CREDIT: Center for American Progress Action Fund
In two weeks, uninsured Americans will finally be able to start signing up for health coverage through Obamacare’s statewide insurance marketplaces. But even as the critical enrollment period inches closer, Obamacare opponents remain engaged in an all-or-nothing effort to block the law. Congress is trying to defund, delay, and repeal Obamacare on a federal level. State executives and lawmakers are working to stymie outreach efforts and undermine its individual provisions. And grassroots misinformation campaigns are ramping up their efforts.
The Center for American Progress Action Fund (CAPAF) released a new report on Thursday exploring the major efforts that Republican officials and Obamacare critics are currently using to sabotage the law:
1. Defund, delay, repeal.
Since Rep. John Boehner (R-OH) won the Speaker’s gavel in 2011, House Republicans have held votes on either fully repealing, partially repeal, delaying, or defunding Obamacare a staggering 41 times. A ThinkProgress analysis in August found that the current Republican Conference in the House has collectively voted to repeal or defund the health law a total of 7,386 times.
The New York Times put it another way back in May: since 2011, the House spent 15 percent of all of its floor activity on repealing Obamacare, which amounts to about $17 million of Republican members’ salaries. And those figures will continue to grow this week, as House Republican leadership caved to conservative members’ and Tea Party senators’ demands to try to defund Obamacare as part of a deal to keep the government funded.
The federal attacks on Obamacare aren’t just focused on the law as a whole, either; they’re also taking on the law’s individual provisions. On Thursday, House and Senate Republicans introduced a bill to delay enrollment in Obamacare’s insurance marketplaces — which launch in just two weeks — until complete data privacy can be assured. The Obama administration has insisted that its digital hub that will handle marketplace enrollment is secure and announced new initiatives to quell fears about privacy and financial security on Wednesday.
2. Preventing Americans from getting all the facts about Obamacare.
What if a health care law could help millions of Americans — but no one knew about it? CAPAF’s report highlights the ways that diehard Obamacare opponents have been imposing hurdles on the Department of Health and Human Services (HHS) and groups trying to teach Americans about Obamacare.
For instance, when word got out that the White House was considering partnering with sports organizations like the NFL and NBA to inform their fans about opportunities they may have under health care reform, GOP members of Congress sent threatening letters to the groups, warning them not to do the Obama administration’s “dirty work.” The plans to partner up with major sports leagues fizzled after the warnings, although individual teams like the Baltimore Ravens have agreed to team up with HHS to promote Obamacare.
Conservative groups’ ongoing misinformation campaigns about the law, the lack of funding allocated for red state’s outreach efforts, and gag efforts on the federal level have all taken their toll. Over 40 percent of Americans who could benefit substantially from the health law remain utterly confused about it. Now, it’s up to outside groups and community organizations to make sure people know how to take advantage of the law.
3. Opposing the law’s optional Medicaid expansion.
The Medicaid expansion is one of the primary mechanisms through which Obamacare tries to extend health coverage to the poor and uninsured. As originally written, the health law would provide generous funding to the states so that they could expand their Medicaid eligibility threshold to anybody earning 138 percent of the Federal Poverty Level (FPL) or less.
But the Supreme Court ruled the expansion to be optional last summer, leaving it up to individual states to decide whether to accept it. And since then, many of the states with the highest rates of poverty and uninsurance in the country have stubbornly refused to take billions of dollars in federal funding to extend basic health coverage to the poorest Americans. Six out of the 22 states that are not expanding Medicaid under Obamacare are among the ten most uninsured states in America, and another five have uninsurance rates that are higher than the U.S. national average of 21 percent. Close to one in five Americans in those states lives in poverty.
Unless those resistant red states come around, about two-thirds of the Americans who were expected to gain Medicaid coverage under Obamacare won’t actually get those benefits next year. And in addition to hampering efforts to extend coverage to additional uninsured Americans, the failure to expand Medicaid in these poor regions also risks driving hospitals that primarily serve the poor and uninsured out of business.
4. Putting onerous requirements on the people who will help Americans sign up for Obamacare plans.
As CAPAF points out, Republicans in Congress have also targeted organizations that are hiring “navigators” — the people that will help Americans sign up for coverage under the law — by asking the groups to submit voluminous amounts of paperwork at the very time when they need to focus their attention on reaching out to Americans about Obamacare. These information requests have actually been targeted in states that have some of the highest uninsurance rates in the country, and are led by conservative officials who have done little to properly implement Obamacare.
It’s not just congressional Republicans targeting the navigators, either. GOP governors critical of the health law, like Rick Scott (R-FL), have also sent Congress letters suggesting that the navigators may wind up being fraudsters, scam artists, or criminals who use their position to steal Americans’ personal financial information. Those concerns were part of the reason that the Obama administration is set to announce new security measures for the insurance marketplaces, such as a toll-free number to report fraud and an identification verification system to prevent identity theft.
Some states have also imposed even tougher restrictions on who is eligible to be a navigator in the first place, making it difficult for some local organizations to hire enough workers just weeks before Obamacare’s initial enrollment period begins.
5. Simply refusing to enforce Obamacare’s provisions.
When all else fails, just refuse to enforce the law you hate so much!
A majority of states have not set up their own insurance marketplaces, opting to let the federal government run one instead. But six of those states (Texas, Arizona, Alabama, Missouri, Oklahoma, and Wyoming) have taken it to an extreme by explicitly refusing to oversee Obamacare’s most basic and popular protections, such as barring insurers from denying coverage to Americans with pre-existing medical conditions and discriminating against women on the basis of gender.
Unlike the other 20 states that will have a federally-run marketplace, these states won’t even police the insurers who sell plans on them within their borders. That means that consumers will have to submit complaints and ask questions to the federal government rather than state insurance departments, which are far more suited to deal with local insurance matters. Texas health advocates worry that this could lead to confusion and harm consumers at a critical juncture for the health care law.
The CAPAF report also explains that seven other states have formed a “health compact” that would essentially repeal Obamacare within those states. Since this compact has to be approved by the federal government, there’s little fear that it will actually happen. State lawmakers in Indiana, South Carolina, and Oklahoma have all introduced (failed) legislation that would make it a crime punishable by fines or prison to implement and enforce Obamacare.