Thursday, April 24, 2014
This week, Democratic candidate for governor Allyson Schwartz hitched her re-election wagon to the Affordable Care Act, touting her pride in the legislation as well as her efforts in helping to craft the law.
"I am the only Democrat in the race that helped write the Affordable Care Act, worked with President Obama to pass it, and now am campaigning on the success of the law," Schwartz said on Wednesday. She also released a 30-second television spot on the subject:
In a conference call with reporters, Schwartz challenged the race's frontrunner: "Tom Wolf and the other Democrats in the race have been evasive in their support of and pride in the Affordable Care Act. If they won't say they are proud of this law and its success now, then they won’t be able to take on Tom Corbett or get the Affordable Care Act implemented right for Pennsylvania."
All Democratic candidates say they support the Medicaid expansion that governor Tom Corbett rejected. On Sunday, the York Daily Record ran a roundup of where exactly the candidates stand on the ACA.
And while her comments didn’t get an immediate reaction from her Democratic challengers, it did get a strongly-worded retort from Corbett:
"Congresswoman Allyson Schwartz is the only Democrat brave enough to run on President Obama's failed policies and the ObamaCare disaster she helped to write," the Corbett campaign said in a release. "We already know they all want to expand ObamaCare's grasp in Pennsylvania, but we agree that our opponents should speak up and join her in proudly voicing their support for this disastrous legislation." The release called out the ACA for allegedly causing 250,000 Pennsylvanians to lose their health plans, even after President Obama pledged "If You Like Your Plan, You Can Keep It.’"
"That number is expected to continue to grow, leaving tens of thousands of more Pennsylvanians without access to health care," according to the release.
The release also alleged that premiums were spiking, citing a Forbes magazine piece based on a recent survey of a 148 insurance brokers nationwide. The survey, carried out by Wall Street giant Morgan Stanley, contends that individual insurance premiums in Pennsylvania are up 28 percent, while premiums for the "small market group" are up 66 percent due to provisions of the ACA. In New Hampshire, it adds, premiums increased by an unholy 90 percent!
Both those claims are, well ... problematic.
The 250,000-residents-lost-their-coverage plan, for one, was skewered by Philadelphia journo Chris Brennan last month. The number, Brennan reported, came from the state’s Department of Insurance, and listed the "number of policy cancellation notices prompted by the Obamacare rollout." But as a department spokeswoman told Brennan, after sending out those notices, insurers had the option of either bringing the policy into compliance with new Obamacare standards, or helping a customer find a new policy that met the criteria. And according to Brennan: The department "never followed up with the companies to find out what happened to those 250,000 policy holders. Some may have been among the 159,821 Pennsylvanians who have signed up for health-care exchange policies as of March 1." In any case, the Obama administration later extended deadlines, allowing non-compliant insurance policies to be renewed all the way to October 2016.
Team Corbett's premium-spiking numbers, meanwhile, also seem skewed.
The article Corbett cites is an analysis of the survey by the American Enterprise Institute, a highly conservative think tank. And the numbers cited are based on a really tiny state-by-state sample of insurance brokers: In fact the Pennsylvania numbers are based on numbers reported by three brokers. (The New Hampshire bombshell is based on the reporting by one broker.)
Morgan Stanley doesn’t release its research methodology, although it does offer a couple of caveats. Among them: "We consider the aggregate trends much more useful than the trends among the individual insurers, where the number of observations is necessarily smaller"; and "Morgan Stanley does and seeks to do business with companies covered in Morgan Stanley Research. As a result, investors should be aware that the firm may have a conflict of interest that could affect the objectivity of Morgan Stanley Research."
But that hasn’t stopped right-wing politicians and conservative news outlets, like Fox News from splashing the numbers all over the place, without even a hint about the small sample size, or the fact that the methodology itself isn't clear.
Their flogging of the data prompted Robert Fraley, deputy managing editor of Factcheck.org, to write a piece entitled "How Not to use a Survey." The piece specifically looked at how politicians and Republican party officials were using the New Hampshire numbers. What Fraley found was that, according to the New Hampshire Department of Insurance, "after the application of federal premium tax subsides, the Individual Market will experience a 9 percent premium decrease overall. [emphasis added]”
Fraley also wrote: "Robert Santos, chief methodologist at the Urban Institute and president of the executive council at the American Association for Public Opinion Research, dismissed the Morgan Stanley survey as 'typical financial marketing material where they pull together some data and create insights.'" But without any explanation of its methodology or margin of error, he said, it has no scientific validity. That’s true of the aggregated nationwide results, he said, but especially the state results which are based on so few responses. "Anyone would be on very tenuous ground in trying to make a state-specific inference," Santos said.
Fraley further told City Paper this morning: "The biggest problem here is that you can’t see their methodology. You have no idea if they sent out a thousand queries and only 148 came back, or were these respondents hand-picked. Without knowing that stuff, it's hard to know the quality of the survey. People need to be very wary of putting too much stock [or] draw[ing] any state-specific inferences from it."
Erin Ninehouser, Education and Outreach Director for the Pennsylvania Health Access Network, told CP that the initial cost of the premium is only part of the story, since premium costs can be offset by tax credits the ACA provides. According to a March report from the U.S. Department of Health and Human Services, 80 percent of Pennsylvanians enrolling in health plans were able to lower their premiums by using tax credits.
"It's disingenuous and purposefully misleading to talk about individual market rates without mentioning at all the actual monthly premiums people are paying, once income-based financial subsidies are applied," Ninehouser says.
What's more, she adds, "It's outrageous to see the Governor talk about plan cancellations when he personally cancelled the health coverage that 500,000 low-income Pennsylvanians should've had January 1st, by rejecting Medicaid Expansion. This was coverage they all paid in for, that was taken away by the Governor's decision to block $43 billion in new federal funding from coming into PA's economy to expand coverage. And that's on top of canceling the coverage of 43,000 workers who relied on adultBasic.
“People understand who has hurt or helped their chances of getting health insurance," Ninehouser says. "They understand what we're losing by failing to expand Medicaid and they're losing patience with this Governor's record on health care.”