{"id":5533,"date":"2016-02-06T12:00:06","date_gmt":"2016-02-06T12:00:06","guid":{"rendered":"http:\/\/associatednews.us\/content\/2016\/02\/06\/a-voters-guide-to-the-health-law-chatter\/"},"modified":"2016-02-06T12:00:06","modified_gmt":"2016-02-06T12:00:06","slug":"a-voters-guide-to-the-health-law-chatter","status":"publish","type":"post","link":"https:\/\/associatednews.us\/content\/a-voters-guide-to-the-health-law-chatter\/","title":{"rendered":"A Voter&#039;s Guide To The Health Law Chatter"},"content":{"rendered":"<p><span style=\"font-style:italic;font-size:16px\">By  <a class=\"colorbox\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/02\/06\/465739617\/a-voter-s-guide-to-the-health-law-chatter?utm_medium=RSS&amp;utm_campaign=healthcare\">Julie Rovner<\/a><\/span>  <\/p>\n<div class=\"ftpimagefix\" style=\"float:left\"><a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/02\/06\/465739617\/a-voter-s-guide-to-the-health-law-chatter?utm_medium=RSS&amp;utm_campaign=healthcare\"><img decoding=\"async\" width=\"150\" src=\"http:\/\/media.npr.org\/assets\/img\/2016\/02\/05\/ted-cruz_custom-eb8dee675343e85f6b1893039ac0b4afcbd4f474-s1100-c15.jpg\" title=\"Republican presidential hopeful Sen. Ted Cruz initially claimed his private insurance had been canceled. It turned out his insurer had transferred him to a plan with a narrow network of providers.\" alt=\"Republican presidential hopeful Sen. Ted Cruz initially claimed his private insurance had been canceled. It turned out his insurer had transferred him to a plan with a narrow network of providers.\"><\/a><\/div>\n<div>\n<div><\/div>\n<div>\n<div>\n<p>Republican presidential hopeful Sen. Ted Cruz <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.politico.com\/story\/2016\/01\/ted-cruz-no-health-insurance-218070\">initially claimed<\/a> his private insurance had been canceled. It turned out his insurer had transferred him to a plan with a narrow network of providers. <strong>Andrew Burton\/Getty Images<\/strong> <strong>hide caption<\/strong><\/p>\n<\/div>\n<p><strong>toggle caption<\/strong> <span>Andrew Burton\/Getty Images<\/span><\/div>\n<\/div>\n<p>Nearly six years after its enactment, the Affordable Care Act remains a hot issue in the presidential race \u2013 in both parties.<\/p>\n<p>&#8220;Our health care is a horror show,&#8221; said GOP candidate Donald Trump at the Republican debate in South Carolina in December. Texas Sen. Ted Cruz, winner of the Iowa caucuses, said at the <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.washingtonpost.com\/news\/the-fix\/wp\/2016\/01\/28\/7th-republican-debate-transcript-annotated-who-said-what-and-what-it-meant\/\">debate in Des Moines<\/a> that the health law has been &#8220;a disaster,&#8221; adding it&#8217;s &#8220;the biggest job-killer in our country.&#8221;<\/p>\n<p>Democrats largely support the law, but even they can&#8217;t agree on how to fix its problems. Hillary Clinton said at the Jan. 25 <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/cnnpressroom.blogs.cnn.com\/2016\/01\/26\/cnn-iowa-democratic-presidential-town-hall-rush-transcript\/\">town hall on CNN<\/a> that she wants to &#8220;build on the ACA. Get costs down, but improve it, get to 100 percent coverage.&#8221;<\/p>\n<p>Clinton&#8217;s rival for the nomination, Vermont Sen. Bernie Sanders, acknowledged that &#8220;the Affordable Care Act has done a lot of good things,&#8221; but added that &#8220;the United States today is the only major country on earth that doesn&#8217;t guarantee health care to all people as a right.&#8221; Sanders is pushing a <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/khn.org\/news\/democratic-candidates-debate-single-payer-but-what-does-that-mean\/\">government-run &#8220;Medicare for All<\/a>&#8221; plan instead.<\/p>\n<p>In some cases candidates are bending the truth. But praise and criticisms of the law can be accurate. That&#8217;s because the health law is so big and sweeping that it has had effects both positive and negative.<\/p>\n<p>Here is a brief guide to some things the health law has \u2013 and has not \u2013 accomplished since it was signed by President Barack Obama in 2010.<\/p>\n<p><strong>CLAIM: The law has increased the number of people with health insurance coverage.<\/strong><\/p>\n<p>This is true, no matter what measure you use. The <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.census.gov\/content\/dam\/Census\/library\/publications\/2015\/demo\/p60-253.pdf\">Census Bureau<\/a> and polling firm <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.gallup.com\/poll\/188045\/uninsured-rate-fourth-quarter-2015.aspx?g_source=CATEGORY_HEALTHCARE&amp;g_medium=topic&amp;g_campaign=tiles\">Gallup<\/a> both found substantial drops in the percentage of people without health insurance after the majority of the law&#8217;s coverage expansions took effect in 2014.<\/p>\n<p><strong>COUNTER-CLAIM: There are still millions of Americans who don&#8217;t have insurance.<\/strong><\/p>\n<p>This is also true. Even though approximately 90 percent of Americans now have insurance, that remaining 10 percent amounts to <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/kff.org\/uninsured\/fact-sheet\/key-facts-about-the-uninsured-population\/\">more than 30 million people<\/a>.<\/p>\n<p>Millions aren&#8217;t eligible for coverage under the law because they&#8217;re not in the U.S. legally. Another 3 million are in the so-called <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/kff.org\/health-reform\/issue-brief\/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid-an-update\/\">Medicaid gap<\/a>, meaning they would be eligible for Medicaid under the ACA except their states opted not to accept the expansion after the Supreme Court effectively ruled the expansion optional.<\/p>\n<p>Still others are eligible to purchase coverage on a health insurance exchange, but either can&#8217;t afford it, don&#8217;t think the insurance available offers a good value, or don&#8217;t know they are legally required to obtain it. An estimated <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.healthcare.gov\/health-coverage-exemptions\/exemptions-from-the-fee\/\">7.5 million Americans paid a fine<\/a> to the IRS for failing to get covered in 2014; millions more were <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.healthcare.gov\/health-coverage-exemptions\/exemptions-from-the-fee\/\">exempt<\/a> from the requirement and didn&#8217;t have coverage.<\/p>\n<p>In recognition of the fact that enrollment has been smaller than expected, the Congressional Budget Office recently <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/healthaffairs.org\/blog\/2016\/01\/26\/cbo-lowers-marketplace-enrollment-projections-increases-medicaid-growth-projections\/\">lowered its projections<\/a> for those who will buy insurance under the law from 21 million to 13 million in 2016.<\/p>\n<p><strong>CLAIM: The ACA has fixed the dysfunctional individual insurance market.<\/strong><\/p>\n<p>Prior to the passage of the health law, millions of people who didn&#8217;t have work-based or government coverage were shut out of buying their own insurance because they had been sick or because the coverage offered did not cover the services they needed.<\/p>\n<p>The law aimed to address the problems in the individual market in <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.ahip.org\/Issues\/Individual-Market-Health-Insurance.aspx\">several ways<\/a>, including requiring insurers to sell to those with preexisting conditions at the same price as healthier people; standardizing the benefits package; and limiting the size of deductibles. Tax credits were made available in order to help people afford coverage. And the law created <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.healthcare.gov\/\">insurance exchanges<\/a> intended to help consumers compare, choose, sign up and pay for health insurance.<\/p>\n<p>How well these changes succeeded in stabilizing the market isn&#8217;t clear. What <em>is<\/em> clear is that <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/kff.org\/health-reform\/issue-brief\/data-note-how-has-the-individual-insurance-market-grown-under-the-affordable-care-act\/\">more people<\/a> are now insured through the market.<\/p>\n<p><strong>COUNTER-CLAIM: The ACA has made the individual market worse.<\/strong><\/p>\n<p>All is not well in the individual market. Even with help paying premiums, many moderate-income Americans are finding that their deductibles and copayments are so high they <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.nytimes.com\/2015\/11\/15\/us\/politics\/many-say-high-deductibles-make-their-health-law-insurance-all-but-useless.html\">cannot afford to use their insurance<\/a>.<\/p>\n<p>In other cases, individuals can get insurance they can afford to use, but it <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.bakerdonelson.com\/files\/Uploads\/Documents\/BartrumNashvilleCouncil.pdf\">doesn&#8217;t include their regular doctors and hospitals<\/a>. In fact, plans that do offer coverage outside of the insurer&#8217;s network are becoming <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/khn.org\/news\/as-hmos-dominate-alternatives-become-more-expensive\/\">harder to find and more expensive<\/a>.<\/p>\n<p>That change affected Cruz, who <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.politico.com\/story\/2016\/01\/ted-cruz-no-health-insurance-218070\">initially claimed<\/a> his private insurance had been cancelled. In fact, his insurer had <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.bloomberg.com\/politics\/articles\/2016-01-23\/ted-cruz-finds-out-he-has-health-insurance-after-all\">stopped offering<\/a> his broad-choice plan and automatically transferred him to a narrow-network product.<\/p>\n<p><strong>CLAIM: The ACA has improved the Medicare program.<\/strong><\/p>\n<p>While most of the law was aimed at those without insurance, lawmakers also took the opportunity to beef up some benefits for the 55 million Americans in the Medicare program.<\/p>\n<p>Medicare enrollees got <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.medicare.gov\/about-us\/affordable-care-act\/affordable-care-act.html\">new coverage<\/a> for preventive services and annual checkups, and those with high prescription drug expenses got help to fill the &#8220;<a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/blog.medicare.gov\/2010\/08\/09\/what-is-the-donut%C2%A0hole\/\">doughnut hole&#8221;<\/a> gap left by the 2003 Medicare drug program.<\/p>\n<p>Over the longer term, the law created several payment experiments intended to <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.medicare.gov\/hospitalcompare\/linking-quality-to-payment.html?AspxAutoDetectCoo\">improve the quality of care Medicare patients receive and lower costs<\/a>. These include efforts to prevent patients from going back to the hospital after they&#8217;ve been discharged.<\/p>\n<p><strong>COUNTER-CLAIM: The ACA has not saved money for Medicare.<\/strong><\/p>\n<p>The rate of increase in Medicare spending <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/kff.org\/medicare\/fact-sheet\/medicare-spending-and-financing-fact-sheet\/\">has slowed<\/a> since the health law was passed in 2010. But it&#8217;s not clear how much of that can be attributed to the law, aside from some provisions that actually cut payments to hospitals and other health providers.<\/p>\n<p>And some of the most highly anticipated projects, including <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/khn.org\/news\/medicare-yet-to-save-money-through-heralded-medical-payment-model\/\">accountable care organizations<\/a> that are paid bonuses for keeping Medicare patients healthy and lowering spending, have not so far shown very good results.<\/p>\n<p><strong>CLAIM: The ACA has killed jobs.<\/strong><\/p>\n<p>One of Republicans&#8217; favorite talking points \u2013 that the health law would depress employment \u2013 has turned out not to be the case.<\/p>\n<p>An <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.rwjf.org\/en\/library\/research\/2015\/08\/recent-evidence-on-the-aca-and-employment%E2%80%94has-the-aca-been-a-jo.html\">analysis in 2015<\/a> by the Urban Institute found that the health law &#8220;had virtually no adverse effect on labor force participation; employment; the probability of part-time work; and hours worked per week by nonelderly adults.&#8221;<\/p>\n<p>While there would be fewer people in the workforce due to the law, the Congressional Budget Office <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.pbs.org\/newshour\/bb\/new-report-forecasts-health-care-reform-law-will-decrease-u-s-labor-supply\/\">found in 2014<\/a> that &#8220;almost entirely&#8221; stems from voluntary actions by workers who could quit because they no longer depended on their jobs for insurance \u2014 now they could buy it on their own.<\/p>\n<p><strong>CLAIM: The ACA has slowed overall health spending.<\/strong><\/p>\n<p>The White House <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.whitehouse.gov\/sites\/default\/files\/docs\/healthcostreport_final_noembargo_v2.pdf\">trumpeted<\/a> the fact that health spending grew at its slowest rates ever between 2010 and 2013. But health policy analysts are still <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/healthaffairs.org\/blog\/2015\/12\/02\/interpreting-new-data-on-health-care-spending-growth\/\">engaged in a lively debate<\/a> about how much of the slowdown was attributable to the recession, to the health law and to other changes in the health care system.<\/p>\n<p>Meanwhile, the rate of spending has begun to <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.cms.gov\/research-statistics-data-and-systems\/statistics-trends-and-reports\/nationalhealthexpenddata\/downloads\/highlights.pdf\">accelerate<\/a> again, jumping from a 2.9 percent increase in 2013 to 5.3 percent in 2014. That has occurred as millions more Americans gained access to health care through the law.<\/p>\n<p><em>Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Julie Rovner<\/em> <em>is on Twitter:<\/em> <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/twitter.com\/jrovner\">@jrovner<\/a>.<\/p>\n<p><em>This entry passed through the Full-Text RSS service &#8211; if this is your content and you&#8217;re reading it on someone else&#8217;s site, please read the FAQ at fivefilters.org\/content-only\/faq.php#publishers.<\/em><\/p>\n<p>Source:: <a href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/02\/06\/465739617\/a-voter-s-guide-to-the-health-law-chatter?utm_medium=RSS&amp;utm_campaign=healthcare\" class=\"colorbox\" title=\"A Voter&#039;s Guide To The Health Law Chatter\" rel=\"nofollow\">http:\/\/www.npr.org\/sections\/health-shots\/2016\/02\/06\/465739617\/a-voter-s-guide-to-the-health-law-chatter?utm_medium=RSS&amp;utm_campaign=healthcare<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"ftpimagefix\" style=\"float:left\"><a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2016\/02\/06\/465739617\/a-voter-s-guide-to-the-health-law-chatter?utm_medium=RSS&amp;utm_campaign=healthcare\"><img decoding=\"async\" width=\"150\" src=\"http:\/\/media.npr.org\/assets\/img\/2016\/02\/05\/ted-cruz_custom-eb8dee675343e85f6b1893039ac0b4afcbd4f474-s1100-c15.jpg\" title=\"Republican presidential hopeful Sen. Ted Cruz initially claimed his private insurance had been canceled. It turned out his insurer had transferred him to a plan with a narrow network of providers.\" alt=\"Republican presidential hopeful Sen. Ted Cruz initially claimed his private insurance had been canceled. It turned out his insurer had transferred him to a plan with a narrow network of providers.\"><\/a><\/div>\n<div>\n<div><\/div>\n<div>\n<div>\n<p>Republican presidential hopeful Sen. Ted Cruz <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.politico.com\/story\/2016\/01\/ted-cruz-no-health-insurance-218070\">initially claimed<\/a> his private insurance had been canceled. It turned out his insurer had transferred him to a plan with a narrow network of providers. <strong>Andrew Burton\/Getty Images<\/strong> <strong>hide caption<\/strong><\/p>\n<\/div>\n<p><strong>toggle caption<\/strong> <span>Andrew Burton\/Getty Images<\/span><\/div>\n<\/div>\n<p>Nearly six years after its enactment, the Affordable Care Act remains a hot issue in the presidential race \u2013 in both parties.<\/p>\n<p>&#8220;Our health care is a horror show,&#8221; said GOP candidate Donald Trump at the Republican debate in South Carolina in December. Texas Sen. Ted Cruz, winner of the Iowa caucuses, said at the <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.washingtonpost.com\/news\/the-fix\/wp\/2016\/01\/28\/7th-republican-debate-transcript-annotated-who-said-what-and-what-it-meant\/\">debate in Des Moines<\/a> that the health law has been &#8220;a disaster,&#8221; adding it&#8217;s &#8220;the biggest job-killer in our country.&#8221;<\/p>\n<p>Democrats largely support the law, but even they can&#8217;t agree on how to fix its problems. Hillary Clinton said at the Jan. 25 <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/cnnpressroom.blogs.cnn.com\/2016\/01\/26\/cnn-iowa-democratic-presidential-town-hall-rush-transcript\/\">town hall on CNN<\/a> that she wants to &#8220;build on the ACA. Get costs down, but improve it, get to 100 percent coverage.&#8221;<\/p>\n<p>Clinton&#8217;s rival for the nomination, Vermont Sen. Bernie Sanders, acknowledged that &#8220;the Affordable Care Act has done a lot of good things,&#8221; but added that &#8220;the United States today is the only major country on earth that doesn&#8217;t guarantee health care to all people as a right.&#8221; Sanders is pushing a <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/khn.org\/news\/democratic-candidates-debate-single-payer-but-what-does-that-mean\/\">government-run &#8220;Medicare for All<\/a>&#8221; plan instead.<\/p>\n<p>In some cases candidates are bending the truth. But praise and criticisms of the law can be accurate. That&#8217;s because the health law is so big and sweeping that it has had effects both positive and negative.<\/p>\n<p>Here is a brief guide to some things the health law has \u2013 and has not \u2013 accomplished since it was signed by President Barack Obama in 2010.<\/p>\n<p><strong>CLAIM: The law has increased the number of people with health insurance coverage.<\/strong><\/p>\n<p>This is true, no matter what measure you use. The <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.census.gov\/content\/dam\/Census\/library\/publications\/2015\/demo\/p60-253.pdf\">Census Bureau<\/a> and polling firm <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.gallup.com\/poll\/188045\/uninsured-rate-fourth-quarter-2015.aspx?g_source=CATEGORY_HEALTHCARE&amp;g_medium=topic&amp;g_campaign=tiles\">Gallup<\/a> both found substantial drops in the percentage of people without health insurance after the majority of the law&#8217;s coverage expansions took effect in 2014.<\/p>\n<p><strong>COUNTER-CLAIM: There are still millions of Americans who don&#8217;t have insurance.<\/strong><\/p>\n<p>This is also true. Even though approximately 90 percent of Americans now have insurance, that remaining 10 percent amounts to <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/kff.org\/uninsured\/fact-sheet\/key-facts-about-the-uninsured-population\/\">more than 30 million people<\/a>.<\/p>\n<p>Millions aren&#8217;t eligible for coverage under the law because they&#8217;re not in the U.S. legally. Another 3 million are in the so-called <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/kff.org\/health-reform\/issue-brief\/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid-an-update\/\">Medicaid gap<\/a>, meaning they would be eligible for Medicaid under the ACA except their states opted not to accept the expansion after the Supreme Court effectively ruled the expansion optional.<\/p>\n<p>Still others are eligible to purchase coverage on a health insurance exchange, but either can&#8217;t afford it, don&#8217;t think the insurance available offers a good value, or don&#8217;t know they are legally required to obtain it. An estimated <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.healthcare.gov\/health-coverage-exemptions\/exemptions-from-the-fee\/\">7.5 million Americans paid a fine<\/a> to the IRS for failing to get covered in 2014; millions more were <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.healthcare.gov\/health-coverage-exemptions\/exemptions-from-the-fee\/\">exempt<\/a> from the requirement and didn&#8217;t have coverage.<\/p>\n<p>In recognition of the fact that enrollment has been smaller than expected, the Congressional Budget Office recently <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/healthaffairs.org\/blog\/2016\/01\/26\/cbo-lowers-marketplace-enrollment-projections-increases-medicaid-growth-projections\/\">lowered its projections<\/a> for those who will buy insurance under the law from 21 million to 13 million in 2016.<\/p>\n<p><strong>CLAIM: The ACA has fixed the dysfunctional individual insurance market.<\/strong><\/p>\n<p>Prior to the passage of the health law, millions of people who didn&#8217;t have work-based or government coverage were shut out of buying their own insurance because they had been sick or because the coverage offered did not cover the services they needed.<\/p>\n<p>The law aimed to address the problems in the individual market in <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.ahip.org\/Issues\/Individual-Market-Health-Insurance.aspx\">several ways<\/a>, including requiring insurers to sell to those with preexisting conditions at the same price as healthier people; standardizing the benefits package; and limiting the size of deductibles. Tax credits were made available in order to help people afford coverage. And the law created <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.healthcare.gov\/\">insurance exchanges<\/a> intended to help consumers compare, choose, sign up and pay for health insurance.<\/p>\n<p>How well these changes succeeded in stabilizing the market isn&#8217;t clear. What <em>is<\/em> clear is that <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/kff.org\/health-reform\/issue-brief\/data-note-how-has-the-individual-insurance-market-grown-under-the-affordable-care-act\/\">more people<\/a> are now insured through the market.<\/p>\n<p><strong>COUNTER-CLAIM: The ACA has made the individual market worse.<\/strong><\/p>\n<p>All is not well in the individual market. Even with help paying premiums, many moderate-income Americans are finding that their deductibles and copayments are so high they <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.nytimes.com\/2015\/11\/15\/us\/politics\/many-say-high-deductibles-make-their-health-law-insurance-all-but-useless.html\">cannot afford to use their insurance<\/a>.<\/p>\n<p>In other cases, individuals can get insurance they can afford to use, but it <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.bakerdonelson.com\/files\/Uploads\/Documents\/BartrumNashvilleCouncil.pdf\">doesn&#8217;t include their regular doctors and hospitals<\/a>. In fact, plans that do offer coverage outside of the insurer&#8217;s network are becoming <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/khn.org\/news\/as-hmos-dominate-alternatives-become-more-expensive\/\">harder to find and more expensive<\/a>.<\/p>\n<p>That change affected Cruz, who <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.politico.com\/story\/2016\/01\/ted-cruz-no-health-insurance-218070\">initially claimed<\/a> his private insurance had been cancelled. In fact, his insurer had <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.bloomberg.com\/politics\/articles\/2016-01-23\/ted-cruz-finds-out-he-has-health-insurance-after-all\">stopped offering<\/a> his broad-choice plan and automatically transferred him to a narrow-network product.<\/p>\n<p><strong>CLAIM: The ACA has improved the Medicare program.<\/strong><\/p>\n<p>While most of the law was aimed at those without insurance, lawmakers also took the opportunity to beef up some benefits for the 55 million Americans in the Medicare program.<\/p>\n<p>Medicare enrollees got <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.medicare.gov\/about-us\/affordable-care-act\/affordable-care-act.html\">new coverage<\/a> for preventive services and annual checkups, and those with high prescription drug expenses got help to fill the &#8220;<a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/blog.medicare.gov\/2010\/08\/09\/what-is-the-donut%C2%A0hole\/\">doughnut hole&#8221;<\/a> gap left by the 2003 Medicare drug program.<\/p>\n<p>Over the longer term, the law created several payment experiments intended to <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.medicare.gov\/hospitalcompare\/linking-quality-to-payment.html?AspxAutoDetectCoo\">improve the quality of care Medicare patients receive and lower costs<\/a>. These include efforts to prevent patients from going back to the hospital after they&#8217;ve been discharged.<\/p>\n<p><strong>COUNTER-CLAIM: The ACA has not saved money for Medicare.<\/strong><\/p>\n<p>The rate of increase in Medicare spending <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/kff.org\/medicare\/fact-sheet\/medicare-spending-and-financing-fact-sheet\/\">has slowed<\/a> since the health law was passed in 2010. But it&#8217;s not clear how much of that can be attributed to the law, aside from some provisions that actually cut payments to hospitals and other health providers.<\/p>\n<p>And some of the most highly anticipated projects, including <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/khn.org\/news\/medicare-yet-to-save-money-through-heralded-medical-payment-model\/\">accountable care organizations<\/a> that are paid bonuses for keeping Medicare patients healthy and lowering spending, have not so far shown very good results.<\/p>\n<p><strong>CLAIM: The ACA has killed jobs.<\/strong><\/p>\n<p>One of Republicans&#8217; favorite talking points \u2013 that the health law would depress employment \u2013 has turned out not to be the case.<\/p>\n<p>An <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.rwjf.org\/en\/library\/research\/2015\/08\/recent-evidence-on-the-aca-and-employment%E2%80%94has-the-aca-been-a-jo.html\">analysis in 2015<\/a> by the Urban Institute found that the health law &#8220;had virtually no adverse effect on labor force participation; employment; the probability of part-time work; and hours worked per week by nonelderly adults.&#8221;<\/p>\n<p>While there would be fewer people in the workforce due to the law, the Congressional Budget Office <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/www.pbs.org\/newshour\/bb\/new-report-forecasts-health-care-reform-law-will-decrease-u-s-labor-supply\/\">found in 2014<\/a> that &#8220;almost entirely&#8221; stems from voluntary actions by workers who could quit because they no longer depended on their jobs for insurance \u2014 now they could buy it on their own.<\/p>\n<p><strong>CLAIM: The ACA has slowed overall health spending.<\/strong><\/p>\n<p>The White House <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.whitehouse.gov\/sites\/default\/files\/docs\/healthcostreport_final_noembargo_v2.pdf\">trumpeted<\/a> the fact that health spending grew at its slowest rates ever between 2010 and 2013. But health policy analysts are still <a class=\"colorbox\" rel=\"nofollow\" href=\"http:\/\/healthaffairs.org\/blog\/2015\/12\/02\/interpreting-new-data-on-health-care-spending-growth\/\">engaged in a lively debate<\/a> about how much of the slowdown was attributable to the recession, to the health law and to other changes in the health care system.<\/p>\n<p>Meanwhile, the rate of spending has begun to <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/www.cms.gov\/research-statistics-data-and-systems\/statistics-trends-and-reports\/nationalhealthexpenddata\/downloads\/highlights.pdf\">accelerate<\/a> again, jumping from a 2.9 percent increase in 2013 to 5.3 percent in 2014. That has occurred as millions more Americans gained access to health care through the law.<\/p>\n<p><em>Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Julie Rovner<\/em> <em>is on Twitter:<\/em> <a class=\"colorbox\" rel=\"nofollow\" href=\"https:\/\/twitter.com\/jrovner\">@jrovner<\/a>.<\/p>\n<p><em>This entry passed through the Full-Text RSS service &#8211; if this is your content and you&#8217;re reading it on someone else&#8217;s site, please read the FAQ at fivefilters.org\/content-only\/faq.php#publishers.<\/em><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[47],"tags":[],"class_list":["post-5533","post","type-post","status-publish","format-standard","hentry","category-health"],"_links":{"self":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts\/5533","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/comments?post=5533"}],"version-history":[{"count":0,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/posts\/5533\/revisions"}],"wp:attachment":[{"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/media?parent=5533"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/categories?post=5533"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/associatednews.us\/content\/wp-json\/wp\/v2\/tags?post=5533"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}