AP FACT CHECK: Pence's Obamacare 'death spiral' chart

Charts don't always tell the full story, any more than politicians do.

Vice President Mike Pence used one Tuesday when telling federal health employees Barack Obama's health care law is in a "death spiral," echoing one of President Donald Trump's favorite descriptions of the law. The statistics behind that claim were correct, but very incomplete.

"Back when Obamacare was first passed, just over seven years ago, the Congressional Budget Office estimated that 23 million Americans would be covered by now," Pence told Health and Human Services Department workers. "That's the blue line on the far left," he added, referring to his chart. "It quickly became apparent that this was farfetched — to put it mildly."

True, only 10.3 million people are enrolled this year in the subsidized health insurance markets, not the 23 million projected by the budget office for 2017.

But Pence — and the chart — omitted any mention of the other major coverage arm of Obama's law, a Medicaid expansion estimated to cover 12 million low-income people this year. More would be covered, but 19 states have refused the expansion because of opposition from Republicans.

Together, the Medicaid expansion and subsidized private health insurance have reduced the number of uninsured by about 20 million people, bringing the uninsured rate to a historic low of about 9 percent, according to the government.

Republican legislation that's before Congress would phase out enhanced federal financing for Medicaid expansion and trim subsidies for private insurance. Progress reducing the number of uninsured could be lost.

To be sure, subsidized private insurance markets like HealthCare.gov have serious problems in many states. Premiums have gone up sharply and some major insurers have pulled out. About one-third of U.S. counties currently have only one insurer in the subsidized markets.

Next year areas of Washington state, Ohio and Missouri face having no participating carrier, unless other insurers step in. More states could find themselves in that predicament. In other states, officials say the markets are working reasonably well.

The Trump administration shares some of the blame for the market turmoil. Insurers have complained that the failure of the White House to send a clear signal on $7 billion in subsidies to the industry is driving up premiums and undermining confidence. If Obamacare ultimately goes into a death spiral, that will be seen as part of the reason.


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