The Supreme Court ruling on the Affordable Care Act (ACA) on Thursday has caused a rush of panic from the opponents of universal health care. Lots and lots of claims about what the law does are being tossed around, and many of these claims are what you might call puzzling to those of us who actually know what’s in the ACA. Now, I don’t want to accuse anyone of intentionally lying without gathering more evidence, but without a deeper understanding of what various conservatives mean by their claims, it’s hard to suppress the sense that they may perhaps just be lying. So, I’ve made a list of questions I want opponents of health care reform to answer so I can better understand how their seemingly outrageous claims about the ACA make sense outside of the most obvious “lying” angle.
How does one “go on” Obamacare? Paul Ryan, denouncing the bill: “Millions of people who are otherwise going to go on Medicaid, are now going to go on Obamacare which costs a whole lot more money.” What is this “Obamacare” that people can go onto? I looked around to see if I could get an insurance plan through the “Obamacare” that Ryan and other conservatives are talking about Americans going on to and all I can find are the same old private insurance companies that existed before. The way Ryan & Co. talk about “Obamacare,” it sounds an awful lot like they think there’s a public option people can buy if they don’t want private insurance and aren’t eligible for Medicaid. But those of us who recall the big political fight over the ACA can tell you that there was originally a public option in the bill, but it was removed in order to get more votes from conservative Democrats. So what is this “Obamacare” conservatives keep insisting you can buy into and where do I find it?
How does the ACA remove your choice or get between you and your doctor? Various claims are being tossed around about health care reform “getting between you and your doctor” or taking away people’s choices in what medical treatments to pursue. In his remarks after the ACA ruling, Romney repeated this claim by saying the government is getting “more and more intrusive in your life” and “separating you and your doctor.”
So my question is: How? What medical decisions will the government now be making for you under the ACA? (Obviously, under conservative-supported legislation, the government has a lot of power to make decisions for women seeking abortion or contraception, but those laws aren’t part of ACA.) If you’re referring to the fact that insurance companies will retain the right to deny coverage for certain procedures they deem unnecessary, well, insurance companies already do that. If anything, the ACA has limited the ability of insurance companies to deny you the ability to pursue medical treatments you and your doctor choose, because the ACA has removed spending limits and banned insurance companies from denying you coverage based on pre-existing conditions.
How is the ACA going to force you to pay for abortion? A typical example of this claim from CNS News, saying the ACA requires that “Americans buy health insurance plans that pay for contraceptives and abortion.” The problem is that the executive order Obama tied to the ACA actually does the opposite on abortion, and requires that every state exchange have insurance options that don’t cover abortion, for those who actually consider that a priority, aka almost no one. If people making this claim are referring to the insurance plans they already have through their employers which often cover abortion, again, that’s a pre-ACA reality that didn’t seem to bother conservatives until they could use it to raise the public’s ire over health care reform.
Where are the parts of the bill requiring “rationing”? There’s no such requirement in the ACA. If people making this claim are referring to the insurance company practice of denying certain coverage they deem too expensive or medically unnecessary, I refer you to the above passage that points out that this was the policy before the ACA, and the ACA has restricted the right of insurance companies to deny coverage.
How is everyone in the country going to pay more in taxes? Paul Ryan and the folks at Fox News were making this claim, that this is a tax that will “hit everyone.” How will “everyone” be hit with this tax penalty? The bill couldn’t be more clear that you don’t pay this penalty if you have insurance. The majority of Americans actually have insurance, and more will buy it under this plan, with the hope being that eventually all Americans will have it. So if the majority are already not in a position of having to pay this and even more people will not be paying this, how does this hit “everyone?” Are conservatives stretching the definition of “paying” a tax to include taxes that you don’t pay, but maybe could have in an alternate reality where no one has health insurance?
What’s the game plan for the “replace” part of “repeal and replace”? In his remarks about the ruling, Romney claimed he wanted to “repeal and replace” the ACA with a bunch of provisions Jon Stewart pointed out are, uh, actually in the ACA. I have no problem believing that Romney, if he were President with Republican majorities in both houses of Congress, would be able to repeal the ACA. But replace it with what amounts to a nearly-identical bill? The first bill was barely able to pass with Democratic majorities in both houses. How would he get a nearly-identical bill past congressmen who have been clear from the get-go that they hate the very idea of health care reform? Why does he think that “repeal and replace” makes more sense than simply passing bills modifying the original legislation to take out the parts he doesn’t like as much, but leaving the parts—i.e., most of the bill—he claims to like intact?
These are but a few of many important questions I need opponents of the ACA to answer in depth to believe that they’re arguing in good faith. Because right now, it seems instead what’s going on is that opponents just hate health care reform, period, and are coming up with a lot of dishonest rhetorical dodges because they know the public at large wants a better health care system than we have now.