Springtime for Obamacare

US President Barack Obama and outgoing Health and Human Services Sec. Kathleen Sebelius attend the annual White House Correspondent's Association Gala at the Washington Hilton hotel May 3, 2014 in Washington, D.C.
Photo: Olivier Douliery-Pool/Getty Images

Stacey Campfield, a Republican State Senator from Tennessee, has compared Obamacare to the Holocaust, and continues to find the historical parallel compelling. “I will continue to stand up against the government takeover of the nations healthcare,” he writes, or attempts to write, in a blog post. “I think Jewish people should be the first to stand up against Obamacare,” Campfield tells the Associated Press. “When you have government deciding who gets health insurance and who doesn’t, what services they get and what services they have to provide, they’re really deciding who lives and who dies.”

You know who else has universal health-care? Photo: Yoav Lemmer/AFP/Getty Images

But give Campfield this: The man has his principles, and he wears them on his sleeve. The more politically influential arguments against Obamacare are not so ideological. They are, instead, rooted in a series of empirical claims: The critics are not insisting that they object to the objectives of a universal health-insurance scheme, but rather that the scheme we have in place is failing to achieve its stated objectives. The empirical objections, unlike the Godwin’s Law–violating ones, are falsifiable. And, as the law goes into effect, they are being falsified almost every day. Here are some of the predictions made by the critics that have taken a factual beating:

Customers aren’t paying their premiums. As the number of exchange customers steadily rose, conservatives insisted the published totals were certainly fake. “The five million enrolless number is nonsense,” charged Fox news pundit Steve Hayes in March. “Eight million “enrollments” is an enormous exaggeration…” wrote the Weekly Standard’s Jay Cost in April. A Republican House committee produced a well-publicized report claiming that only two-thirds of the exchange customers had paid their premium.

Bloomberg News reports today that major insurers are testifying that their payment rates range from 80% to 90%:

As many as 90 percent of WellPoint customers have paid their first premium by its due date, according to testimony the company prepared for a congressional hearing tomorrow. For Aetna, the payment is in the “low to mid-80 percent range,” the company said in its own testimony. Health Care Service Corp., which operates Blue Cross Blue Shield plans in five states including Texas, said that number is at least 83 percent.

Health insurance doesn’t make you healthy. Last year, a study found that people in Oregon selected to benefit from Medicaid enjoyed higher financial stability and better mental health, but no discernible improvements in diabetes and blood pressure. Other studies had reached different conclusions, but conservatives seized upon the Oregon study to insist that, contrary to the intuitive beliefs of pretty much everybody, giving health insurance to people who lack it doesn’t make them better off. (Some researchers have argued that there were too few people in the Oregon study to draw this conclusion.) This belief has been a foundational element of opposition to Obamacare.

A new study released this week, this one in Massachusetts, powerfully undermined the notion that health insurance doesn’t make you healthier. The study found that the expansion of health insurance in Massachusetts — the one that became the model for Hitlercare — reduced the mortality rate of beneficiaries by 3 percent over four years. Researchers examined a huge sample size. David O. Meltzer, a health economist from the University of Chicago, tells the New York Times, “In the hierarchy of evidence, this ranks way above everything we’ve seen in the past in terms of the effects on mortality.” We should be able to agree that people who are alive are, with some well-publicized exceptions, healthier than people who are dead.

The uninsured rate won’t go down. For months, conservatives have speculated or simply asserted as fact, that Obamacare would fail even to reduce the number of Americans without insurance, because the number of people losing their existing plans would allegedly outnumber those gaining coverage. Measuring the effects of the law on the uninsured population is really hard, but all the evidence we have suggests just the opposite. The most recent Gallup poll shows the uninsured rate falling once again to the lowest level since it began asking the question in 2008:

It’s almost as if a law designed to insure people too poor or sick to afford health insurance actually results in them getting health insurance. Imagine.

Premiums are going to skyrocket. Last year, Wellpoint, a major insurance company, told investors it might have to increase premiums “double digit plus.” The prediction launched a million apocalyptic predictions — premiums would double! Or even quadruple!

Last week, Wellpoint announced that a surge of customers in the exchanges had created a healthy mix of customers, and walked back its frightening prediction: “Rates will vary by market, but given this information, they may not be what we thought from previous reports.

The cost would be unaffordable. Obamacare combined two ambitious goals: to make affordable health insurance available to all legal residents, while also reducing the rate of medical inflation, so that over time the law did not add to the long-term debt burden. Conservatives fervently insisted that budget projections were far too optimistic, and the new law would increase rather than decrease the cost of health care.

Yesterday, the Committee for a Responsible Federal Budget, a debt-hawk group, released a new report of the improving fiscal picture. Since the passage of Obamacare, the federal budget is not only projected to spend less on medical care than it was when Obamacare first passed. It is now projected to spend less than it expected before Obamacare became law:


The Stacey Campfields have no reason to change their mind. Say what you want about the tenets of Obamacare-is-national-socialism, at least it’s an ethos. Those who have made more concrete predictions, on the other hand, are in a tricker spot.

I am not asking opponents of the law to abandon their philosophical opposition to national health insurance. I am not even asking them to concede that the law is certain to work generally as intended. They still have many predictions of doom that cannot be falsified for years and years to come. And some parts of the law will continue to go wrong, just as the launch of the website did. But if they truly believe the arguments they have made — that the law not only should not but cannot work — shouldn’t they be expressing, at minimum, some serious doubts?

Springtime for Obamacare