Despite the fact that conservatives often fancy themselves the kind of people who define political self-interest as strictly a cold, financial matter, the reality is that they’re far better than liberals at exploiting things like social stigma, bigotry, taboo and other “irrational” emotions to point people in the direction they want them to go. You’re really beginning to see that with the rollout of the ACA. While the ostensible arguments against it being levied by conservatives are financial, the emotional underpinnings are pure stigmatization. I was all about Brian Beutler’s piece at Salon yesterday about “waiver mania”, and I particularly liked this insight:
You can see traces of the same Galtist tendencies among conservatives in states that are resisting the implementation of the Affordable Care Act. It’s not just that Republican governors are denying their poorest constituents a paid-for Medicaid expansion, though that will certainly contribute to a tiering in American health care that will insulate the right from the left. It’s also that Affordable Care Act private health plan enrollment in conservative states is in general lagging far, far behind enrollment in liberal states.
This isn’t just a Healthcare.gov vs non-Healthcare.gov state issue. It’s also true amongstates with federally facilitated exchanges. And there are political and cultural forces behind the trend. Enrollment isn’t just discouraged in conservative parts of the country, it’s stigmatized. Remember Bette, from the GOP’s official State of the Union response? Her problem stems from the fact that she “wouldn’t go on that Obama website at all” — and she’s from relatively liberal Washington state!
That’s what’s going on, I think, in the disconnect between the “horror stories” that conservatives are trotting about about insurance companies canceling plans and selling their customers more expensive plans and the inevitable fact-checking that comes later, when mainstream media points out that if the person in question just bought through the health care exchange, they would actually save money. The latest version is this woman in a Koch brothers-paid ad in Michigan that is wildly dishonest. Her claim:
I was diagnosed with leukemia. I found out I only have a 20 percent chance of surviving. I found this wonderful doctor and a great health care plan. I was doing fairly well fighting the cancer, fighting the leukemia, and then I received a letter. My insurance was canceled because of Obamacare. Now, the out-of-pocket costs are so high, it’s unaffordable. If I do not receive my medication, I will die. I believed the president. I believed I could keep my health insurance plan. I feel lied to. It’s heartbreaking for me. Congressman Peters, your decision to vote Obamacare jeopardized my health.
That’s terrible! Except it’s bullshit. Obamacare actually lowers her health care costs, as the Washington Post reports. Not only was there a plan in the exchange that included her current doctor, it was a plan that limited her out-of-pocket costs:
The claim that the costs are now “unaffordable” appeared odd because, under Obamacare, there is an out-of-pocket maximum of $6,350 for covered expenses under an individual plan, after which the insurance plan pays 100 percent of covered benefits. The Blue Cross Blue Shield plans in Michigan that appear to match Boonstra’s plan, as described in local news reports, all have that limit.
Meanwhile, Boonstra told the Detroit News that her monthly premiums were cut in half, from $1,100 a month to $571. That’s a savings of $529 a month. Over the course of a year, the premium savings amounts to $6,348—just two dollars shy of the out-of-pocket maximum.
We were unable to reach Boonstra, but on the fact of it, the premium savings appear to match whatever out-of-pocket costs she now faces.
So, either way, she actually made out okay. As Kevin Drum explains:
So here’s my question: if this is the best AFP can do, does that mean that no one is truly being harmed by Obamacare? Hell, I’m a diehard defender of Obamacare, and even I concede that there ought to be at least hundreds of thousands of people who are truly worse off than they were with their old plans. But if that’s the case, why is it that every single hard luck story like this falls apart under the barest scrutiny? Why can’t AFP find someone whose premiums really have doubled and who really did lose her doctor and who really is having a hard time getting the care she used to get?
If this is happening to a lot of people, finding a dozen or so of them shouldn’t be hard. But apparently it is. So maybe it’s not actually happening to very many people at all?
But here’s the thing: It doesn’t really matter that no one is actually harmed by enrolling in an insurance plan at healthcare.gov. The point of these ads is not to make the argument that people lost money, since that argument will get fact-checked pretty quickly. The point is to send the message that, if you go onto the website, bears will eat your face and dragons will set fire to your ass and you will be a sad person who is never the same again. A sad person with a little more money in your pocket, but so what? THERE BE DRAGONS AT HEALTHCARE.GOV. It’ a purely emotional pitch, and the facts are just noise to fill up airtime to convey the actual message, which is this poor person went to that dangerous website and now look how sad they are.
Fact-checking, of course, is very important, but what we need to understand is that deluding people on the facts is the least of the anti-ACA forces’ concerns right now. After all, if people go to healthcare.gov, they basically fact-check themselves by finding much better plans than they thought they would. So the key, for anti-ACA forces, is to keep people from ever going to the site in the first place. These ads are supposed to stigmatize—don’t go to healthcare.gov or you’ll be like this lady, and you don’t want to be this lady!—more than argue a point.