A Columbus Dispatch editorial attacked parts of the Affordable Care Act (ACA) by regurgitating popular myths and misconceptions, including the falsehood that many companies are cutting workers' hours due to the employer mandate, that young and healthy Americans are choosing to not pay for health insurance, and that the role of “navigators” is limited to only assisting with enrollment, despite evidence showing none of these claims are based in fact.
MYTH: Companies Are Reducing Workers' Hours Due To ACA
Dispatch: “Many Employers Are Cutting Employee Hours” So They Do Not Have To Pay For Health Insurance For Their Employees. The Dispatch editorial claimed that “many employers” are cutting their employee's hours below 30 hours per week in order to avoid paying their healthcare costs:
Because the law says full-time employees must be offered health insurance, and then redefines full time as 30 hours, rather than the traditional 40 hours, many employers are cutting employee hours so they don't hit the 30-hour threshold. [The Columbus Dispatch, 8/28/13]
FACT: Most Companies Are Not Cutting Workers' Hours Due To ACA
Federal Reserve Bank Of Minneapolis Study: 89 Percent Of Individuals Surveyed Said Their Companies Did Not Plan To Cut Hours For Employees. According to a study by the Federal Reserve Bank of Minneapolis, of the 205 contacts surveyed, 89 percent reported not planning to cut workers' hours due to the Affordable Care Act:
The survey asked: Has your company or organization shifted to more part-time workers in response to the Affordable Care Act (federal health insurance requirements)?
Only 4 percent said they had shifted to more part-time workers, while another 7 percent said they planned to do so. But 89 percent said they had not made, nor were planning, such a move.[Federal Reserve Bank Of Minneapolis, 3/20/13]
CEPR Study: Only 0.6 Percent Of The Workforce Work Just Below 30 Hour Cutoff. According to a July 2013 study by the Center for Economic and Policy Research, an analysis of the Current Population Survey shows that only 0.6 percent of the workforce is currently working just under the 30 hour cutoff for a full-time employee, suggesting “that employers do not appear to be changing hours in large numbers in response to the sanctions in the ACA.” [Center for Economic and Policy Research, July 2013]
Federal Reserve Bank Of San Francisco Study: Any Effect ACA Has On Reduced Hours For Workers Is “Likely To Be Small.” According to a study by the Federal Reserve Bank of San Francisco, “most large employers already faced IRS rules” preventing them from denying coverage to full-time workers but haven't reduced workers' hours to avoid paying those costs. The report further notes that once the ACA is fully implemented “the ultimate increase in the incidence of part-time work [...] is likely to be small, on the order of a 1 to 2 percentage point increase or less.” [Federal Reserve Bank of San Francisco, 8/26/13]
MYTH: Young, Healthy People Will Choose Not To Buy Insurance
Dispatch: Young, Healthy People Will Pay A Penalty Instead Of Purchasing Insurance. The Dispatch editorial claimed, “A leading concern is that young healthy people will defy the law's mandate” and instead pay the penalty associated with not having insurance:
A leading concern is that young, healthy people will defy the law's mandate to sign up for health-care coverage, since rates are expected to increase sharply for this group and the cost of insurance already is greater than the tax penalty scofflaws face. [The Columbus Dispatch, 8/28/13]
FACT: Estimates Find Very Few Americans Will Opt For Penalty
Kaiser Health News: CBO Estimates That Less Than 2 Percent Of Americans Will Pay The Fine. According to an August 27 Kaiser Health News piece, when taking into account those who would be exempt from purchasing insurance, the Congressional Budget Office estimated that less than 2 percent of Americans would opt to pay a penalty instead of purchasing insurance:
The regulations specify nine categories of individuals who are exempt from the mandate, including people who can't afford coverage or taxpayers whose income is so low they don't have to file a tax return, according to a fact sheet from the agencies. People in jail or who are not in the country lawfully are also exempt, as are individuals who experience a coverage gap of three months or less.
When filing 2014 taxes in 2015, individuals must indicate on their returns if they have health insurance coverage and, if not, pay a fine. The individual penalty is the greater of $95 or 1 percent of income, rising to the greater of $695 or 2.5 percent of income, in 2016. The Congressional Budget Office estimates that less than 2 percent of Americans who don't have health insurance will pay the fine. [Kaiser Health News, 8/27/13; Congressional Budget Office, September 2012]
FACT: The Cost Of Purchasing Insurance For Young, Healthy Americans Not Much More Than Penalty
MSNBC: Choosing To Pay The Penalty Instead Of Purchasing Insurance Makes Little Financial Sense. An August 9 MSNBC piece on the benefits of younger, healthy Americans purchasing insurance explained that most young Americans will qualify for subsidies to make their insurance more affordable and that passing on a health care plan could leave them subject to “financial ruin” if medical care is necessary:
As we approach the full implementation of Obamacare, the Republicans are again calling on young adults to help destroy it--this time by refusing to buy health coverage through the marketplaces that will open this fall. “There are a million reasons to burn your Obamacare card, whether it's the sky-high costs or your right to choose your own health care,” the advocacy group FreedomWorks bellows in a brash new online campaign. “We're asking Patriots across the country to pledge to burn their Obamacare card and opt-out right now. If 3 million Americans refuse to obey this unconstitutional mandate, Obamacare falls apart for good. Together we can do this. Pledge to Burn your card today!”
Obamacare also uses tax credits to discount most young people's coverage. Anyone with an income between 100% and 400% of the federal poverty level ($11,490 to $45,960 in 2013)--which is to say the vast majority of healthy young adults--will benefit accordingly. In Los Angeles, a 25-year-old man earning $17,235 will pay $34 per month for silver-level coverage next year. That's 80% less than the same coverage would cost without the discount ($174 per month).
Suppose that young man heeds the FreedomWorks call to action. By passing on the health insurance and paying a penalty of $27 per month (the fixed rate for anyone making less than $32,500), he'll save himself a grand total of $7 per month--the price of a turkey sandwich.
He may really want the sandwich, but he should understand that it's not a free lunch. He's actually choosing between two purchases. He can pay $27 a month for... nothing. Or he can pay $34 for a health plan that provides ready access to primary care and could spare him financial ruin if he suffers a serious illness or injury. “It usually costs a little more to buy the plan than pay the penalty,” says Jay Angoff, the Washington-based attorney who oversaw the initial rollout of Obamacare for the Department of Health and Human Services. “But if you look at what you're getting in return, there's no contest. For most people, paying an extra few bucks a month to get health insurance is the rational choice.” [MSNBC, 8/9/13, emphasis added]
MYTH: ACA's Navigators Only Enroll Americans In Health Coverage
Dispatch: Health Care Navigators Role Is To “Sign Up People For Coverage.” An August 28 editorial in The Columbus Dispatch criticized health care navigators claiming their role was to “sign up people for coverage” and said their funding could be “spent better in fixing the flaws coming to light virtually every day.” [The Columbus Dispatch, 8/28/13]
FACT: Health Care Navigators Do More Than Sign People Up For Coverage
Under The ACA, Certain Exchanges Require At Least One Not-For-Profit Certified Navigator Entity. An article for California HealthCare Foundation's California Healthline explained that the finalized rules for the navigator program require that exchanges “be operated solely by or in partnership with the federal government are required to have at least two certified navigator entities, one of which must be a not-for-profit” :
Under the ACA, exchanges that will be operated solely by or in partnership with the federal government are required to have at least two certified navigator entities, one of which must be a not-for-profit. HHS has allocated $54 million in funding grants to train and pay navigators in the 37 states with federally run exchanges.
Navigator workers must provide “fair, impartial and accurate information that assists consumers with submitting the eligibility application, clarifying distinctions among [qualified health plans] and helping qualified individuals make informed decisions during the health plan selection process.” They also must provide additional assistance to:
- Consumers with disabilities, limited proficiency in English; or
- Consumers who are unfamiliar with health insurance. [California Healthline, 7/15/13]
CMS: Health Care Navigators “Provide Outreach And Education To Raise Awareness About The Marketplace.” A Centers for Medicare & Medicaid Services factsheet explained that health care navigators have a “vital role” in helping consumers enroll in coverage, as well as assisting in other services for all types of Marketplaces:
Navigators have a vital role in helping consumers prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability program. They also provide outreach and education to raise awareness about the Marketplace, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary. Navigators play a role in all types of Marketplaces, are funded through state and federal grant programs, and must complete comprehensive training. [Centers for Medicare & Medicaid Services, accessed 8/28/13]
Kaiser Health News: Navigators Are “Trained People Who Will Provide Face-To-Face Assistance” To Explain Exchanges. A June 27 article from Kaiser Health News in partnership with The Philadelphia Inquirer explained that navigators will be able to provide assistance to those who are confused about the new law, including those with limited Internet access or who don't speak English, and will “hang out at church picnics and beauty salons, and even go door to door” to reach out to individuals or will be available for people to call them and ask for help:
The new exchanges are expected to attract individuals and small business workers.
This new venue is expected to raise a tsunami of questions from consumers. Where will potential enrollees turn if they can't use the Internet or don't speak English?
Consumers can call on “navigators,” trained people who will provide face-to-face assistance.
Or, it is hoped, the navigators will call on them.
These helpers will hang out at church picnics and beauty salons, and even go door to door. Ideally, they will be people well-known in the neighborhood, working through established groups.
After the navigators undergo training and pass a test, their job will be to point out differences in plans so enrollees can decide which would best suit their needs and income. [Kaiser Health News, 6/27/13]