Multiple media outlets have targeted young Americans in an attempt to spread misinformation and myths about the Affordable Care Act (ACA), claiming that coverage is too expensive, the ACA provides too much coverage to young adults, and that Millennials are better off not signing up for coverage, despite vast evidence showing that young people both need and want coverage under the ACA.
A Las Vegas Review-Journal editorial left out key details of the insurance market prior to the passage of the Affordable Care Act (ACA) and the affordability of current ACA plans to attack the law and claim it should be repealed.
The November 20 editorial discussed insurance companies terminating certain Americans' current health plans while claiming that those seeking insurance will have to pay higher costs under the new ACA-compliant plans:
So the insured were part of the problem all along. The people who were responsible enough to purchase coverage that fit their needs and their budgets, without being threatened with a penalty tax, were too dumb to understand they were actually buying "predatory" garbage. The people who gave themselves an economic incentive to take care of their health, who willingly paid cash for routine medical care, needed to be forced to pay even more for coverage they didn't want or need.
Obamacare strikes out on premium affordability, too. According to the Manhattan Institute, Obamacare is projected to increase individual-market premiums by 179 percent in Nevada, the biggest jump in the nation. Sticker shock, not technical failure, is the major reason why so few people are buying insurance from Obamacare exchanges. The Twitter account @MyCancellation documents the cancellation notices Americans are receiving, as well as their outrageous new premium quotes. One tweet this week read "From Alabama: Old plan canceled was $180/mo w/ $6,700 ded. New plan under #ACA $400/mo &ded nearly doubles $12,000."
Americans were lied to. No amount of revisionist history can save this law or make its awful consequences acceptable. Are you paying attention, Sen. Reid? Repeal and replace.
The issue isn't so much with the insured as the companies providing insurance. As the Center on Health Insurance Reforms at the Georgetown University Health Policy Institute explained, "Pre-ACA, consumers faced a 'wild west' when buying health insurance." Providers were allowed to indiscriminately change plans and raise premiums without any safeguards. As Consumer Reports explained, the pre-ACA individual insurance market was "a nightmare" with many uninsured being unable to afford an individual plan, or if they did have insurance, most disliking their coverage. The article further noted:
Because of the new health care law people like these, who did nothing wrong except to have the bad luck to be stranded in the individual market, can now get health coverage at a price they can afford. Insurers can't turn them down or exclude coverage of the treatments they need the most. They can't slice and dice risk pools to drive longtime policyholders away. They can't charge them more because of pre-existing conditions.
In addition, insurance companies misled their clients by introducing non-ACA compliant plans without informing them that the plans they had would only be available for a short period of time, or in the case of Humana, sent threatening cancellation letters or letters that omitted crucial information about the ACA. As a Talking Points Memo investigation found, insurance companies around the country "have sent misleading letters to consumers, trying to lock them into the companies' own, sometimes more expensive health insurance plans rather than let them shop for insurance and tax credits on the Obamacare marketplaces," which could save consumers thousands per month.
Fox News claimed the Obamacare rollout has "clearly" been worse for the American people than the government shutdown, because the shutdown's "biggest inconvenience" was a few closed national parks and memorials -- ignoring the shutdown's cuts to domestic violence centers, women and children's food and health care, stalled scientific research, and severe economic losses.
On the November 11 edition of Fox News' Fox & Friends, co-host Steve Doocy and Fox legal analyst Andrew Napolitano held a "pop quiz" to determine "[w]hich was more harmful to your personal freedoms," Obamacare or the government shutdown? Both decided that there was no contest: Doocy proclaimed that Obamacare was "clearly" worse than the "slimdown," and Napolitano agreed that it was "[n]ot even a close call." As evidence, Napolitano pointed out that "the biggest inconvenience" of the government shutdown was "a couple hundred well-intended people trying to get into national parks and monuments and the government had closed them." In contrast, he claimed that Obamacare hurts people by forcing them to buy expensive "high end, one-size-fits-all" health insurance policies.
Fox's faulty comparison ignored the significant impacts of the government shutdown, which harmed the economy and slashed funding to necessary programs for low-income Americans.
Because of the shutdown, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a program that helps provide health care for at-risk babies and "helps new mothers feed themselves and their babies properly," saw its funding slashed, and states that were unable to lend the program local funds were forced to stop accepting enrollees. The shutdown also cut federal funding to at least 2,000 shelters for victims of domestic abuse, workplace safety inspections were halted, federal workers stopped inspecting toxic waste sites, and the CDC stopped monitoring the spread of the flu. National Geographic further reported that the shutdown caused long-term setbacks in scientific research, and The Washington Post detailed how the shutdown's fallout cost low-income workers their economic stability.
The shutdown also did lasting damage to the U.S. economy. Moody's Analytics estimated that the shutdown "cut real GDP by $20 billion, shaving half a percentage point off growth in the fourth quarter," according to a Congressional Research Service (CRS) report. CRS also noted that "JP Morgan Chase's chief economist was quoted as estimating that the shutdown reduced fourth quarter growth by 0.5 percentage points, with half the reduction attributable to lower government spending and half to 'spillover effects and lost activity' in the rest of the economy." The shutdown also eroded consumer confidence and may have derailed our gradual economic recovery, and economists argue that the shutdown will have lingering effects on the labor market and overall economy for several months.
Napolitano's argument that "5,500,000 innocent Americans were told they don't - they won't have health insurance on January 1st" is also inaccurate. Fox has repeatedly worked to hide the fact that rather than losing coverage outright, most of these consumers are simply being offered new, often better, options because policies will be required to include basic standards of care. Moreover, the rollout of the Affordable Care Act, though rocky, has successfully allowed hundreds of thousands of Americans to sign up for Medicaid.
Despite the GOP's strategy of obstructionism throughout the Affordable Care Act's (ACA, commonly known as Obamacare) implementation, Fox News pundits claimed Republicans have done nothing to contribute to ACA rollout problems.
From the November 20 edition of Fox News' America's Newsroom:
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Fox News misleadingly implied the Obama administration was at fault for not allowing people to keep their health insurance policies indefinitely, while hiding the fact that health insurance companies routinely alter consumer's plans every year.
Fox News' Bill O'Reilly distorted a provision of the Affordable Care Act known as risk corridors, falsely claiming the law subsidizes insurance companies if they don't make a profit under the new health care system.
On the November 19 edition of Fox's The O'Reilly Factor, O'Reilly hosted Sen. Marco Rubio (R-FL) to discuss Rubio's Wall Street Journal op-ed in which he described risk corridors as a "bailout for Obamacare." During the segment, O'Reilly adopted Rubio's attack, claiming that "one of the little-known parts of Obamacare is an option for the feds to reimburse private health insurance companies if they are not making enough money under the affordable health care law. In effect, the feds would subsidize private insurance companies if they don't make profit from Obamacare." Rubio described the provision by claiming "any shortfalls that may happen as a result of the law, that they are going to come in and make up for it. And according to the rule the way they've written it, it could be any amount":
But risk corridors are not a bailout. The provision is a way of stabilizing the insurance market by protecting insurers who cover higher-risk individuals by transferring costs from insurance plans that cover healthier people. A Health Affairs policy brief explained that risk corridors are "particularly useful in a period of transition, such as is likely to be the case in 2014 when many sicker people and those with preexisting health conditions will be buying coverage through insurance exchanges for the first time":
Fox's Megyn Kelly misrepresented a recent Justice Department memo to make it appear as though employer-provided health plans would be forced to change under the Affordable Care Act. But group plans that existed before the passage of the law remain unaffected unless insurers and employers choose to substantially alter them.
The Affordable Care Act exempted insurance plans that existed before March 23, 2010 from many of its regulations, allowing insurers to continue offering those plans on the condition that they did not significantly change either the benefits offered or the overall cost. Those policies are known as "grandfathered plans."
On the November 18 edition of Fox News' The Kelly File, host Megyn Kelly highlighted language from an October 2013 Department of Justice brief which estimated that most plans would lose their grandfathered status over time. Kelly claimed the memo contradicted President Obama's assertion that the vast majority of insurance cancellations were in the individual market, as opposed to employer provided plans. Kelly hosted Andrew McCarthy who used the brief to call the ACA "a massive fraudulent scheme" in a National Review Online post. During the segment, McCarthy claimed the brief predicted that consumers in the group market would "lose their coverage."
But the brief does not say that people who are insured in group plans, such as employer-sponsored insurance, will lose their coverage. Rather, it points out that group health plans could merely lose grandfather status if they're changed. As the Kaiser Family Foundation explained in their 2012 Employer Benefits Survey, under the ACA insurance plans do not lose grandfathered status unless the insurer makes "significant changes that reduce benefits or employee costs." In fact, according to the Kaiser survey, the primary reason firms chose not to grandfather a health plan was to maintain flexibility in making future plan choices.
Fox's Martha MacCallum hosted a guest to attack the Affordable Care Act who ended up supporting the changes the ACA has made to substandard insurance plans.
On the November 18 edition of America's Newsroom, MacCallum interviewed former health care executive Stan Hupfeld in a segment that described him as a top insurance industry official "warning against the Obamacare fix." However, in the interview that followed, Hupfeld recommended switching to ACA-compliant policies and underlined the reasons behind the cancellations of old, inadequate plans:
HUPFELD: Well the insurance companies, obviously, somewhere in the debate became supporters because they saw the opportunity for millions more uninsured to come their way. Part of the problem it seems to me, and certainly consistent with your last guest, was that many people with their old plans, with these very high deductibles, didn't really realize until they came to the point of having to use the plans, some of the inadequacies. You know, when you have a family of four each with a $5,000 deductible, for the average patient that shows up at the hospital, they're essentially uninsured because they can't, in most cases, meet those deductibles.
MACCALLUM: What would you recommend to people? If you got the cancellation notice and you were booted off your policy and you're still looking around trying to figure it out, would you say yes, I recommend you go back and continue that plan, or try your luck with some of these new things that the president claims will actually be cheaper in the end?
HUPFELD: Well obviously it depends on whether your circumstances, whether you're sicker and older or younger and healthier. I think for the most part, you'd be better off in trying to make the change now, to the new plan.
The New Hampshire Union Leader promoted a plan that would use Medicaid expansion funds available under the Affordable Care Act (ACA) not to expand Medicaid to cover more of New Hampshire's poorest residents, but to subsidize private insurance plans. However, under this plan, people would potentially pay higher premiums for their private plans or be left without health insurance.
In a November 17 editorial, the Union Leader advocated for using Medicaid expansion funds to extend New Hampshire's practice of providing subsidies for private insurance policies and mocked legislators who warned that this approach could leave consumers vulnerable to price hikes due to lack of marketplace competition:
That is why Senate President Chuck Morse's plan to use Medicaid dollars to subsidize private insurance for qualified Granite Staters is such a great proposal. He called the Democrats' bluff. Now they are throwing up every objection that they can, even ones that undermine the party's position on Obamacare.
State Senate Republicans had proposed moving newly Medicaid-eligible Granite Staters into subsidized private insurance plans purchased on Obamacare's state insurance exchange, and doing that by 2015. Last week Democrats hilariously complained that this was "unworkable" (Gov. Maggie Hassan's word) because there is no competition on New Hampshire's exchange, which is serviced by only Anthem and Delta Dental.
By pushing for Morse's proposal, the Union Leader failed to take into account two major impediments to the Senate plan. First, a special waiver must be proposed by the state and approved by the federal government before Medicaid funds can be used for private insurance. Knowing this could be a lengthy process, other states that have taken this route have already submitted proposals for approval. The Senate plan backed by the Union Leader forecasts only one year for federal approval, and would end expansion efforts if the plan had not been approved by the end of that year. A different proposal by the House also recommends using Medicaid expansion funds to offer private insurance subsidies, but that plan does not foresee moving people to private plans for at least three years.
The second problem with the Senate plan is the lack of competition in the state exchange marketplace. With only one provider on the marketplace so far, New Hampshire's exchange is not competitive enough to make the Senate private subsidy plan viable, nor does it have the time to grow competition before the Senate plan would be implemented. According to the Boston Globe:
Insurance Commissioner Roger Sevigny cautioned the Senate panel that its timeline is ambitious. Sevigny said he has not heard of any companies preparing to enter the marketplace as the Senate plan envisions in 2015 to join the lone provider, Anthem Blue Cross and Blue Shield.
The House plan rejected by the editorial is deemed more practical, because it would only shift Medicaid funds to private insurance if three providers are competing on the exchanges. According to Forbes, competition is vital to keeping prices low and quality of care high:
In the future, to stay competitive, insurers will need to increase value for their customers. They'll do so by including in their networks only those physicians and hospitals that provide higher quality at a lower cost. This will require providers to improve the processes and outcomes of the care they deliver.
This shift in competition will begin a virtuous cycle. The lower cost, higher-quality insurance plans will attract more people. A growing membership base will give them greater leverage to demand increased efficiency, higher quality and superior outcomes from doctors and hospitals in their networks. This, in turn, will result in further market-share growth as more consumers see the value.
As the Concord Monitor further explained:
Implementing Obamacare and expanding access to Medicaid, let alone doing so under an as-yet unwritten plan that requires federal approval, is enormously complicated. Almost every part of every endeavor is in flux. So without getting into the deep weeds, the sticking point is this: The governor and the House want the people newly eligible for Medicaid to be able to obtain coverage under the standard Medicaid programs now being overseen by three managed care companies until at least 2017 before shifting them to private plans with what amounts to a voucher to subsidize the cost. The added time could allow players other than Anthem, the only insurer signed up to participate in the health care exchange marketplace, to join, thus increasing competition and lowering costs.
Fox News misleadingly compared the Affordable Care Act's HealthCare.gov to private website HealthSherpa.com, despite the fact that the programmers previously explained to Fox this was not an "apples to apples comparison."
In response to the troubled rollout of the federal HealthCare.gov, three private programmers recently created HeatlhSherpa.com, a site which shows some health insurance plans available through the new health care law's exchanges, based on a person's zip code, income, and family size. The site does not allow users to purchase insurance, does not verify citizenship, and can only estimate tax breaks and subsidies that users might be eligible for, all functions of the HealthCare.gov website that make purchasing an insurance policy possible.
On the November 18 edition of Fox & Friends, Fox News host Elisabeth Hasselbeck ignored many of these differences in the websites' functionality to claim HealthSherpa.com was a "working healthcare website" and implied it was a preferable alternative to the "failed HealthCare.gov website." Hasselbeck interviewed Michael Wasser, one of the founders of HealthSherpa.com, who explained some of the functional differences between his site and the federal health care website:
WASSER: I think the HealthCare.gov was focused on providing an interface for everybody, multiple languages, actually signing up for the health insurance plans directly on the website. There is a much larger feature set that theirs looked at. We were really focused on reviewing plan data and giving simple instructions on how to sign up for those plans directly through the insurer.
But this is not the first time one of HealthSherpa.com's programmers have explained this faulty comparison to Fox. On the November 13 edition of Fox Business' Varney & Co., host Stuart Varney also described HealthSherpa.com as "a working alternative website" to HealthCare.gov, but was quickly corrected by one of the website's programmers, George Kalogeropoulos:
KALOGEROPOULOS: It's not really a fair apples to apples comparison to compare HealthSherpa.com to HealthCare.gov, and that's because the government website talks to the IRS for your tax status, talks to Homeland Security for immigration status, and it talks to the states. All we do is show you prices. So we say where are you, and then show you what's available and what it costs. So it's a much more limited goal.
[T]he team at HealthCare.gov is extraordinarily competent technically, I'm sure they could have done what we did, what we did technically speaking is not that complicated.
In a November 11 article, CNN's Doug Gross further explained why "it's not fair to compare the creation of Health Sherpa to the rollout of the more complicated government ACA site":
Of course, it's not fair to compare the creation of Health Sherpa to the rollout of the more complicated government ACA site, which everyone from President Obama on down has acknowledged as a horribly botched affair.
For one, you can't actually use Heath Sherpa to sign up for coverage. The site states that it's for research purposes only, and that users must verify the premiums and subsidies they find there with state health care exchanges, insurance companies or on HealthCare.gov itself.
The problems facing the Affordable Care Act's implementation have given the law's critics no shortage of ammunition to take potshots at President Obama's signature legislative accomplishment. But to hear those critics tell it, the ACA's problems are an unfolding political catastrophe in which Democrats are poised to abandon ship and the law is just a hair's breadth from repeal. Repeal of the law is and always has been a fantasy, but right now it's being enabled by members of the mainstream press for whom the ACA's problems aren't serious enough and somehow merit embellishment.
Tea Party congressmen and conservative pundits have been keeping the repeal fantasy alive ever since the law was signed back in 2010. The backlash from the government shutdown, which was inspired by Tea Party efforts to gut the ACA, did nothing to dull enthusiasm for the "repeal Obamacare" crowd. "Obamacare will be repealed well in advance of the 2014 elections," conservative wag Steven Hayward wrote in Forbes on November 11. "There is a chance Obamacare could be repealed in a bipartisan vote," wrote Ed Rogers in the Washington Post. Congress "could try to vote now, under new conditions and with the American people behind them, to repeal the whole thing," Peggy Noonan wrote in the Wall Street Journal. "And who knows, they just might." No, they won't. And even if Congress did somehow manage to pass a bill repealing the ACA, it would in all certainty be vetoed by President Obama.
But this is what pundits and activists do: shape and spin stories to conform to their preferred outcome. The National Journal's Josh Kraushaar, rather than tamping down this irrational enthusiasm among the law's opponents, is giving it a leg up. "There's a growing likelihood that over time, enough Democrats may join Republicans to decide to start over and scrap the whole complex health care enterprise," Kraushaar writes in his November 18 column. Now, this is caveated to the point that it's essentially meaningless -- he's saying there's an increased chance of something possibly happening over an indeterminate time period -- -- but Kraushaar nonetheless wants us to think that repeal is a real threat.
Fox host Chris Wallace tossed softball questions to health insurance industry lobbyists about people losing their coverage and ending up with more expensive plans, failing to mention that many insurance companies were recently exposed for only informing customers about pricier plans they offered, rather than more affordable options available on healthcare exchanges under the Affordable Care Act (ACA).
On the November 17 edition of Fox News Sunday, Wallace interviewed Karen Ignagni, the president and chief executive officer of America's Health Insurance Plans (AHIP), which represents the health insurance industry nationwide. During the segment, Wallace highlighted a statement from AHIP that suggested that President Obama's recently proposed fix could "destabilize the market and result in higher premiums for consumers." Wallace later asked Ignagni if most canceled policies will be reinstated and if, when Obama told people that "if you like your plan, you can keep your plan," she knew "that was not possible under the terms of Obamacare":
Wallace's interview neglected to highlight that a number of health insurance companies were not forthcoming with consumers about less costly plans made available to them as a result of ACA implementation. An investigation by Talking Points Memo reported that "these insurers put their customers at risk of enrolling in plans that were not as good or as affordable as what they could buy on the marketplaces":
Across the country, insurance companies have sent misleading letters to consumers, trying to lock them into the companies' own, sometimes more expensive health insurance plans rather than let them shop for insurance and tax credits on the Obamacare marketplaces -- which could lead to people [...] spending thousands more for insurance than the law intended. In some cases, mentions of the marketplace in those letters are relegated to a mere footnote, which can be easily overlooked.
The extreme lengths to which some insurance companies are going to hold on to existing customers at higher price, as the Affordable Care Act fundamentally re-orders the individual insurance market, has caught the attention of state insurance regulators.
The insurance companies argue that it's simply capitalism at work. But regulators don't see it that way. By warning customers that their health insurance plans are being canceled as a result of Obamacare and urging them to secure new insurance plans before the Obamacare launched on Oct. 1, these insurers put their customers at risk of enrolling in plans that were not as good or as affordable as what they could buy on the marketplaces.
But Fox News Sunday's softball interview was par for the course on the network, which has consistently churned out misleading information about ACA "horror stories" that don't stand up against scrutiny.
On Fox News' Hannity, host Sean Hannity invited a panel of people who claimed to have fallen victim to ACA implementation during the October 11 edition of his show. Business owners Paul and Michelle Cox insisted that ACA regulations forced them to "cut back on hiring full-time employees" and "keep [employees] below 30 hours":
MICHELLE COX: We received a letter from our insurance company stating that we would no longer be able to have our existing health plan, despite the president's promise that we would be able to keep that existing plan.
As a business, we are jumping through more hoops, more regulation, more paperwork. And we've also cut back on hiring full-time employees because of the health care costs involved, even though we'd love to do that.
HANNITY: You'd like to hire full-time employees --
MICHELLE COX: We would love to.
HANNITY: -- but you -- so you're going to keep them below 30 hours.
MICHELLE COX: Exactly.
PAUL COX: We've had to keep them below 30 hours or we wouldn't be able to -- you know, not that we wouldn't want to pay it, we just wouldn't be able to --
MICHELLE COX: Yes.
PAUL COX: -- stay in business and pay it. [Fox News, Hannity, 10/11/13]
It was later revealed that the Coxes overhyped their claims and would have saved money through the health exchanges. In fact, their business only employed four people, and is therefore unaffected by the law's 49-employee threshold, according to an October 18 post at Salon from Eric Stern, senior counsel to former Montana Gov. Brian Schweitzer:
First I spoke with Paul Cox of Leicester, N.C. He and his wife Michelle had lamented to Hannity that because of Obamacare, they can't grow their construction business and they have kept their employees below a certain number of hours, so that they are part-timers.
Obamacare has no effect on businesses with 49 employees or less. But in our brief conversation on the phone, Paul revealed that he has only four employees. Why the cutback on his workforce? "Well," he said, "I haven't been forced to do so, it's just that I've chosen to do so. I have to deal with increased costs." What costs? And how, I asked him, is any of it due to Obamacare? There was a long pause, after which he said he'd call me back. He never did.
There is only one Obamacare requirement that applies to a company of this size: workers must be notified of the existence of the "healthcare.gov" website, the insurance exchange. That's all.
Fox host Neil Cavuto pretended that the Affordable Care Act's (ACA) ban on gender discrimination, which requires all policies to include maternity care coverage, was never "telegraphed" to the American people when the law was first discussed -- Cavuto is right, if you ignore repeated remarks made by President Obama, Health and Human Services Secretary Kathleen Sebelius, and multiple media outlets prior to the bill's passage.
Under the ACA, all insurance plans are now required to cover maternity and newborn care, one of the law's 10 categories of 'essential health benefits' that every policy must include. The maternity care requirement puts an end to the systemic discrimination against women that pervaded the insurance industry. Previously, many companies charged women higher rates than men for the same plans and denied coverage or increased premiums for women who become pregnant, actions which the law prohibits.
Fox host Neil Cavuto referenced this requirement on the November 15 edition of Your World while discussing the ACA with MIT economist Jonathan Gruber. After Gruber explained the impetus behind the rule, Cavuto claimed that it "was never, ever" explained to the country until now:
GRUBER: The key thing is, if you want to end discrimination, for example by gender, if you want to say that women should not have to pay more than men for health insurance, then that means that everyone has to share the cost of maternity coverage. Now if you don't think that's right, that's a totally legitimate position to take --
CAVUTO: But that was never telegraphed. When all of this started, Jonathan -- that's fine, if you want to say that now though -- none of that was telegraphed, as was the fact that many people would lose their plans and many more would pay a lot more for plans. None of that was this Utopian view that you would do better by doing some good, maybe paying more, but in the net positive the country would benefit. That was never -- that was never ever said.
What Cavuto claims was "never, ever said" was said, repeatedly -- by the media, the president, and the Health and Human Services (HHS) cabinet secretary, all before Congress passed the ACA on March 23, 2010.
Rush Limbaugh invoked eugenics and the holocaust in an attack on health care reform architect Jonathan Gruber's use of the phrase "genetic lottery" while describing discrimination in the health care system.
On the November 13 edition of MSNBC's Daily Rundown, host Chuck Todd asked MIT Professor Jonathan Gruber about the discriminatory nature of the health care system that the Affordable Care Act is designed to address. Gruber explained that "we currently have a highly discriminatory system where if you are sick... you cannot get health insurance":
That means that the genetic winners, the lottery winners who've been paying an artificially low price because of this discrimination now will have to pay more in return. And that, by my estimate, is about four million people. In return, we'll have a fixed system where over 30 million people will now for the first time be able to access fairly price and guaranteed health insurance.
During the November 15 edition of his radio show, Rush Limbaugh railed against Gruber's comments, denying that health insurance discriminates against the sick. Limbaugh distorted Gruber's comments to claim that he, like President Obama, believes "some people and some races are inherently genetically inferior." Limbaugh compared this belief to Adolf Hitler and the Nazis, saying "the Nazis thought that the genetic lottery losers should be murdered, Adolf Hitler believed that Jews were genetic lottery losers and what did he do about it? Now Obama doesn't think that, apparently Obama and Mr. Gruber believe that genetic lottery losers should be compensated for their lousy genes":