During an appearance on CSPAN’s Washington Journal Thursday morning, Rep. Steve King (R-IA) claimed that the Affordable Care Act would increase the number of Americans without health insurance, dismissing analysis showing that 30 million people would gain coverage under the law.

“Everybody in America has access to health care, and we even have many many organizations that make sure they fill those holes,” King explained. “The effort was to increase the number of insured in America and that number does not look like it will increase under Obamacare”:

KING: We’re actually going to get more people uninsured under Obamacare and this creates the foundation for a one-size-fits-all federally-run socialized medicine system. We’re not completely there and I think we are a lot better off to let the free markets do this and encourage people to be personally responsible.

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King’s analysis of health policy couldn’t be more wrong. While organizations and hospitals do provide emergency services to uninsured Americans, the cost of that uncompensated care is shifted to private premium payers, resulting in higher health care spending system-wide. Obamacare accepts King’s premise of encouraging personal responsibility and will require able-bodied citizens to pay for their own health care expenses beginning in 2014.

During the interview, King also reiterated his opposition to requiring insurers to provide health care coverage to people with pre-existing conditions and said that Republicans should repeal the health care law in its entirety without preserving its popular provisions. This position puts him at odds with Republican leaders, who are drafting a plan to maintain aspects of the law that allow young people to stay on their parents health care plans and outlaw discrimination against sick people.

One of the things Americans like most about the Affordable Care Act is that insurance companies can no longer deny people coverage because of a pre-existing condition like cancer or diabetes. That provision will take effect in 2014, but in the meantime, individuals and families with pre-existing conditions can enroll in temporary high-risk insurance pools that provide coverage for those who are can’t find insurance elsewhere.

Since large groups of sick people are very expensive to insure — they spend the premiums they pay into the risk pool — enrollment has lagged behind expectations, as high risk pools attracted the sickest (and more desperate) individuals willing to pay a hefty price for coverage. But since the federal government instituted a series of reforms, enrollment has picked up. In Alabama, for instance, the size of the state’s pool increased six-fold over the last year, when premiums were cut by 40 percent. Other states also saw tens of thousands more Americans join their state’s pools:

The U.S. Department of Health and Human Services reports that as of the end of February, 389 people in Alabama were on the special insurance, an option for people with illnesses that make them a high risk, such as cancer or diabetes. Last February, there were 61 enrollees. [...]

Alabama’s uptick in enrollment follows a national trend over the last 12 months, when enrollment grew from 12,437 to 56,257. The plans are for people who have been denied coverage because of their health status and are struggling to find affordable insurance. To qualify, people must have gone without health insurance for six months and not be eligible for Medicaid or Medicare.

“For too long, Americans with pre-existing conditions were locked out of the health care system, and their health suffered,” HHS Secretary Kathleen Sebelius said in a recent prepared statement. “Thanks to health reform, our most vulnerable Americans across the country have the care they need.”

Alabama is far from alone in seeing higher enrollment. According to the National Conference of State Legislatures, 49 states, plus Washington, DC, saw an increase in enrollment in their high-risk pools last year. (The lone outlier, Vermont, was not listed as having any enrollees in its pool, but is a “guaranteed issue state” which offers policies to all eligible applicants regardless of their health.) The federal government’s contribution to the program — $5 billion — is running out fact, but given the new enrollment numbers, the law is clearly having an impact.

-Zachary Bernstein

Since passing the House Budget using a legislative tactic they’ve previously described as “unconstitutional,” Republicans have begun their appropriations process by marking up legislation that would cut millions from federal safety net programs and middle class health care benefits in order to finance their $3 trillion giveaway to corporations and the richest Americans.

Under the Republican-approved budget, for instance, the House Ways & Means committee is instructed to reduce the deficit by $53 billion between 2013 and 2022 and members are not wasting any time going after the benefits that lower and middle class Americans rely on and block granting social programs to the states. First on the chopping block: are health care subsidies for middle class families earning up to $90,000 a year who will purchase insurance in the state-based exchanges, child care and related assistance for 4.4 million children, Meals On Wheels and other home-based services for nearly 1.7 million older Americans, and transportation services for almost 1 million disabled individuals.

During this morning’s hearing, Rep. Xavier Becerra (D-CA) pressed the Joint Committee on Taxation on the consequences of the GOP’s health subsidy proposal — which would require families to pay back the government if their incomes fluctuate and dissuade people from claiming credits in the first place. Under current law, the premium support is paid out as an advance refundable amount to insurance companies based on an estimate of annual income (the assistance is available, on a sliding scale, to families of four making up to $90,000 a year). Should a family’s income change during the year, it will have to pay the government back a specific dollar amount come tax season. Congress has increased the amount since the law passed and under the current Republican proposal, “an individual would be liable for the full amount of the overpayment.”

The JCT found that the tax increase would lead 350,000 people to lose coverage and, as the National Women’s Law Center explained in a letter to Becerra, it would “especially hurt women”:

BECERRA: The letter from the National Women’s Law Center points out that eliminating this provision, which is called the safe harbor provision, would especially hurt women… A 2008 study by the Congressional Budget Office found that women experience more large changes in earnings from year to year than men. This suggests that women are more likely to have a difference in estimate actual income during the year and therefore more likely to repay a portion of the tax credit during the reconciliation. Eliminating the safe harbor by removing the repayment cap will leave women who enrolled in coverage but had an income change mid-year…vulnerable to an unaffordable tax bill. As a result hundreds of thousands of women will refuse coverage for fear of the repayment penalty.

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Republicans have also proposed repealing the health care law in its entirety, which would result in 30 million Americans becoming uninsured.