Fake News over Millions Losing their Insurance

Fake news has replaced responsible journalism. It’s hard to know what to believe. It wasn’t long ago that supermarket tabloids like National Enquirer were considered fake news. Now it seems the Enquirer and TMZ may be more reliable sources of accurate news than the New York Times or Washington Post.

Government agencies aren’t immune from the fake news trend either. The Congressional Budget Office describes itself as, “Strictly nonpartisan; conducts objective, impartial analysis; and hires its employees solely on the basis of professional competence without regard to political affiliation.”

I’ll bet most newspapers and television news networks say the same about their own objectivity.

The CBO analyzed the American Health Care Act of 2017, a lame effort by Republicans to repeal and replace Obamacare.  Passed by the House, it’s now on to “the greatest deliberative body in the world.” Here the Senate will dither and dawdle, and likely not pass anything. What about the election? What about Trump’s campaign promise to repeal and replace? Campaign promises are for chumps, after all. Congress has had years to repeal and replace Obamacare and has done nothing. Ditto on tax cuts, immigration reform, building a wall, and other campaign promises easily made but not kept.

Even Senate Majority Leader Mitch McConnell has thrown in the towel, saying, "I don't know how we get to 50 votes at the moment.” He has 52 votes in his caucus, but perhaps it’s Common Core math leading him to conclude that 52 is less than 50. Senator Lindsay Graham joined the chorus of naysayers also saying no Obamacare repeal this year. Does the GOP establishment even want to repeal Obamacare? I wonder.

The CBO threw cold water on the House repeal effort claiming 23 million more would be uninsured by 2026 under AHCA compared to the status quo of Obamacare. This assumes that when the individual mandate disappears, the law requiring everyone to purchase health insurance whether or not they want or need it, no one will purchase insurance of any kind. Really?

If inexpensive catastrophic plans became available as an alternative to Obamacare, no one would buy them? That’s like saying if BMW went out of business, sales of other car brands would remain the same, not increase with BMW customers choosing Fords or Toyotas instead. Inexpensive catastrophic plans are ideal for many young healthy adults but are not available under the rules of Obamacare. They would, however, be purchased if priced reasonably. Just like with expensive cars.

A bit of positive news too from the ACHA which has not been reported. The CBO also predicted a $120 billion savings from the ACHA over the next 10 years, but this wasn’t deemed newsworthy by the media, burying this fact in the 18th paragraph of their stories.

Those wanting to maintain the status quo of Obamacare, such as California Senator Kamala Harris, doubled down on CBO projections saying “129 million people with preexisting conditions could be denied coverage.” How real is that number?

The Kaiser Family Foundation notes that 49 percent of Americans receive employer-based insurance, which covers preexisting conditions. Ditto for 20 percent on Medicaid and 14 percent on Medicare. Leaving only 16 percent on individual plans (Obamacare) or uninsured. The uninsured constitute 9 percent and preexisting conditions are moot as these individuals don’t have insurance anyway. Leaving 7 percent on Obamacare plans.

As an interesting aside, why are 9 percent of Americans still uninsured? I thought Obamacare was supposed to fix this?

Of the 7 percent on Obamacare plans, the good news for them is that the ACHA does require coverage for preexisting conditions. Even CNN concedes that point.

The devil, however, is in the details. Covering a condition doesn’t mean coverage for each and every available treatment option. Those with Obamacare policies already know this. Limited formularies. Many top hospitals and physicians out of network. Unaffordable copays and deductibles.

Your heart problem may be covered but the only hospitals and surgeons able to treat your particular problem are not in your insurance network.  Or the out-of-pocket portion is unaffordable. So you are technically covered for your preexisting condition but may not like or be able to afford the treatment options available to you. In other words, if you like your doctor you may not be able to keep your doctor.

The reality is that only 500,000 individuals are in potential danger of losing their preexisting coverage if Obamacare is repealed, according to a detailed analysis by Betsy McCaughey. All told, a drop in the bucket, but for the media, the sky is falling.

These half million individuals could easily be placed on Medicaid, covering their preexisting conditions with little out-of-pocket expense. Much smarter to attend to this small group rather than make a mess of the system for the remaining 99-plus percent.

Right now we only have a House bill. One of many small steps before grand pronouncements can be made about what replaces Obamacare. It’s not law, simply a bill. The Senate needs to pass their own bill, a long shot at this point. Then back to a House-Senate conference to reconcile the two different bills. Followed by another vote in both the House and Senate before it even gets to President Trump for signature and passage into law.

The media, by throwing out fake or exaggerated news as the legislative process has just gotten underway, undermines any realistic chance of dismantling Obamacare. Despite the fact that it is unaffordable for many and in its own death spiral.

It seems preserving Obama’s legacy is the media’s priority over thoughtful reporting and analysis. Expect the media to double down after Trump threw away one of the other Obama legacies, the Paris Climate Agreement. If the media continues to throw cold water on every repeal and replace effort from Congress, via fake news and fear-mongering, Congress will cower and eventually do nothing. Leading to the irony of Obama’s legacy being the ashes of Obamacare once it finally implodes.

Brian C. Joondeph, MD, MPS, is a Denver-based physician and writer. Follow him on Facebook,  LinkedIn and Twitter.

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