Editorial: Sununu’s Obamacare falsehoods

Sunday, August 20, 2017

Gov. Chris Sununu has shown true concern for the plight of the victims of mental illness and addiction and their families, and we applaud him for that. He’s also spoken out against his party’s misguided attempt to repeal the Affordable Care Act without replacing a law that resulted in some 20 million more Americans with insurance. But the governor continues to repeat lines from the Republican playbook that are false and shouldn’t go unchallenged.

First among those is the contention that Obamacare is failing. In a recent conversation with New Hampshire Public Radio host Laura Knoy, Sununu said, “The entire Obamacare system is broken. There’s just no doubt about that. It’s not a free-market system. It doesn’t work.”

In fact, Obamacare has worked, though not nearly as well as it could have if Republicans had worked with Democrats to improve it rather than attacking it. More Americans support Obamacare than oppose it. The law is popular because it made health insurance more affordable for millions and eliminated some of the worst aspects of a bad system – things like bans on insuring people with pre-existing conditions, caps on insurer payments and the cancellation of coverage when a subscriber develops a serious illness.

The act’s expansion of Medicaid, in states like New Hampshire that did so, is not just popular. It’s lowered hospital costs, improved health and helped keep down premium increases for those with private insurance. It has the support of hospitals and business.

Yes, though three companies will compete in New Hampshire next year, fewer insurers are willing to participate in the health care exchanges, but in large part that’s because of the uncertainty caused by presidential threats and congressional inaction. The federally extended deadline for insurers to announce rate increases for the next policy year is just weeks away but they still don’t know whether the government subsidies that make premiums affordable will be continued, reduced or killed.

Sununu faults Obamacare because it’s not a free-market system, but much of the act’s problem exists because it was an attempt, originally by the conservative Heritage Foundation, to provide a free-market solution to health care where free market rules don’t work. The result was an inherently inefficient, needlessly expensive system that preserved fee-for-service medicine and pays providers more to treat people when they’re sick than to keep them healthy.

Administrative expenses, the price of paying legions of back-office people to process forms and fight with insurers, now eat up 23 percent of health care costs, according to the Kaiser Family Foundation. The insurance industry pegs the figure at 17 percent but the administrative costs in Medicare are just 2 percent. The governor wants the feds to allow each state to create its own free-market system, but 50 different systems with different rules would add to administrative costs not lower them.

Competition hasn’t and won’t do much if anything to lower health care costs. It’s a conservative chimera. Providers just merge as more than 1,400 hospitals already have or they buy up independent provider practices to eliminate competition and increase market share.

Finally, the governor keeps blaming the Obama administration for bloated federal spending. Medicaid spending has to be reduced because “our spending over the last eight years has gone completely out of control,” Sununu said during an interview on PBS with Judy Woodruff. But Obama isn’t to blame. Federal spending increased less under him than under any president since Dwight Eisenhower, according to the libertarian Cato Institute, just 1.3 percent per year on average compared to George W. Bush’s 4.6 percent.

Sorry, governor. When falsehoods are repeated, particularly by people in power, they must be rebutted.