But sometimes we need to fact-check the moderators (or perhaps the TV producers who help create questions outside a moderator’s area of expertise).
Witness the last month’s debate among candidates for the Democratic Party’s presidential nomination. Most of it was focused on foreign policy, but there were a few health care questions. At one point, moderator Martha Raddatz noted that health insurance premiums had risen 27 percent in five years. She then asked Hillary Clinton how she would fix the Affordable Care Act:
Secretary Clinton, the Department of Health and Human Services says more than 17 million Americans who are not insured now have health coverage because of Obamacare. But for Americans who already had health insurance the cost has gone up 27 percent in the last five years while deductibles are up 67 percent. Health care costs are rising faster than many Americans can manage.
What’s broken in Obamacare that needs to be fixed right now? And what would you do to fix it?
Where to begin unpacking that?
Raddatz cited a statistic pertaining to premium increases for employer-sponsored health insurance – but which was based on a five-year time period that included some years before ACA coverage expansion. She used those numbers to frame her question about the ACA – which also could have used some explaining, clarification and historical context.
The 27-percent figure comes from the Kaiser Family Foundation/Health Research & Education Trust 2015 Employer Health Benefits Survey. It did in fact find that health insurance premiums had risen from 27 percent from 2010 to 2015. That included only two years of ACA expansion – plus “Obamacare” plans actually are separate from employer-sponsored plans and not included in this data. Some provisions of the ACA do indirectly affect the coverage many of us get at work – preventive health for instance. But that wasn’t implemented in 2010 and it’s not even close to being the driver of costs. And it wasn’t what she was asking.
Secondly, according to that same Kaiser survey, employer-sponsored health plans had also risen 27 percent the previous five years – most of which was under President George W. Bush, a decidedly un-Obamacare era.
And we have apparently forgotten that health insurance inflation was even higher in the not-so-distance past. For 2000-2005, premiums for employer-sponsored plans rose a whopping 69 percent.
The 67-percent deductible increase she cited, also from that annual survey, pertained to workers’ coverage – and that cost shifting to employees also predated the ACA. According to the survey, the average deductible for all covered workers in 2015 reached $1,077 – up 67 percent from $646 in 2010. Back in 2006, it had been $303 – so as a percentage, the increase from 2006 to 2010 (the year of ACA passage) was even higher.
After the debate, I contacted Drew Altman, president and chief executive of the Kaiser Family Foundation, which conducted the study. He told me, “The premium increase has been historically moderate and not a function of Obamacare. The 67 percent increase in deductibles over the last five years is for employment-based insurance and also has nothing to do with Obamacare.”
We face many legitimate – even, pressing – questions about the affordability of health insurance – both the premiums and the out of pocket expenses including deductibles. But to have that debate, we need to start with clear and accurate premises. Reporters need to keep that in mind and attempt to correct the confusion, whether generated by candidates or moderators, as we cover the coming debates, in the primaries and the general election.