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Steve Contorno
By Steve Contorno March 20, 2014

Americans for Prosperity claims people are getting less at a higher cost under Obamacare

Americans for Prosperity has been active on the airwaves already this election cycle. The group, which opposes Obamacare, has run a handful of ads featuring people telling health care "horror stories" meant to tug on the heartstrings. We’ve looked at a couple and explained how they can be misleading.  

But a pair of new ads take an entirely different tack to undercut support from Democratic Sens. Mary Landrieu of Louisiana and Mark Udall of Colorado. (It has also run against Sen. Kay Hagan, D-N.C., and Sen. Mark Pryor, D-Ark.)

In these ads, a woman on screen trashes political ads in her 30-second personal pitch.

"People don’t like political ads. I don’t like them either. But health care isn’t about politics," she says. "It’s about people. And millions of people have lost their health insurance, millions of people can’t see their own doctors, and millions are paying more and getting less."

We’ve tackled claims about lost insurance and access to personal doctors before. But we haven’t heard someone say that the health care law is causing people to pay more for less, so we decided to check it out.

Paying more

There are a lot of factors in the health care law — and health insurance in general — that make it difficult to pin down whether people are paying more or less for coverage.

In general, insurance premiums were increasing every year well before Obamacare became law. In fact, rates have increased consistently during the last 15 years. But there are signs that the rate of the increase has declined since the law was passed.

Kaiser Family Foundation, for example, surveyed people who purchase insurance through their employer. Here are the average annual cost of premiums:

 

Year

Single

% increase

Family

% increase

1999

$2,196

 

$5,791

 

2000

$2,471

12.52%

$6,438

11.17%

2001

$2,689

8.82%

$7,061

9.68%

2002

$3,083

14.65%

$8,003

13.34%

2003

$3,383

9.73%

$9,068

13.31%

2004

$3,695

9.22%

$9,950

9.73%

2005

$4,024

8.90%

$10,880

9.35%

2006

$4,242

5.42%

$11,480

5.51%

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2007

$4,479

5.59%

$12,106

5.45%

2008

$4,704

5.02%

$12,680

4.74%

2009

$4,824

2.55%

$13,375

5.48%

2010

$5,049

4.66%

$13,770

2.95%

2011

$5,429

7.53%

$15,073

9.46%

2012

$5,615

3.43%

$15,745

4.46%

2013

$5,884

4.79%

$16,351

3.85%

 

Other than a sharp increase between 2010 to 2011, the Obama years have experienced the smallest rate increases of the last 14 years. Throughout much of the early 2000s, premium increases of 9 percent or more were the norm.

The Centers for Medicare and Medicaid also found a slowdown in the increase in health costs during the last four years, including a modest 4 percent increase from 2011 to 2012.

The government attributed the decrease in health costs to the economic downturn. Kaiser, too, said the recession accounted for much of the decline, though they said the health care law may have played a role, too.

Because of the law, people making up to 400 percent of the federal poverty level are now eligible for subsidies to buy insurance, and for many of them, costs are going down. Those costs are capped at a percent of their income.

But some people may see rate increases on existing policies or as they transition to new plans.

Insurers can no longer deny individuals with pre-existing conditions, and there is now a much larger pool of people looking to purchase coverage. For younger, healthier people, this means they are now taking on some of the financial burden so older or sick people can buy insurance at a reasonable price. (This is especially true for young males, since young women were often charged more, and even more so if they don’t qualify for premium subsidies.)

There were also people who previously purchased very cheap plans. But those policies provided very little coverage or capped their benefits at low levels, which the new health care law bars. So they’re getting more coverage, albeit at a greater cost.

Getting less?

Which gets us to our next point.

We found it strange that the ad claimed that people are getting less under the Affordable Care Act. In fact, we’ve usually heard the opposite from critics of the law that people are now paying for types of coverage they don’t need.

The favorite example is single men who now will now have maternity coverage if they buy a plan on the individual market. In October 2013, Rep. Renee Ellmers, R-N.C., grilled Secretary of Health and Human Services Kathleen Sebelius on this very point.

"An insurance policy has a series of benefits whether you use them or not," Sebelius said during her testimony on the Hill.

"And that is why the health care premiums are increasing this high," Ellmers said. "We’re forcing them to buy things that they will never need."

"Individual policies cover families. Men often do need maternity coverage for their spouses and for their families," Sebelius responded.

"To the best of your knowledge, has a man ever delivered a baby?" Elmers asked. The discussion ended there.

So are you getting less coverage, or getting more than you need? We asked Americans for Prosperity to clarify their position.

"Getting less speaks to a multitude of data points that has been America's Obamacare experience so far: botched website, shrinking provider networks, a string of broken promises, missed deadlines, and unilateral rule changes that have kept the entire country in limbo ever since this debacle rolled out," said spokesman Levi Russell.

That’s a pretty ambiguous definition of "less." We think most people would assume "less" is referring to the amount of coverage or benefits under the law.

Americans are getting more benefits under the law in a number of ways -- including, in some cases, being able to buy affordable insurance for the first time.

In addition, insurance purchased in the individual and small group marketplace must meet 10 essential health benefits. This includes coverage for emergency services and hospitalization, prescription drugs, free preventative coverage for things ranging from basic immunizations to HIV screening, and maternity care.

The law also caps out-of-pocket costs, providing greater protection from exorbitant hospital bills. The most a person could pay for health care in a year is $6,300; the most a family can pay is $12,600.

Before the law passed, some insurers capped annual or lifetime benefits, forcing people who thought they were covered to pay large hospital bills once they passed the threshold.

People with pre-existing conditions are also seeing a lot more benefits, since they previously couldn’t buy a policy at all.

So it’s a tough sell to say millions are getting less. And for many, they aren’t paying more, either.

Our ruling

Americans for Prosperity said "millions are paying more and getting less" under Obamacare. We found their explanation of "less" rather dubious. Most people on the individual market are getting more benefits under the law. At worst, they’re paying more to get more, though in many cases they’re actually paying less.

We rate this claim False.

Our Sources

Americans for Prosperity, "AFP launches new ads in Louisiana, Colorado," March 17, 2014

Email interview with Levi Russell, spokesman for Americans for Prosperity, March 19, 2014

Kaiser Family Foundation, "Why Premiums Will Change for People Who Now Have Nongroup Insurance," Feb. 6, 2013

Kaiser Family Foundation, "The Flip Side of Higher Premiums: Better Coverage," March 21, 2013

Kaiser Family Foundation, "Health Cost Growth Is Down, Or Not. It Depends Who You Ask," March 5, 2014

Centers for Medicare and Medicaid Services, National Health Expenditures 2012 Highlights, accessed March 20, 2014

Kaiser Family Foundation, 2013 Employer Health Benefits Survey, Aug. 20, 2013

Congressional Budget Office, The Slowdown in Health Care Spending, Sept. 19, 2013

National Bureau of Economic Research, "Is this time different? The slowdown in health care spending," Dec. 2013

Executive Office of the President of the United States, Trends in health care cost growth and the role of the Affordable Care Act, Nov. 2013

National Review, "GOP Rep. Asks Sebelius Why Single Men Need Maternity Coverage," Oct. 30, 2013

Healthcare.gov, "What does Marketplace health insurance cover?" accessed March 18, 2014

RAND Corp., "No Widespread Increase in Cost of Individual Health Insurance Policies Under Affordable Care Act," Aug. 29, 2013

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Americans for Prosperity claims people are getting less at a higher cost under Obamacare

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