# The Repeal of Obamacare/ACA: Step-bystep, Inch-by-inch

**URL:** <https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146>\
**Category:** The BBQ Pit\
**Created:** [January 2, 2017, 5:06pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146 "2017-01-02T17:06:13Z")\
**Posts on this page:** 20\
**Page:** 34

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**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\
**Post date:** [May 4, 2017, 10:13pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/661 "2017-05-04T22:13:09Z")

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> [@Bricker](#):
>
> I am at a loss to understand your faith in the CBO.
> 
> For the original Obamacare, the CBO predicted that CBO predicted that in 2016 there would be 23 million covered through the exchanges by 2016.
> 
> In fact, it was 10.4 million.
> 
> Is it possible that the CBO could be. . .um. . . well, wrong?

… uh, not really.

> **[CBO's Obamacare Predictions: How Accurate? - FactCheck.org](https://www.factcheck.org/2017/03/cbos-obamacare-predictions-how-accurate/)**
>
> So, was the Congressional Budget Office really "way, way off ... in every aspect" of how it predicted that Obamacare would work, as the White House claims? No, it wasn't.

> [@](#):
>
> Coverage
> 
> As it normally does, CBO attempted to forecast the law’s effects in each of the following 10 years. And here we compare what actually happened last year with what CBO predicted for 2016.
> 
> CBO got the big picture right. It predicted that millions of people would gain coverage, and millions did.
> 
> It predicted that the number of nonelderly (under age 65) people lacking insurance would drop to 30 million in 2016. And that turned out to be pretty close. The actual number was 27.9 million during the first nine months of last year, according to the latest figures from the Centers for Disease Control and Prevention’s National Health Interview Survey. That’s a decline of 20.3 million since 2010, by CDC’s reckoning.
> 
> In percentage terms, CBO predicted 89 percent of the nonelderly would be covered by last year. CDC put the actual percentage at 89.7 percent.  
> Exchanges
> 
> Where CBO had trouble was predicting the number of newly insured who would get their coverage by purchasing private insurance through the new exchanges set up by the law. CBO predicted that in 2016 there would be 23 million getting policies through the exchanges. The actual number was 10.4 million during the first half of the year, according to the Centers for Medicare & Medicaid Services.
> 
> That’s less than half the predicted total.  
> Medicaid
> 
> On the other hand, CBO was too low in its estimate of the number who would gain coverage through expansion of Medicaid, the state-federal program for low-income people and children.
> 
> CBO estimated 10 million would be added to the Medicaid rolls by 2016, even with many states refusing to expand eligibility. But that was too low. As of the first quarter of last year, 14.4 million adults had enrolled in Medicaid as a result of the Affordable Care Act’s expansion of the program, according to an analysis by the nonpartisan Kaiser Commission on Medicaid and the Uninsured.
> 
> So to a large extent, CBO’s mistake was in estimating where the uninsured would get covered, not how many of them would gain coverage.

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**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\
**Post date:** [May 4, 2017, 10:16pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/662 "2017-05-04T22:16:53Z")

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> [@GIGObuster](#):
>
> … uh, not really.
> 
> [CBO's Obamacare Predictions: How Accurate? - FactCheck.org](http://www.factcheck.org/2017/03/cbos-obamacare-predictions-how-accurate/)

“LOL CBO was wrong!!!” is just the stock GOP talking point to blunt the disastrous rating the AHCA is bound to receive. It’s not meant to be accurate, it’s like “fake news” – muddy the waters so ’ no one’ is right then lie your ass off when there’s no one credible left to challenge you.

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**Author:** ![JackieLikesVariety](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackielikesvariety/32/296_2.png) [@JackieLikesVariety](https://boards.straightdope.com/u/JackieLikesVariety)\
**Post date:** [May 4, 2017, 11:48pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/663 "2017-05-04T23:48:54Z")

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> [@Ann\_Hedonia](#):
>
> I imagine that the original CBO didn’t take into account the states that refused to set up exchanges and refused the Medicaid expansion. I bet they didn’t take into account the effects of the massively irresponsible ad campaign aimed at getting young people to go uninsured and the general instability in the insurance markets caused by their constant threats of repeal.
> 
> It’s OK to complain that your new car doesn’t perform as well as Consumer Reports lead you to believe it would, but not after you slashed the tires and drilled holes in the gas tank.

THIS

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**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\
**Post date:** [May 5, 2017, 1:35am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/664 "2017-05-05T01:35:52Z")

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> [@GIGObuster](#):
>
> … uh, not really.
> 
> [CBO's Obamacare Predictions: How Accurate? - FactCheck.org](http://www.factcheck.org/2017/03/cbos-obamacare-predictions-how-accurate/)

Not really?

ME: The CBO predicted that CBO predicted that in 2016 there would be 23 million covered through the exchanges by 2016. In fact, it was 10.4 million.

YOU: Not really! Look:

FACTCHECK: CBO predicted that in 2016 there would be 23 million getting policies through the exchanges. The actual number was 10.4 million during the first half of the year, according to the Centers for Medicare & Medicaid Services. That’s less than half the predicted total.

Not really, huh?

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**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\
**Post date:** [May 5, 2017, 1:46am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/665 "2017-05-05T01:46:26Z")

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A lot of people that didn’t qualify for subsidies purchased their ACA policies from brokers or direct from the insurers rather than off the exchanges. The insurers did a lot of advertising urging people to deal directly with them. I purchased my ACA policy from a broker. I don’t believe we’re included in that statistic.

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**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\
**Post date:** [May 5, 2017, 1:49am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/666 "2017-05-05T01:49:28Z")

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> [@Bricker](#):
>
> Not really?
> 
> ME: The CBO predicted that CBO predicted that in 2016 there would be 23 million covered through the exchanges by 2016. In fact, it was 10.4 million.
> 
> YOU: Not really! Look:
> 
> FACTCHECK: CBO predicted that in 2016 there would be 23 million getting policies through the exchanges. The actual number was 10.4 million during the first half of the year, according to the Centers for Medicare & Medicaid Services. That’s less than half the predicted total.
> 
> Not really, huh?

The rest of the story.

> [@](#):
>
> And after the Supreme Court struck down a key part of that law — ruling that states could not be forced to expand eligibility for Medicaid — CBO updated its estimates accordingly in July 2012.
> 
> As it normally does, CBO attempted to forecast the law’s effects in each of the following 10 years. And here we compare what actually happened last year with what CBO predicted for 2016.
> 
> Exchanges
> 
> Where CBO had trouble was predicting the number of newly insured who would get their coverage by purchasing private insurance through the new exchanges set up by the law.\*\* CBO predicted that in 2016 there would be 23 million getting policies through the exchanges. The actual number was 10.4 million during the first half of the year, according to the Centers for Medicare & Medicaid Services.\*\*
> 
> That’s less than half the predicted total.  
> Medicaid
> 
> **On the other hand, CBO was too low in its estimate of the number who would gain coverage through expansion of Medicaid, the state-federal program for low-income people and children.**
> 
> CBO estimated 10 million would be added to the Medicaid rolls by 2016, even with many states refusing to expand eligibility. But that was too low. As of the first quarter of last year, 14.4 million adults had enrolled in Medicaid as a result of the Affordable Care Act’s expansion of the program, according to an analysis by the nonpartisan Kaiser Commission on Medicaid and the Uninsured.
> 
> So to a large extent, CBO’s mistake was in estimating where the uninsured would get covered, not how many of them would gain coverage.

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**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\
**Post date:** [May 5, 2017, 1:51am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/667 "2017-05-05T01:51:47Z")

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> [@Bricker](#):
>
> … The CBO predicted that CBO predicted that…

He did it again again!

> [@](#):
>
> …FACTCHECK: CBO predicted that in 2016 there would be 23 million getting policies through the exchanges. The actual number was 10.4 million during the first half of the year, according to the Centers for Medicare & Medicaid Services. That’s less than half the predicted total…

I’m a mathtard but isn’t that “less than half for the predicted total” for the year? As measured at six months? Huh?

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**Author:** ![jshore](https://avatars.discourse-cdn.com/v4/letter/j/b5e925/32.png) [@jshore](https://boards.straightdope.com/u/jshore)\
**Post date:** [May 5, 2017, 2:25am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/668 "2017-05-05T02:25:34Z")

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> [@Bricker](#):
>
> Not really, huh?

Noone said that your one cherry-picked Republican talking point was not technically true. It is just that it chose to focus on the worse “miss” that the CBO had and ignore the larger picture of how the CBO got other numbers…and, particularly, the big picture numbers of how many people would end up covered in total…considerably more accurate.

Even if they have as big a miss on the big picture with the Republican plan as your cherrypicked talking point on a more specific point, then we would still end up with about 11 million losing coverage (and that, of course, assumes that the miss is in the direction of overestimating the number who lose coverage). So, the absolute best case scenario we can work up based on a cherrypicked reading of how the CBO performed in the past leads to a result that is hardly something to write home about!

By the way, another reason for the CBO’s estimate of the number being covered through the exchanges was [“Initially, CBO analysts believed exchange enrollment would be higher in part because employers would drop insurance plans in favor of the marketplaces. That has not occurred.”](http://www.politifact.com/truth-o-meter/statements/2017/mar/12/mick-mulvaney/fact-checking-white-house-attack-nonpartisan-cbos-/)

> [@elucidator](#):
>
> I’m a mathtard but isn’t that “less than half for the predicted total” for the year? As measured at six months? Huh?

I don’t think this sort of statistic depends strongly on the length of time quoted.

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**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\
**Post date:** [May 5, 2017, 2:32am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/669 "2017-05-05T02:32:44Z")

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> [@running\_coach](#):
>
> The rest of the story.

Yep, it seems that time lines once again are demonstrated to be a blind spot for the conservative mind. 🙂

Also, one wonders when are guys like **Bricker** gonna notice that while the bill is horrible the items that it left still make a mockery of what many like him would want to see as an example of the “purity of their essence” of their ideology that government should not do anything for others regarding health care, sounds to me that many republicans are singing praises for damaged goods as the guys at reddit noticed:

[https://www.reddit.com/r/Trumpgret/comments/69aexx/the\_donald\_discussing\_preexisting\_conditions\_lots/?limit=500](https://www.reddit.com/r/Trumpgret/comments/69aexx/the_donald_discussing_preexisting_conditions_lots/?limit=500)

A supporter of Trump goes first talking about how good premiums will drop for many, when high risk pools are set with _government funding_.

Then:

[QUOTE=MasterOfIllutions]

Isn’t “gov’t funding” = taxpayer funding?  
[/QUOTE]

[QUOTE=-bad username-]  
Wait, so basically the new bill just makes it so that tax payers end up with exactly the same burden as they did before, but the only thing different is that insurance companies are now still able to profit from the low-risk population?

It’s like double dipping at the tax-payers and insurance-payers expense…

[/QUOTE]

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<div class="post-metadata">

**Author:** ![Little\_Pig](https://avatars.discourse-cdn.com/v4/letter/l/c57346/32.png) [@Little\_Pig](https://boards.straightdope.com/u/Little_Pig)\
**Post date:** [May 5, 2017, 3:26am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/670 "2017-05-05T03:26:09Z")

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**Trump** praises Australia’s universal health-care system: [‘You have better health care than we do’.](https://www.washingtonpost.com/news/post-politics/wp/2017/05/04/trump-praises-australias-universal-health-care-system-you-have-better-health-care-than-we-do/?utm_term=.0f0ae80e46a5) :eek:

:smack::smack::smack::smack::smack::smack::smack:

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**Author:** ![Kamino\_Neko](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kamino_neko/32/34_2.png) [@Kamino\_Neko](https://boards.straightdope.com/u/Kamino_Neko)\
**Post date:** [May 5, 2017, 3:57am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/671 "2017-05-05T03:57:04Z")

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Trump really comes across as a perfect personification of the Party from Nineteen Eighty Four.

Staffing government positions with people who oppose the stated purpose of the position, blatant historical revisionism, pitting the people against each other, a supreme mastery of doublethink…

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<div class="post-metadata">

**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\
**Post date:** [May 5, 2017, 1:27pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/672 "2017-05-05T13:27:08Z")

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> [@Whack-a-Mole](#):
>
> It may not be as slim as you think. This is going to the senate as a reconciliation bill which means it cannot be filibustered. Because of that though not all provisions will make it to the floor. It will be up to the Senate parliamentarian (un-elected official) to decide what makes it. He could tear our big chunks.

Yes, reconciliation is the reason they had to do the extra vote before the AHCA vote in order to strip out the Congressional exception.

If the parliamentarian does cut things out, that will likely be because McConnell wants her to. She’s not a puppet, but her job is utterly dependent on the majority.

So watch what she does and how McConnell reacts. She might say “This part needs to go” and McConnell says, “Gosh, we’d take that up, Ryan, but we totally can’t. Our hands are tied.”

But if they want to take up any particular part, they will work with her, probably behind the scenes.

The Senate will have to wait for a CBO score to see if this can even come under the reconciliation requirement (it has to cut the deficit). Lots of parts look iffy to me (like the waivers for states), but of course the reconciliation rules/Byrd rule/filibuster, etc. are all creations of the Senate and can be altered whenever they really want to.

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**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\
**Post date:** [May 5, 2017, 1:33pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/673 "2017-05-05T13:33:24Z")

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> [@jsgoddess](#):
>
> Yes, reconciliation is the reason they had to do the extra vote before the AHCA vote in order to strip out the Congressional exception.

H.R. 2192, to be clear.

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<div class="post-metadata">

**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\
**Post date:** [May 5, 2017, 1:44pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/674 "2017-05-05T13:44:58Z")

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And [this](https://twitter.com/ddiamond/status/860342416167063553) will make everyone feel really great. GOP Rep Collins talks about how no one who voted for the bill actually read it.

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<div class="post-metadata">

**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\
**Post date:** [May 5, 2017, 1:49pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/675 "2017-05-05T13:49:20Z")

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> [@Bricker](#):
>
> Not really?
> 
> ME: The CBO predicted that CBO predicted that in 2016 there would be 23 million covered through the exchanges by 2016. In fact, it was 10.4 million.
> 
> YOU: Not really! Look:
> 
> FACTCHECK: CBO predicted that in 2016 there would be 23 million getting policies through the exchanges. The actual number was 10.4 million during the first half of the year, according to the Centers for Medicare & Medicaid Services. That’s less than half the predicted total.
> 
> Not really, huh?

Again, CBO’s overall estimate of how many Americans would gain insurance, whether through exchanges or Medicaid expansion, was pretty accurate. Yes, they got the mix wrong, but if I predict the Patriots will win next year’s Super Bowl on the strength of their offense, and they end up winning on the strength of their defense, I suspect that most people will call me pretty accurate, all things considered.

But if you consider CBO to be wrong, what source of estimates do you consider to be reliable for predicting the impacts of the Trump health care plan?

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<div class="post-metadata">

**Author:** ![Fiveyearlurker](https://avatars.discourse-cdn.com/v4/letter/f/da6949/32.png) [@Fiveyearlurker](https://boards.straightdope.com/u/Fiveyearlurker)\
**Post date:** [May 5, 2017, 2:12pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/676 "2017-05-05T14:12:08Z")

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> [@Little\_Pig](#):
>
> **Trump** praises Australia’s universal health-care system: [‘You have better health care than we do’.](https://www.washingtonpost.com/news/post-politics/wp/2017/05/04/trump-praises-australias-universal-health-care-system-you-have-better-health-care-than-we-do/?utm_term=.0f0ae80e46a5) :eek:
> 
> :smack::smack::smack::smack::smack::smack::smack:

You and I both know that he has absolutely no idea what quality, or even form, of health care Australia has.

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<div class="post-metadata">

**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\
**Post date:** [May 5, 2017, 2:16pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/677 "2017-05-05T14:16:07Z")

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> [@Kamino\_Neko](#):
>
> Trump really comes across as a perfect personification of the Party from Nineteen Eighty Four.
> 
> Staffing government positions with people who oppose the stated purpose of the position, blatant historical revisionism, pitting the people against each other, a supreme mastery of doublethink…

Can they be masters of doublethink if they haven’t mastered think? 😃

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<div class="post-metadata">

**Author:** ![Okrahoma](https://avatars.discourse-cdn.com/v4/letter/o/90db22/32.png) [@Okrahoma](https://boards.straightdope.com/u/Okrahoma)\
**Post date:** [May 5, 2017, 2:30pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/678 "2017-05-05T14:30:08Z")

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> [@Ravenman](#):
>
> Again, CBO’s overall estimate of how many Americans would gain insurance, whether through exchanges or Medicaid expansion, was pretty accurate. Yes, they got the mix wrong, but if I predict the Patriots will win next year’s Super Bowl on the strength of their offense, and they end up winning on the strength of their defense, I suspect that most people will call me pretty accurate, all things considered.

They predicted 23 million in the exchanges. Instead it was 10.4.  
They predicted 10 million in Medicaid. Instead it was 14.4.

23+10 = 33 - they predicted  
10.4+14.4 = 24.8 - the actual result.

CBO was off by 33% from the actual numbers. You think that’s “pretty close”?

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<div class="post-metadata">

**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\
**Post date:** [May 5, 2017, 2:33pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/679 "2017-05-05T14:33:07Z")

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> [@Okrahoma](#):
>
> They predicted 23 million in the exchanges. Instead it was 10.4.  
> They predicted 10 million in Medicaid. Instead it was 14.4.
> 
> 23+10 = 33 - they predicted  
> 10.4+14.4 = 24.8 - the actual result.
> 
> CBO was off by 33% from the actual numbers. You think that’s “pretty close”?

So what you’re saying is that the ACA helped almost 25 million Americans get health care that didn’t have it before?

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<div class="post-metadata">

**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\
**Post date:** [May 5, 2017, 2:34pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/680 "2017-05-05T14:34:14Z")

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> [@Okrahoma](#):
>
> They predicted 23 million in the exchanges. Instead it was 10.4.  
> They predicted 10 million in Medicaid. Instead it was 14.4.
> 
> 23+10 = 33 - they predicted  
> 10.4+14.4 = 24.8 - the actual result.
> 
> CBO was off by 33% from the actual numbers. You think that’s “pretty close”?

Some of the 23 million got coverage though medicare rather than the exchanges. The total is still close to the original 23 million predicted.  
You’re doing TrumpMath.

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