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The demise of the American Health Care Act closes a chapter in the Republicans’ seven-year quest to topple the Affordable Care Act.
It would be hard to name a battle that has generated more checkable claims -- PolitiFact has checked more than 1,400 claims about health care -- and the claims continued as House Speaker Paul Ryan and President Donald Trump pulled the plug on the bill they had cast as a defining moment for their cause.
Insurance companies and Obamacare
In a question-and-answer session with reporters, Trump blamed the Democrats for the stalemate and said, "Obamacare is exploding."
"I was in Tennessee the other day, and they’ve lost half of their state in terms of an insurer; they have no insurer," Trump said.
This isn’t completely correct. According to the Kaiser Family Foundation, a neutral source of health care statistics, Tennessee went from four to three insurance companies offering plans through the government insurance marketplace. That has left people in 73 of the state’s 95 counties with a choice of plans from just one carrier.
So, not "no insurer" as Trump said, but not much choice or competition either, at least for people seeking premium subsidies. Subsidies are only available through the government marketplaces. (People not seeking subsidies can buy elsewhere.)
The lack of choice is widespread. When Trump asserted before that there was only one insurer participating in the Affordable Care Act marketplaces in one-third of American counties, we rated that True.
Insurance premiums up but not that much
In his news conference, Trump gave another example of Obamacare’s problems, saying, "Last year you had over a 100 percent increases in various places."
And he went on to say, "many places, 50, 60, 70 percent, I guess it averaged -- whatever the average was -- very, very high."
Actually, the average rate hike wasn’t that high. The federal government reported that some states did see those sorts of increases in the price of a benchmark insurance plan. The Health and Human Services Department found that premiums rose an average of 25 percent across the 39 states that use the HealthCare.gov marketplace.
Arizona was the only state that saw a triple digit rise of 116 percent. Another five states had increases in Trump’s range:
Percentage increase 2016-2017
Trump made a similar claim during his address to a joint session of Congress. We rated that Half True.
Obamacare not doomed
For Republicans, the imminent collapse of Obamacare is talking point No. 1. Trump didn’t use the term "death spiral," but House Speaker Paul Ryan and others deploy it frequently. That statement is False
The latest data shows enrollment has fallen slightly, by about 4 percent, and younger (typically healthier) people are signing up at the same rate as last year. And while premiums are increasing, that isn’t affecting the cost for most consumers, due to built-in subsidies.
An analysis by the American Academy of Actuaries did note that "enrollment in the individual market has been lower than initially expected and enrollees have been less healthy than expected."
But that report did not predict an imminent collapse, nor did it describe the conditions for a death spiral, but it said there’s "a need for improvement."
The Congressional Budget Office, the nonpartisan number crunchers for Congress, compared the Affordable Care Act with the Republican health care bill. The CBO wrote that "the nongroup market would probably be stable in most areas under either current law or the legislation."
Has Obamacare 'failed'?
Similarly, Ryan’s assertion in February that "Obamacare has failed," rated Mostly False on the Truth-o-Meter. The law has not accomplished everything it set out to do. Former President Barack Obama’s promise that "if you like your plan, you can keep it," was untrue for millions of Americans. But coverage expanded greatly, and millions of Americans who couldn’t afford insurance before or were blocked by virtue of a pre-existing condition have health insurance today as a result of the law.
A promise to repeal and replace
We track Trump’s campaign promises on the Trump-o-Meter. His vow to "immediately repeal and replace Obamacare" is now Stalled. In his remarks to reporters after the Republican bill was pulled from a vote on the House floor, the president said he had time to make good on that.
"I never said repeal it and replace it within 64 days," he said.
He might not have literally said 64 days, but he did tell voters he would do it quickly, and that no longer seems to be in cards.
White House, Remarks by President Trump on the Health Care Bill, March 24, 2017
U.S. Health and Human Services Department, Health plan choice and premiums in the 2017 health insurance marketplace, Oct. 24, 2016
Kaiser Family Foundation, 2017 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces, Oct. 24, 2016
Healthinsurance.org, Tennessee health insurance marketplace: history and news of the state’s exchange, Dec. 27, 2016
Tennessean, BCBST's exit from 3 Obamacare markets sends shock waves, Sept. 26, 2016
American Academy of Actuaries, An evaluation of the individual health insurance market and implications of potential changes, January 2017
PolitiFact Wisconsin, Paul Ryan wrongly claims actuaries have determined Obamacare is in a 'death spiral', Jan. 18, 2017
PolitiFact Wisconsin, Testing Paul Ryan's damning attack on the Affordable Care Act: 'Obamacare has failed', Feb. 1, 2017
PolitiFact, Fact-checking Donald Trump’s claim about soaring Obamacare premiums, Feb. 28, 2017
PolitiFact, Donald Trump: One-third of counties have only one insurer on Affordable Care Act exchanges, March 13, 2017
Politifact, Gridlock in House stalls Trump's pledge to repeal Obamacare, March 24, 2017