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Herman Cain’s longshot 2012 Republican presidential bid may be long over, but he’s continued to opine on national affairs. Take, for example, his recent blog post titled, "Nine facts Democrats don't want you to hear before you vote tomorrow."
The post, published Nov. 3, 2014, and forwarded to us by a reader, begins this way: "As we all get ready to head to the polls tomorrow, Democrats want you focused on the Koch brothers (that evil, fang-toothed fictionalized version, not the real ones who are excellent and highly successful businessmen) and their ‘war on women’ crapola."
The post goes on to offer nine bullet-point items that "Democrats do not want to talk about," including claims about the economy, home ownership, taxes, debt and foreign policy.
On health care policy, Cain offers this:
"Obamacare is a failure! More people are losing their insurance than are becoming newly insured, and 51 percent of those enrolled in the exchanges say they will not re-up given the opportunity the next time around. Then there are the 29ers (people being limited to 29 hours a week because of Obamacare mandates) and the 49ers (not the San Francisco ones ... the businesses intentionally staying under 50 employees to avoid the coverage mandate). There are also thousands of doctors refusing patients with Obamacare coverage because they can’t cover their costs on the reimbursements, while thousands more doctors are retiring early."
That’s a lot to chew on, but we were especially interested in checking Cain’s claim that "more people are losing their insurance (due to Obamacare) than are becoming newly insured." (An inquiry to Cain’s staff was not returned.)
We will start off with a big caveat: The data available on this question is imperfect.
For starters, the most historically credible, long-term statistics for health coverage and uninsurance -- the annual figures published by the U.S. Census Bureau -- do not include the big surge in insurance signups that occurred during the first quarter of 2014, which was the deadline for obtaining insurance for 2014 under the Affordable Care Act.
What remains is data compiled by the private sector. However, the figures for new signups are somewhat piecemeal, with a less certain historical track record than the Census data. And the figures for cancellations are even fuzzier.
That said, we’ll look at the consensus of data compiled by private-sector organizations. These have been calculated on a net basis -- the number of newly covered Americans minus the number of Americans newly lacking coverage. For Cain to be right, this number would have to be negative -- more losses than gains. Is it?
The polling company Gallup has been studying uninsurance rates every quarter in a reasonably real-time fashion. In its most recent study, covering the third quarter of 2014, Gallup found that 13.4 percent of Americans lacked health insurance. That’s down significantly from its 18 percent rate in the third quarter of 2013, before the health care exchanges began operations. (As a reminder, insurance-coverage gains from the health care law stem from several sources, including people who signed up for plans on the exchanges, people who were newly able to sign up for Medicaid coverage in the states that allowed it, and young adults under age 26 who were allowed to remain on their parents’ plan.)
These Gallup numbers shows a decline in uninsured Americans of 4.6 percentage points since the law took full effect -- the opposite of the direction Cain suggests.
All told, between October 2013 and June 2014, Gallup found that 10.3 million nonelderly adults gained health insurance coverage. It’s possible that this number has grown since the data cut off in June 2014.
Gallup’s finding tracks with what other sources have found.
The New England Journal of Medicine estimated that, through June, 10.3 million adults gained coverage. Also through June, the Commonwealth Fund estimated the number at 9.5 million. And over the same period, the Urban Institute offered an estimate of 8 million.
An earlier study -- through March -- by the RAND Corp. estimated a net gain of 9.3 million American adults with health insurance.
This is a high degree of similarity between five separate studies, pointing to a net increase of 9 million to 10 million through June.
And there’s reason to believe that number could be higher. These estimates do not include children under 18, and it’s possible that additional Americans have gained insurance in the months since June.
It’s certainly possible that some of the other elements of Obamacare, including employer mandates, will lead to further losses of coverage once they take effect. (The administration has delayed the start of employer contribution requirements.) And the administrative hassle of losing one’s former plan is undeniably a hassle, even if one ends up with a different plan later.
But as of now, there isn’t any evidence to back up Cain’s claim that more people are actually losing coverage than gaining.
Cain said that "more people are losing their insurance (due to Obamacare) than are becoming newly insured." While it’s reasonable to ask questions about the limitations of the available data, there is wide consensus from five private-sector organizations that roughly 10 million more Americans are insured today than were before the law began operations in late 2013. That’s inconsistent with Cain’s claim, so we rate it False.
Herman Cain, "Nine facts Democrats don't want you to hear before you vote tomorrow," Nov. 3, 2014
Department of Health and Human Services, "Survey Data on Health Insurance Coverage for 2013 and 2014," Oct. 31, 2014
Kaiser Family Foundation, "Measuring Changes in Insurance Coverage Under the Affordable Care Act," April 30, 2014
ACASignups.net, "Urban Institute joins the crowd: 4 major surveys agree, U.S. uninsured down by 10-13 million due to ACA," July 10, 2014
Urban Institute, "QuickTake: Number of Uninsured Adults Continues to Fall under the ACA: Down by 8.0 Million in June 2014," July 10, 2014
Commonwealth Fund, "Gaining Ground: Americans' Health Insurance Coverage and Access to Care After the Affordable Care Act's First Open Enrollment Period," July 10, 2014
RAND Corp., "Survey Estimates Net Gain of 9.3 Million American Adults with Health Insurance," April 8, 2014
New England Journal of Medicine, "Health Reform and Changes in Health Insurance Coverage in 2014," Aug. 28, 2014
Gallup, "In U.S., Uninsured Rate Holds at 13.4%," Oct. 8, 2014
PolitiFact, "John Boehner says more people are uninsured since Obamacare took effect," March 18, 2014
Email interview with Charles Gaba, blogger at ACASignups.net, Nov. 3, 2014
Email interview with Gail Wilensky, head of Medicare and Medicaid under President George H.W. Bush, Nov. 3, 2014
Email interview with Craig Palosky, director of communications for the Kaiser Family Foundation, Nov. 3, 2014
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