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WASHINGTON -- When President Barack Obama and a Republican lawmaker sparred Thursday over what might happen to health insurance premiums in an overhauled system, both cited a nonpartisan analysis that looked at that very question. The president gave a fairer summary of what the analysis found.
Tennessee Sen. Lamar Alexander declared in his statement to the White House health policy conference that "for millions of Americans, premiums will go up" under the Obama plan. That much could be true -- but for millions of others, premiums are expected to go down and those who face higher costs would be getting better coverage than they have now.
The debate on that point is key if Americans are to accept the insurance changes Obama wants. Democrats know that pitching their plan as a means to extend coverage to the uninsured is not enough: They must convince middle-income Americans who already have insurance that they, too, will end up with a better deal under the overhaul. So the squabble was about more than a bureaucratic report.
Obama sharply challenged Alexander on his claim and insisted he had the facts on his side when quoting from the report by the Congressional Budget Office. For the most part, he did.
Obama: "Lamar, when you mentioned earlier that you said premiums go up, that's just not the case, according to the Congressional Budget Office."
Alexander: "Mr. President, if you're going to contradict me, I ought to have a chance .... The Congressional Budget Office report says that premiums will rise in the individual market as a result of the Senate bill."
Obama: "No, no, no, no. Let me -- and this is an example of where we've got to get our facts straight."
Alexander: "That's my point."
Obama: "Well, exactly, so let me -- let me respond to what you just said, Lamar, because it's not factually accurate. ... Here's what the Congressional Budget Office says: The costs for families for the same type of coverage that they're currently receiving would go down 14 percent to 20 percent. What the Congressional Budget Office says is that because now they've got a better deal, because policies are cheaper, they may choose to buy better coverage than they have right now, and that might be 10 percent to 13 percent more expensive than the bad insurance that they had previously."
Both are right, but Obama offered important context that Alexander left out.
The analysis estimated that average premiums for people buying insurance individually would be 10 to 13 percent higher in 2016 under the Senate legislation, as Alexander said. But the policies would cover more, and about half the people would be getting substantial government subsidies to defray the extra costs.
As the president said, if the policies offered today were offered in 2016, they would be considerably cheaper under the plan, even without subsidies. One big reason: Many more healthy young people would be signing up for the coverage because insurance would become mandatory. They are cheap to insure and would moderate costs for others.
Moreover, the analysis estimated that almost 60 percent of the people covered under individual policies would qualify for subsidies, bringing their own costs down by more than half from what they pay now.
Obama was correct that the forecast for higher costs on average is based on the expectation that people would buy better coverage. But that might not be as voluntary as he made it sound. The report said the Senate legislation sets minimum levels of coverage and that would require some people to pay for better insurance than they have now.