Trump’s tweet overlooks millions covered who weren’t before

President Donald Trump speaks during the “American Leadership in Emerging Technology” event in the East Room of the White House, Thursday, June 22, 2017, in Washington. (AP Photo/Evan Vucci)

President Donald Trump speaks during the “American Leadership in Emerging Technology” event in the East Room of the White House, Thursday, June 22, 2017, in Washington. (AP Photo/Evan Vucci)

In its drive to repeal and replace the Affordable Care Act, popularly known as Obamacare, the Trump administration turned to Twitter with a list of how bad the program is. An accompanying video described multiple failings.

One of its assertions jumped out at us as particularly wrong: that Obamacare has led to fewer health insurance options for millions of Americans.

Before passage of the Affordable Care Act (Obamacare) in 2010, many Americans either couldn’t afford insurance or were denied coverage because of pre-existing conditions. Thousands gained coverage as a result of the law. A 2016 estimate from the U.S. Health and Human Services Department put the number at 20 million.

That included 2.3 million young adults who took advantage of a provision that allowed them to stay on their parents’ plans until they turned 26. The remaining 17.7 million got coverage through a private plan or public insurance, primarily Medicaid.

The drop in the uninsured rate gives another way to look at this. Gallup, a major polling organization, reported that by the first quarter of 2016, the fraction of people ages 18 to 64 without insurance had fallen to 11 percent. “This marks a record low since Gallup and Healthways began tracking the uninsured rate in 2008,” it said. In 2008, the rate was 14.6 percent.

Part of the decline was due to an improving economy. About half of Americans get their insurance through their employer. Part was tied to the law’s requirement that all adults have insurance. Another factor was the expansion of Medicaid for poor people, an option chosen by about 36 states that provided coverage to about 10.7 million people who weren’t eligible before, according to the Kaiser Family Foundation.

The White House statement does apply in a more limited sense. The video included a statistic about insurance companies deciding not to offer policies on the health insurance exchanges set up under the law.

The original idea of the exchanges was to have companies competing for business. In many counties, particularly rural ones, it hasn’t turned out that way, said Daniel Polsky, professor of health management at the Wharton School. “Fewer plan options will be available when compared to the early years of the Affordable Care Act,” Polsky said.

He called that “an unfortunate aspect” of the law, but said the White House has added to instability in the exchanges. Despite requests from insurance companies, the administration has not promised to continue payments that make policies affordable, and it has indicated it won’t enforce the individual mandate, the requirement for everyone to obtain insurance.

The exchanges represent a small slice of the insurance market.They are for people who don’t get insurance through their jobs or a public program like Medicaid or Medicare. The individual market covers about 7 percent of all Americans, and slightly more than half of those policies are sold on the exchanges.

We reached out to the White House for this fact-check and did not hear back.

Our ruling

About 20 million more people have insurance today than before as a result of the new health care law. The White House neglects that critical point. The sole thread of truth is that in the insurance exchanges set up by the law, the number of carriers has dwindled. That is a problem, but experts and insurance companies say it is partly a result of what this administration has done. They say Trump policies on spending and enforcement have undercut carriers’ ability to participate in the exchanges.

We rate this claim Mostly False.


Obamacare has led to fewer health insurance options for millions of Americans.

— Donald Trump on Wednesday, June 21st, 2017 in a White House tweet