There was once a time – five months ago, to be precise – when the big fear surrounding the Affordable Care Act was that it would cause health insurance premiums to “skyrocket.” That, at least, was the terminology the Hill used in a headline for a story on its health policy blog, which quoted a handful of anonymous insurance executives in reporting that “ObamaCare-related premiums will double in some parts of the country, countering claims recently made by the administration.” The Hill’s report was eagerly shared and promoted by conservative and Republican opponents of the ACA, who waved it around as proof that the law was a disaster.
Despite all the fanfare, there was little reason to believe the Hill’s reporting. The ACA’s first open enrollment period was still going at that point, so there was no way to know how many Obamacare enrollees there were, their ages, their health status – all factors that go into calculating rate increases. Getting a better picture of what the rate adjustments for 2015 would like required waiting, and patience.
Well, now we’re starting to see the picture develop, and it looks very different from the 100-percent increases conservatives were secretly (or overtly) hoping for just a few months ago. PricewaterhouseCoopers put together a “preliminary look at 2015 individual market rate filings,” and they found that, for the 27 states for which data are available, the average premium increase will be 7.5 percent. It’s all preliminary, of course, but it’s a hell of a lot better than the Hill’s citation of a former insurance executive’s “gut” feeling. The New Republic’s Jonathan Cohn writes that “the experts I consulted all saw the available information as relatively encouraging, particularly in comparison to what many were predicting just a few months ago.”
So where are conservatives looking for proof that the Affordable Care Act is not living up to its moniker? Florida. The Miami Herald reported earlier this week that “Floridians who buy health insurance on the individual market for next year will face an average increase of 13.2 percent in their monthly premiums, according to rate proposals unveiled Monday by the state’s Office of Insurance Regulation.” That isn’t anywhere near the “skyrocketing” that Republicans assured us was coming, but 13.2 percent would qualify as a “double-digit rate increase,” and conservatives were quick to point that out. (Consumer health advocates in the state accused regulators of employing a flawed methodology, as the Herald notes.)
One loud critic of the Florida premium increase is the state’s Republican governor, Rick Scott, who said in a statement that “Obamacare is a bad law that just seems to be getting worse,” and “Florida families are going to be slammed with higher costs. Obamacare has failed to live up to its promises in nearly every way.” That’s an audacious statement for Scott to make, given that he and the Republican-controlled Florida Legislature did everything in their power to make it as difficult as possible for the Affordable Care Act to function in the state. They set out to sabotage the law, and now they’re trying to score political points off the fruits of their sabotage.
Florida was one of the many states that refused to expand Medicaid and refused to build their own health insurance exchange. But Rick Scott went a step further and turned the state into a laboratory of anti-Obamacare activism. He and the state Legislature passed a law last June that temporarily suspended the ability of state regulators to negotiate with insurance companies on premiums for individual insurance plans. At the time, Democratic Sen. Bill Nelson accused Scott of doing pretty much exactly what he’s doing right now: “Nelson … contended in his veto request that legislators removed state rate regulation in order to blame the health care overhaul if rates go up.”
Scott’s opposition to Obamacare and his commitment to its failure were such that he actively worked against the interests of his constituents. He and the Legislature passed another law in 2013 that “made it more difficult for Floridians to obtain the cheapest insurance rates under the exchange and to get help from specially trained outreach counselors.” All this despite the fact that Florida, at the time of the ACA’s rollout, had the second highest uninsurance rate in the country.
Generally speaking, Obamacare is performing well in the states that embraced the law, and not as well in the states that rejected expanded Medicaid and declined to build their own insurance exchanges. It’s a simple bit of cause-and-effect logic: cooperation with Obamacare produced better outcomes, while opposition made the law less effective. But the Republicans and conservatives who fought desperately against the law’s success are now professing to be absolutely shocked and appalled that the Affordable Care Act isn’t able to fully make good on its promises. That's about as disingenuous an argument as you can make.