"If we can't pick our own doctor, how do I know my family's getting the care they need?"
— "Julie," in a TV ad sponsored by Americans for Prosperity
What is it about children and health care?
The conservative advocacy group Americans for Prosperity is launching a $700,000 ad buy that features a mother expressing concern that her son won't get the medical care he needs for seizures because of the Affordable Care Act, a.k.a. Obamacare.
Meanwhile, the pro-Obama group Organizing for Action also released a TV ad featuring medical care for a child, to highlight the law's ban on lifetime limits on medical coverage.
As attack ads go, the AFP ad is fairly gentle, posing questions and directing viewers to a website, ObamaCareRiskFactors.com, intended to generate doubts about the law.
Let's explore the basis for Julie's question, which suggests that Americans will lose their preferred doctors because of the law.
Levi Russell, spokesman for AFP, pointed us to three statements, with news article citations as a basis for the question:
1. Many health insurers are planning to decrease the network of health care providers available to their customers because of the law's cost-increasing effects.
2. The Congressional Budget Office estimates that 7 million Americans with employee-sponsored health insurance will lose their coverage by 2022 because of ObamaCare's high costs, leaving them with less choice in deciding their health care providers.
3. One-third of doctors are expected to not accept new Medicaid patients in states that choose to expand the program under the law.
First of all, notice that the first and third statements have to do with aspects of the law intended to increase the number of Americans with health insurance. In other words, these are mainly people who do not currently have health insurance. "Julie," however, is talking about the medical care that her son had been receiving, so presumably her family already had health insurance.
So these statements have little to do with people like "Julie."
The second statement refers to a CBO estimate that, as the law takes effect over the next 10 years, some employers will drop their coverage so that workers can participate on health care exchanges under the law.
The 7 million figure is actually a net figure. The CBO says that in 2019, when the net figure is 8 million people, 12 million people will lose their employer-based health insurance, while 7 million people will gain it because of the law; another 3 million people would have an offer of employer-based insurance but choose another option instead (such as exchanges), presumably because it would be less expensive.
But it's important to remember that the number of people with employer-based insurance in 2023 was expected to be 167 million, so we're talking about only 4 percent of the total. The percentage of non-elderly Americans with employer-based health insurance would remain roughly at the level of today (55.5 percent in 2023 versus 56.6 percent in 2013).
"Whatever the actual percentage ends up being is now the question, and we won't know until it actually starts happening," Russell said. "Like Julie says in the ad . . . we all deserve some answers, rather than being told everything will be just fine and quit worrying."
Russell appears to be referring to President Barack Obama's comment in April that for the 85 to 90 percent of Americans who already have insurance "their only impact is that their insurance is stronger, better and more secure than it was before. Full stop. That's it. They don't have to worry about anything else."
That statement is not entirely true, because some percentage will lose their employer-based coverage.
The AFP ad sets up a straw man — the notion that people are going to lose access to their doctor. For the vast majority of Americans, that's not going to be the case. Under the law, millions of other Americans, for the first time, are supposed to gain access to regular health insurance.
Certainly it is appropriate to ask questions about this complex law, but focusing an ad on such an emotional — and unlikely — hypothetical goes too far.