Click on any point or refutation to see the other writer’s response; you can click on the writer’s response to see the refutation to that response and so on. In other words, you can click on anything anyone has written, including refutations, to see the other writer’s response. Some points have multiple refutations, separated by dotted lines. Click a point again to collapse the refutations.

All points in blue were written by Jenna Selden, arguing for Obamacare. All points in red were written by Jeremy Lewin, arguing against Obamacare.

Obamacare is good for our country

  • Obamacare is already raking in positive outcomes. Before Obamacare, more than 15% of the country was uninsured, but with the ACA those numbers’ dropped to 5%. As a result of the plan, 45 million previously uninsured Americans are eligible for health insurance; that’s more than 95%. Seniors on Medicare are still protected and those on Medicaid (with some state-based exceptions) have more stable and less expensive insurance. Though younger people may be paying more in order to pitch in on the “shift” of insurance costs, they will have better, more secure insurance as well as the option to stay on their parent’s plans up to age 26.
  • These statistics fail to take into account that all Americans were always “eligible” for insurance.
  • All Americans are eligible to take a rocket to the moon, but that doesn’t mean they all can, practically. Eligibility, or a basic right to health care, doesn’t mean that health care is always practical or accessible to all. Before the ACA, 45 million (or, as you imply below, 47 million) uninsured Americans were eligible for health care, but the likelihood of them obtaining that care was minuscule at best. With the ACA, health care is more affordable, and 32 million previously uninsured Americans are on their way to receiving health care because of the ACA.
  • Blue Cross Blue Shield, the largest insurance company on the exchange and a company who very much wants the exchange to succeed for their own economic benefit, only predicted 11 million enrollments anyway.
  • With little to no decrease in premiums, insurance hasn’t become more affordable under the ACA and the quality of insurance offered is far lower. For the uninsured, all the ACA did was create a government sponsored system of promoting certain favored insurance plans; it didn’t increase accessibility because the government doesn’t offer adequate low income assistance with premiums and doesn’t offer a government sponsored cheaper plan to drive private premiums down, so the cruel, heartless, profit crazed insurance companies still artificially inflate insurance costs for their own economic benefit.
  • Yes, uninsurance was always a problem, with up to 15% of the country being uninsured before the ACA, but guess what, the numbers are not 5%, they are closer to 11%, with only 8 million Americans enrolling through the exchange and over 5 million choosing to pay the meager and ineffectual fines associated with opting out of the mandate.
  • Firstly, let’s establish that you are accepting the fact that 47 million (15%) of Americans did not have insurance. I’m glad that you agree that this is a troubling statistic and that “insurance was always a problem.” The “5 million” who opted to pay the penalty fee are putting money into the system. They are participating in the ACA.
  • Secondly, there are absolutely no numbers supporting the popular Republican cry that more people got cancellations than those who signed up. Let’s look at the facts as reported in the LA Times (3/30): 8 million people have signed up for health insurance on the new marketplace; 4.5 million previously uninsured adults have signed up for state Medicaid programs; 3 million young adults have gained coverage by remaining on their parents’ health plans until they turn 26; 9 million people, most of whom were uninsured, bought health plans directly from insurers, instead of using the marketplaces. That’s over 22 million people who have already benefitted from the ACA.
  • First of all, opting out of the system and continuing to use an emergency room as your PCP isn’t “putting money in the system”. That is ludicrous and nonsensical. The purpose of the fine is to discourage people from doing that, and if the fine is so miniscule that millions are opting to pay, it hasn’t accomplished much and probably hasn’t created much meaningful revenue, certainly not considering that if any of those 5 million continuing to be uninsured adults gets medical care, the government will still have to pay as before. Nothing changed.
  • Furthermore, the 9 million people who purchased insurance from private insurers outside of the ACA have nothing to do with the gains of the ACA. The insurance market is constantly fluid as people change insurance when they move, switch jobs, or simply decide to move on, and that statistic is inflated by people just switching insurance, which has nothing to do with the ACA. You can’t point to any tangible reason why the ACA would affect these people. In the first half of 2011, before the ACA, there were 10-12 million private insurance plans purchased, a number very similar to the number of people purchasing insurance independent of the exchanges. Before and after the ACA, nothing changed for these people; they cannot be counted as among those directly affected by the ACA, except that they now have to pay the more medical related tax increases as well as the various income tax increase associated with the ACA.
  • Lastly, just because these people got insurance from the exchange doesn’t mean they are better off, as the quality of insurance purchased elsewhere, without the price cap driven quality and coverage cuts, is far better than that of the plans purchased through the exchanges.
  • Younger people are paying more for their insurance plans, and often these people end up on what are called “underinsurance plans” like high deductible yield 80/20 plans that have customers paying up to 30% of their medical costs out of pocket before insurance kicks in. Many of these plans also force customers to change their doctor to reduce healthcare costs. While it’s nice and dandy to say that the ACA is insuring more Americans, it’s also vital that we look at the quality of insurance and care that these individuals are procuring and whether the gains justify the massive tax increases associated with the plan.
  • The bottom line is that these statistics are unsubstantiated and “there is a scare campaign underway to make young adults worried about their health care costs.” At most, 3% of young adults will see premium increases.
  • What they’ll see is a massive increase in the amount of money they will have to pay if they’re sick, for no decrease in premiums. They get less coverage and instead have to foot a good portion of the exorbitant health care costs in this country should they get sick. I’m pretty sure the only thing scaring young adults about their health care costs is the actual cost if they get sick and they have ACA coverage.
  • Small penalties for no insurance add incentive but are flexible and understanding. Every single American is guaranteed- and actually required- to get insurance regardless of their current health conditions. If they do not meet this requirement, they have to pay a small penalty. However, the penalty is waived if the person in question truly can’t afford the insurance, and the rule is only in place so that people will not take advantage of the zero-discrimination policy and end up waiting to get insurance until they are injured or sick. The enrollment periods are in place for the same reason.
  • This is a nice way of saying that the fees are so small in comparison to the tremendously high cost of buying insurance that millions of Americans have already and will continue to, avoid the ACA all together and continue to use the emergency room as their GP, changing the cost to the government and the health care providers.
  • If people avoid the ACA altogether and don’t buy insurance, it won’t change the costs. Before the ACA, if an uninsured person used an emergency room, the taxpayer picked up the tab. After ACA, the same would be true. However, by adding millions more payers into the system, the burden on all taxpayers is decreased.
  • The fee is waived only happens for individuals who truly don’t have the money to pay for insurance, not people who can barely afford insurance and if they purchased it, they would have to cut back on groceries, housing and other basic necessities.
  • Again, this is simply untrue—the only people who might see an increase in premiums are the 3% of people who currently have insurance (not via their employer) and have incomes 250% of the Federal Poverty level. So a single citizen earning $30,000 might have a small increase in insurance premiums but would have a better insurance plan (no lifetime coverage limits, no gender discrimination, no being dropped when you get sick, etc). I’d say that’s a fair deal.
  • The insurance isn’t better. As I will exhaustingly explain over and over again, the insurance offers far inferior coverage and quality of care for the same cost, or as you concede, possibly a bit more. The issue isn’t that premiums are raised at all, it is that in order to avoid the large scale price increases that many analysts predicted, the insurance companies drastically cut coverage leaving insurees vulnerable to exorbitant medical costs bankrupting their family and the threat of having to switch doctors to keep medical costs down.
  • Furthermore, the enrollment periods mean that anybody with an unorthodox or sudden change in circumstance can only buy insurance during specific intervals and sometimes must remain uninsured for up to 5 months before the next enrollment cycle. The cycles were actually implemented because insurance companies can maximize their profits by clustering all of their enrollments and standardizing their payment schedules. As always, the ACA prioritizes the profits of heartless insurance companies before the struggling average American.
  • So you’re worried about a five-month lag in insurance but you discount the 22 million people who have benefitted from the ACA?
  • I don’t discount the 22 million people who have been affected by the ACA, but I wholeheartedly disagree that they have been assisted by the legislation. You haven’t offered any proof that the ACA has helped these people. The fact that they are affected doesn’t inherently means they have benefitted. In fact, many are no better off because their plans don’t offer enough coverage to eliminate the threat of medical bankruptcy should they become seriously ill, because their plans force them to change their doctors to lower quality and lower priced physicians, because their taxes have been significantly raised or because the government never offered the assistance it claimed and they cannot truly afford to buy health insurance but are now mandated to do so under the ACA. How many of those 22 million are affected negatively? I take into account the experience of every individual; the question is why are you willing to overlook a serious gap in the coverage offered to new enrollees?
  • The ideologies behind the ACA are complex but comprehensive-and they make sense for our country. This type of healthcare reform focuses on justly determining insurance costs by accounting for a variety of factors. These include the reduction of premium costs and out-of-pocket costs for millions of small businesses and families who have not been able to afford coverage in the past. There will be caps on out-of-pocket care, as well as free preventative care, which will improve insurance for people who are already getting insurance from their employers and will be otherwise unaffected.
  • While premium costs have generally been lowered, in certain states they have actually been raised in anticipation of the inclusion of pre-existing condition patients into the general insurance premium calculation pool, and in every case, the majority of plans offered have high out of pocket costs associated with high deductible plans that are almost always 80/20 or 75/25 plans that have Americans paying for as much as 30% of their health care costs out of pocket. With the ever rising cost of care in this country, that is out of touch with the economic struggles of the middle and lower classes, and doesn’t make sense for our nation.
  • As noted above, only 3% of people will see premiums rise, and they’ll get better coverage. But if we accept your premise, it sounds like you’re saying that you don’t like the idea that people might pay for 20-30% of their healthcare expenses and would prefer them to pay much less. I guess that means that you would prefer the wealthier taxpayers to pay for those without insurance. I agree!
  • It’s not about the wealthy taxpayers. That type of misunderstanding of the health care system caused the linear approach that the ACA has taken in attempting to solve uninsurance. The issue is holding the insurance companies and medical providers accountable for the immense profits they rake in and the market wide price inflation and denial of adequate services that has made health care such a major and complicated issue. The ACA was co-authored by lobbyists working for the insurance companies, who have endorsed and partly run the exchanges. These companies charge high premiums simply because they can and because the ACA did nothing to police or regulate their practices. The ACA is so expensive because it does nothing to address inflated costs; the only way for the exchanges to be competitively priced is for the insurance companies to offer less coverage, hence the 80/20 plans and the constant threat of bankruptcy for sick people on these plans. The premiums haven’t gone up because the coverage has gone done which is even more concerning.
  • Non-discriminatory insurance selection is on par with American ideals. Before Obamacare, gender, current health status, and age were factors in determining healthcare plans. With it, this kind of discrimination is eliminated. This is one in several factors that work to level the playing field by making costs more affordable and more comprehensive.
  • This might be the only good and honest part of the ACA. While it is tremendously beneficial, it doesn’t justify the 1 trillion dollar price tag, which has not been adequately explained or justified by the Obama Administrations of Democratic proponents of the law in Congress.
  • “$1 trillion dollar price tag?” The Congressional Budget Office has estimated that the ACA will reduce the deficit by over $109 billion over the next decade (see below). It turns out that being good and honest is also good for the economy.
  • Nothing is honest and good in politics. And the CBO said that the ACA reduced the deficit by using tax income from the proposal, money off the tables of average Americans, to more than cover the cost of the plan. A cost that totals more than 900 billion USD, hence the 1 trillion dollar price tag, paid in full by the already struggling American taxpayers who have seen their inflation adjusted per capita median PPP decline 3-4% in the last decade.
  • We have already seen this method work. While Republicans can buckle down and continue repeating the same recycled mantras regarding the ACA, the fact remains that “[The Massachusetts] law was the model for the nation’s law,” and no matter what side of the aisle you look at it from, it works. The Massachusetts reform act cut down the percentage of uninsured from 7% to 2% despite the nation’s steady increase of uninsured. Republicans argue that the ACA will raise premiums, but in Massachusetts there was actually a decrease in premiums.
  • The Massachusetts law is NOT the ACA. It has vastly different insurance plan minimum standards, significantly higher penalties for not being insured, has Commonwealth Care for low income individuals, and was accompanied by massive Medicaid reforms. In addition, the state legislature worked with the largest health care providers in state to make sure that none of the plans were excluded from health care provider’s list of accepted plans. This has not been done with the ACA.
  • The Massachusetts plan isn’t the ACA- but it laid out the foundation for the ACA. Over 22 million people have already benefitted from the ACA and that the Congressional Budget Office analysis concludes that it is in fact good for the economy.
  • As I address during the other times you mention the ACA being good for the economy and benefiting 22 million people, the CBO didn’t say it was good for the economy, only that the tax revenue created by the excessive tax increases in the plan more than cover the cost
  • There were 22 million people AFFECTED by the ACA. That doesn’t mean that they all benefited.
  • The ACA is good for the economy. Cutting government overspending, and putting an end to waste, fraud and abuse, will reduce the deficit by more than one hundred billion dollars over the next ten years, and in twice as many years that number will increase to one trillion. The ACA, like the Massachusetts plan, focuses on expanding care rather than modifying costs, and it is expected to raise more than 1 trillion dollars in tax increases and spending cuts, surpassing the necessary 1 trillion and reducing the deficit.
  • 1 trillion dollars in tax increases will help the economy? Taxing the economically productive in this country will only slow consumer spending and slow economic growth. Excessive taxation, unless augmented with tremendous infrastructural stimulus as in Keynesian economics, never has and never will be beneficial for the nation. And to say that the ACA is cutting waste is ludicrous. More than 30% of the expenditures in the nearly 20,000 pages of the ACA are not related to health care, also known as pork or political horse-trades to get the bill passed. Cutting waste and greed by expanding waste and greed to a new level of efficaciousness? Sounds a bit disingenuous to me.
  • My point was not that “tax increases will help the economy” but rather that “the ACA will reduce the deficit, and is in that regard good for the economy.” The Council of Economic Advisers recently put out an analysis proving that the ACA is absolutely beneficial to the economy. Reducing deficit over the long term lays the foundation for growth in the future. The Congressional Budget Office (which is obviously bipartisan) estimates that in the next ten years the deficit will be cut by about 100 billion dollars, but over the next 20 that number will become over 1 trillion dollars. This huge dent in the deficit directly correlates to an increase national saving, which leads to higher capital accumulation and the reduction of foreign borrowing, ultimately making workers more productive and increasing national income and living standards over time.
  • What you are failing to mention is that the ACA is reducing the deficit by raising taxes. Taxes have been increased to raise over 1 trillion dollars over the next 20 years, and the ACA only uses 900 billion of that funding, so the rest goes to reducing the budget. Taxes did that. Not the ACA. The ACA just wasted 900 billion dollars that used to belong to the good taxpayers of this nation and spent it on an ineffectual health care plan that leaves most Americans equally or more vulnerable to health care bankruptcy or inadequate care to due cost related issues. The ACA isn’t good for the economy, it simply reduces the deficit by an inconsequential amount relative to the total debt and taxes the country, something that you even admit doesn’t foster economic growth which is what we ultimately need to become more economically stable in the future.

Obamacare is bad for our country

  • The ACA doesn’t offer adequate plans to the average American. It relies on duplicity to present its plans as affordable. Proponents of the ACA have tried to herald its plans as affordable and revolutionary, making health insurance dramatically more affordable for the average American. However, they aren’t taking into account all of the insurance company designed fine print that was written into the ACA by the numerous lobbyists and special interest groups that President Obama catered to in drafting the legislation. The average ACA plan is an 80/20 plan with a high deductible, usually around 7,000 dollars per annum per dependent. This means that the owner of such a plan must pay $7,000 out of pocket before insurance covers anything, and then must pay 20% of the medical costs they incur after their deductible. This means that someone who is making the median income in this country (approx. 50k per yr) and is paying for a plan tailored to their income level (usually around $400 per month, or almost 5k (10% of their income), would have to more than double their deductible before their insurance does anything to help them. Then, if they needed heart surgery, usually around $100,000 in the US, they would need to pay 20% of the costs after their deductible. This system allows the insurance companies to lower their rates 12% and allows Obama to herald the ACA as a success without helping average Americans who can still easily be bankrupted by illness. People who follow the system and pay as much as they can afford for insurance are getting subpar plans that don’t adequately protect them under the ACA.
  • Who do you think paid for heart surgery before the ACA? Either the individual was bankrupted or the taxpayers paid (in the form of higher healthcare costs and insurance premiums). The idea behind the ACA is that we should all pay for health care insurance to avoid this situation. We are all required to have auto insurance in order to protect society and ourselves in case we suffer from an accident. The ACA is based on the same idea—make sure everyone is covered by insurance so they can get adequate health care, reduce insurance and healthcare costs, and make everyone pay their fair share of the costs based on what they can afford.
  • That sounds like a compromise answer. You are saying that it does “something” to achieve a goal it was ultimately supposed to achieve. It was supposed to protect Americans from bankruptcy due to health care costs, but as I proved earlier, it is very plausible that someone participating in an ACA exchange could still be bankrupted by their health care costs. So what has the ACA accomplished in protecting America’s ill from financial ruin? Nothing.
  • We now know that, as of April 1st, 7.1 million people signed up on the exchanges—actually surpassing the original target! Millions more have signed up for Medicaid—that means there are millions more Americans who have health insurance and are protected from financial collapse. That’s a quite a lot of “nothing” if you ask me!
  • You can’t always keep your doctor. President Obama very clearly stated that every American could keep their doctor under the ACA while stumping for it’s passage by Congress. This couldn’t be farther from the truth. In fact, as many as 23% of national health care providers are not accepting Obamacare plans, as they have different payment formularies that often lead hospitals and doctor unpaid for treatments that other independent insurance plans generally cover. Furthermore, a number of plans listed on the ACA exchange website are plans that restrict your choice of doctors to “partnered” institutions which offer special rates and restrictions to the insurance companies to keep costs down and maximize insurance company profit. The ACA website does even not do an adequate job of pointing out to customers which plans are restricted; you often have to change your doctor to a one of lower quality who is actually getting financial incentives from your insurance company to reduce your healthcare costs by rationing your care or being complacent with your health. That sounds like big government working for big business, not the average American.
  • This is partially true but still manages to be misleading. Here’s the President on March 14th: “If you’re in the middle of life-saving treatment with a particular doctor, then we will work to make sure that you can keep that treatment and not shift. But for the average person, for many folks who don’t have health insurance initially, they’re going to have to make some choices. They might have to end up switching doctors in part because they’re saving money. But that’s true if your employer suddenly decides this network is going to give you a better deal. ‘We think this is going to help keep premiums lower. You gotta use this doctor as opposed to this one.” So essentially as an uninsured person shops for an insurance plan, the network they choose will be based on both cost and the doctors in the plan.
  • You have just acknowledged that people do have to often give up their doctors to switch to cheaper alternatives under the ACA. Your last sentence basically said that the average American, who can’t afford the most expensive and exclusive ACA plans, is given to second class service in the exchanges and can only afford to buy a plan where they have doctors of lesser quality than those who charge a higher co-pay, all to maximize the profit for the private insurance companies who run these plans. Ultimately, it isn’t President Obama’s decision whether an insurance company makes a sick person switch doctors abruptly. Nowhere in the ACA does it give the government the authority to make such pronouncements. As before, the insurance companies, duplicitous and immoral enterprises, still make all the decisions.
  • First, nothing I said suggests that people will end up with second-class service or doctors of lower quality. When individuals go shopping, they need to prioritize their needs. When you shop for a house, you may decide to prioritize minimizing the commute to school over a swimming pool. When you shop for a car, you may decide to prioritize gas mileage over cargo space. When you shop for health insurance for the first time, you may decide to prioritize the physician over the monthly premium. In the end, you end up with the house, car, or insurance that you’ve chosen–this is how people live in the real world, every day.
  • The ACA’s full time employment insurance standards have led to largescale reduction in hours for low wage workers. Companies including AT&T, Walmart, Stop and Shop, Home Depot, McDonalds, Burger King, Chick Fil-A, Wendy’s, Taco Bell and Chipotle have all taken drastic measures to save money by not having to offer their minimum wage workers health care. The ACA stipulates that any worker working more than 40 hours per week must be offered subsidized insurance by their employer, however it doesn’t regulate employee practices, so these companies have reduced their worker’s hours to 39 hours per week or less and hired more workers for fewer hours per week to save money. This has led to a reduction in take home pay for some of the most vulnerable and most abused Americans in the workforce but has done nothing to assist them in gaining affordable or adequate medical care.
  • Once again, this data is unsubstantiated and a representation of the vast minority of people included in the ACA’s system. Forbes refutes this claim in an article entitled, “One Of The Great Anti-Obamacare Lies Exposed — Data Proves ACA Not Responsible For Growth In Part-Time Jobs”. Admittedly, some companies may resort to reducing employee hours to avoid health care costs, but these companies were doing so before the ACA was implemented and will continue on that trajectory regardless of healthcare reform. However, the Bureau of Labor Statistics show that the overall number of part time workers is declining under the ACA. The Bureau of Labor Statistics shows that only 8 million of the 27 million part-time workers of our nation are working in part-time jobs because they cannot get a full time job- the other 19 million are part-time voluntarily. The 8 million part-time workers previously comprised of 6% of the work force, but under the ACA they only make up 5.5%.
  • The article isn’t substantiated in itself. The statistics it cites don’t create an accurate link to the ACA and instead they are arguing that arbitrarily, before the ACA has really taken full effect on the job market, that it doesn’t contribute to part-time employment. In fact, Bank of America, which not only employs over 250,000 people nationally, but also handles the banking of more than two thirds of the Fortune 500 companies in the US, recently published a “Health Care Market Response Analysis” that proved without doubt that the largest employers in the country are cutting wages, hours and overall employment to avoid health care costs, are setting up underfunded “health care IRA” accounts and forcing employees into buying private insurance as part of their performance review at their employer, and setting up internal private exchanges that not only compete with, but actually surpass and render obsolete and unnecessary, the ACA exchanges. Ultimately the numbers may not have changed publically and nationally at the moment, but the stories are already pouring in and the employment market in the U.S. is not at all excited about or on board with, the ACA.
  • The Government doesn’t offer adequate assistance to individuals barely capable of affording health plans. Unlike the Massachusetts’ Plan, the ACA doesn’t have a government subsidized system to assists those who don’t qualify for Medicaid to get solid and honest plans that help them stay insured. The plan instead relies on government assistance vouchers to have individuals buy private insurance through the exchange, low premium plans that can easily bankrupt a middle income American. The government also isn’t providing the subsidies they previously claimed they would provide. Since the aid is calculated based on a complicated formula that includes the cost of an average plan in each particular state and an individual’s income, many people who live in states where insurance is generally less expensive are being cut out of the government assistance programs. This problem is exacerbated by the fact that the government miscalculated insurance costs for 2013. In states like Wisconsin, an individual making more than 222% of the Federal Poverty level would not receive government aid. That figure is significantly smaller than 400% of the NPL, the figure Obama initially promised. Since the “mandate fine” is relatively small and insignificant, many of these people, who do not feel as though they can afford insurance, have chosen to pay the meager fine and take a chance with their health, the exact scenario the bill was introduced to eliminate.
  • If you are advocating for more government assistance for people barely capable of affording health insurance. If that is the case, than I will happily agree.
  • I am. I think that the government should help poor people more with their insurance costs. Unfortunately the ACA does a horrendous job of helping struggling members of our healthcare market, leaving them either underinsured or uninsured and paying the fine.
  • I am glad we agree that the US Government should do even more to help people. I also agree that the ACA is still early in its implementation and is having growing pains—it is not perfect. It would be a tragic mistake, however, to eliminate the ACA, a plan that is already helping millions of people, and furthermore to simply scrap it because it is not perfect. Keep in mind, “The perfect is the enemy of the good.”
  • The ACA is NOT universal health care. We do need universal healthcare, but let’s not blind ourselves into calling the ACA universal health care. The ACA injures the middle and upper class members of this nation, who tend to be the economic powerhouse that drives our economy forward. These members pay higher taxes, get lower quality insurance programs, and ultimately don’t benefit from the plan at all. With the poor implementation of the plan, not even low-income individuals are benefitting. Obamacare is doing serious harm to the nation and the citizenry and needs to be scrapped so that a new, well-planned and effective healthcare bill can be drafted.