On Monday, The Hill reported on a new Rasmussen poll under the provocative title, "Nearly half of voters don't believe key healthcare promise by Obama." That supposed pledge, as The Hill described it, was that "the law would not require
January 4, 2011


On Monday, The Hill reported on a new Rasmussen poll under the provocative title, "Nearly half of voters don't believe key healthcare promise by Obama." That supposed pledge, as The Hill described it, was that "the law would not require individuals to change their coverage." But absent from this incendiary meme was the real guarantee President Obama repeatedly made that "what I'm saying is the government is not going to make you change plans under health reform." Sadly, as the accelerating erosion of workplace health care coverage shows, your employer is another matter.

Rasmussen (whose polls The Hill noted in passing "are widely believed to trend to the right") found:

Among voters with health care insurance, 45% believe the new law will force them to change coverage, with 26% who say it is Very Likely. Forty-six percent (46%) think it is unlikely that they will have to change their coverage, including 19% say that's Not At All Likely to happen.

But throughout the explosive health care debate in 2009, Obama made clear time and again that when he said, "nobody is talking about taking that away from you," the President was referring to the government. His was an obvious - and understandable - effort to debunk a Republican talking point dating back to the demise of the Clinton health care debacle.

For example, at a June 23, 2009 press conference, President Obama left no doubt about the meaning of his message:

"When I say if you have your plan and you like it, ... or you have a doctor and you like your doctor, that you don't have to change plans, what I'm saying is the government is not going to make you change plans under health reform."

In a June 24, 2009 interview with Diane Sawyer of ABC News, Obama was even more explicit in clarifying that while employers or private insurers might continue to force workers to switch plans, the government would not under his proposals:

"I can guarantee you that there's the possibility for a whole lot of Americans out there that they're not going to end up having the same health care they have," he said Tuesday. "Because what's going to happen is, as costs keep on going up, employers are going to start making decisions: 'We've got to raise premiums on our employees. In some cases, we can't provide health insurance at all'"...

"That's the case whether we pass health care or not. The fact is that right now, all across the country, people are losing their health care. Every day," he said.

"If you're happy with it, and your employer's happy with it, keep it," he said. "If your employer is not providing you the health care that you need, then we're going to give you a set of options to make sure that you continue to have health care."

Two months later at an August 15, 2009 town hall event in Grand Junction, Colorado, President Obama was again very precise about what he was - and wasn't promising by trying to bring coverage to 32 million Americans, banning lifetime caps and exclusions for pre-existing conditions:

First of all, what we're proposing is a common-sense set of consumer protections for people with health insurance, people with private insurance. I expect that after reform passes, the vast majority of Americans are still going to be getting their insurance from private insurers...

I just want to be completely clear about this; I keep on saying this but somehow folks aren't listening -- if you like your health care plan, you keep your health care plan. Nobody is going to force you to leave your health care plan. If you like your doctor, you keep seeing your doctor. I don't want government bureaucrats meddling in your health care. But the point is, I don't want insurance company bureaucrats meddling in your health care either.

Finally, in his September 2009 address to Congress, President Obama made this commitment:

"First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have."

But employers and private insurers are another matter.

This fall, the U.S. Census Bureau announced that the number of uninsured in America jumped to 50.7 million (16.7%) in 2009 from 46.3 million (15.4%) just the year before. But the Bush recession which began in December 2007 accounts for only a portion of that dramatic drop-off. A September 2010 analysis by the Economic Policy Institute found that employer-sponsored coverage plummeted from 68.3% of those under 65 years old in 2000 to just 58.9% in 2009. (A Thomson Reuters survey last year put the figure for 2009 at a stunning 54.6%.) It was only the expansion of government programs including SCHIP and Medicaid which offset the erosion of employer coverage over the last two years.

And that's just the beginning of the health care nightmare for employees that Republicans are determined to prolong. As the New York Times reported this fall, the Employer Health Benefits 2010 Annual Survey produced by the Kaiser Family Foundation found:

Since 2005, while wages have increased just 18 percent, workers' contributions to premiums have jumped 47 percent, almost twice as fast as the rise in the policy's overall cost.

As the Washington Post reported last spring, a study by the National Business Group on Health of 507 companies with over 1,000 employees found that:

Many say they may charge more to cover spouses, tighten eligibility standards for their health plans and dispense financial rewards or penalties based on the results of certain lab tests. At some companies, overweight employees could be excluded from the most desirable plans.

Meanwhile, employees at many companies can expect significantly higher premiums, deductibles and co-payments.

That cost-shifting will take a number of forms. Twenty-eight percent of employers plan to use spousal surcharges next year, up from 21 percent this year. Meanwhile, 12 percent of employers plan to offer only high-deductible coverage next year. And the percentage of firms considering employee biometric screening and health care appraisals to incentives for hitting weight, blood pressure and cholesterol targets is growing rapidly.

To be sure, over the past year, millions of Americans have lost their insurance and seen their workplace benefits slashed even as their costs continue to sky-rocket. But aside from a few examples repeatedly cited by the right-wing echo chamber, the Affordable Care Act has had nothing to do with it. (The public option, the one provision which under certain scenarios might have led some Americans to change their plans as a result of the ACA, was not included in the final bill signed by President Obama.)

Instead, with their endless calls for repeal of the health care reform law, it is Republicans who seek to guarantee that millions more Americans won't be able to keep either their doctor or their insurance plan.

(This piece also appears at Perrspectives.)

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