked, but as more women headed to the workplace, such plans became an increasingly expendable option.
No doubt the health law is imposing some additional costs on employers, though once again Cruz elides any debate over the benefit trade-offs involved. But even UPS is emphasizing (not that Republicans will listen) that the ACA isn’t a controlling factor in ending spousal benefits. “One way of saying this is that we are restructuring our benefits ‘because of the ACA’—but that’s not accurate,” Andy McGowan, a UPS spokesman, told Cohn. “We are doing this because we are looking at many different factors adding to our costs, and ACA is one of them.”
Finally, you might have wondered if UPS only has 15,000 employees. It does not! The company is only ending the benefits of spouses who already have a job where they can get health insurance. In other words, not a single person is actually losing coverage because of this move. Cruz doesn’t mention that.
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