Five Myths About Obamacare

Here’s another post in our series to help consumers understand the Affordable Care Act for health insurance (ACA, or “Obamacare”) for which people may begin signing up starting Tuesday. Today, we knock down some persistent myths about the law.

Minnesota Public Radio (MPR) enlisted Lawrence Jacobs, professor of political science at the University of Minnesota and an expert on the ACA, to discuss his top five myths about Obamacare. Jacobs also contributes to PolitiFact, a sort of quality control for media claims.

1. The law creates “death panels.”

In 2009 as the debate over health-care reform began, former GOP vice presidential candidate Sarah Palin said on Facebook that seniors and the disabled will “have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care.”

Uh, no. The law does not create panels that choose who gets care and who doesn’t. Palin might have been referring to a provision in one version of the bill being debated at the time that would have created a group to study which medical treatments are the most effective. We’d call that evidence-based medicine, and it’s not even in the same solar system as the creation of a death panel.

2. The law is a government takeover of health care.

We’ve heard that since the early days of the health-care debate. The government isn’t taking over anything. It is creating online marketplaces where consumers and small business owners can shop for health insurance plans.

Initially, Obama wanted to create a public option-a government insurance program similar to Medicare, but open to everyone. That idea lasted for 10 minutes.

The health-care law does not make doctors public employees and it does not put the government in charge of hospitals, as is the case in parts of Europe.

The law does make important changes to how health insurance works in the U.S.: It prevents insurers from denying coverage to people with pre-existing medical conditions; it requires health plans to provide a minimum level of coverage (see our blog “Health Plan Model Disappoints”). But those amount to new federal regulations affecting an industry that is already highly regulated at the state level.

Hardly a government takeover.

3. You won’t be able to keep your doctor or your current insurance.

That’s neither true nor false; it depends. For people who get their insurance through their employer, not a whole lot will change unless the employer decides to change the coverage it offers. Nothing in the law requires changes.

If you buy insurance through one of the new exchanges, you might not find a plan that includes your current providers. But that’s largely a function of the provider networks insurers use, and it doesn’t mean you won’t be able to choose your providers within a defined network.

If you buy your own insurance now and like it, you may keep it-assuming the coverage meets the minimum federal coverage requirements. Some plans won’t. But if you later switch to an insurance plan sold on a state exchange, the coverage may be more robust to meet new standards for plans sold on the exchanges.

The bare-bones plans grandfathered in (that is, they existed before the passage of the ACA in 2010) under the law eventually will disappear.

4. The ACA covers unauthorized immigrants and abortions.

The Affordable Care Act doesn’t cover anything. It’s not an insurance program.

It’s a law that bars unauthorized immigrants from purchasing insurance through the exchanges. They also are prohibited from obtaining Medicare or nonemergency Medicaid coverage. The law does allow them to get care at an emergency room, but they can do that now.

The Affordable Care Act did not change abortion coverage; federal funds may not be used to cover abortions unless it is a case of rape, incest or the mother’s life is in danger.

Obamacare does not compel insurers that market plans on the state exchanges to cover abortions, but insurers may offer that coverage if they want to. Some states have banned abortion coverage.

People buying insurance on the exchange may be eligible for federal subsidies. So the law includes a mechanism to ensure that money isn’t used to subsidize abortion coverage.

5. The ACA is a “job-killer.”

This claim is based on a mischaracterization of a Congressional Budget Office report that predicted that more than 800,000 people who keep their jobs now solely for the health-care coverage would leave the workforce because they’ll be able to find affordable insurance through the state insurance exchanges.

This idea is misleading at best, and health-care hokum at worst.

The health-care law requires that businesses with 50 or more full-time employees (those who work more than 30 hours a week) must provide health insurance. Opponents of the law say employers won’t be able to afford to give all their workers coverage or will find the cost of their current insurance so onerous that they will be forced to lay off people.

Despite little evidence to support this scenario, some employers might cut worker hours below 30 to avoid the employer mandate. According to a recent survey by the International Foundation for Employee Benefit Plans, 17.8% of Midwest businesses have or will cut hours because of the health-care law requirements.

That’s notable, but still represents fewer than 1 in 5 employers.

Keep in mind that the demands of the Affordable Care Act are creating jobs to administer and monitor the new mandated provision of health care. And the law is expected to create demand for doctors and nurses because more people will have health insurance.

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