“Alternative facts,” and Obamacare’s impacts

“Alternative facts,” and Obamacare’s impacts

“Alternative facts” are far more common in debate than people realize. The clash over Obamacare, and the number of insured Americans, provides an example.

The very first executive order that Donald Trump signed as president called to end any enforcement of the Affordable Care Act (ACA) that might “impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.” This action was soon overshadowed by a senior advisor defending the President’s belief in “alternative facts” about the number of people that attended his inauguration. This phrase is interesting because debating about facts is one of the more misunderstood types of argument.

The complexities of the ACA, also known as Obamacare, have been debated for several years, and this recent action signals that Americans are in for another round of arguments back and forth about its benefits and drawbacks. One of the best defined points of contention revolves around the actual number of people that have received medical insurance as a result of the ACA. Specifically, there are competing reports from the Department of Health and Human Services (HHS) and the Heritage Foundation that provide an excellent example of how to engage a debate about facts.

Kellyanne Conway defended the use of "alternative facts"

The term “alternative facts” is fast becoming synonymous for “a lie.” But what is true and false isn’t always as clear-cut as seeing a photo with your own eyes and drawing a conclusion. Such is the case with the number of people insured due to the ACA. No matter what figure is presented as the “truth,” it all always be someone’s best guess at reality. This uncertainty allows for competing approaches to come to a conclusion.

The Department of Health and Human Services chose to use 2 surveys, the National Health Interview Survey (NHIS) and the Gallup-Healthways Well-Being Index (WBI). HHS explained in earlier drafts that they felt the survey was the most reliable source because of its high response rate and robust sample size. In argumentation theory, defending the reason why one is using selected data to support a claim is known as the warrant.

The Heritage Foundation instead chose to use data from Mark Farrah Associates, a company that provides data products for healthcare analysis. The Daily Signal explains that this data is more reliable than a survey because it measures enrollment data directly from insurance companies. In a debate, this is what is known as a counter warrant.

The important thing to recognize is that neither side of the debate is accusing the other of falsifying data. They aren’t claiming that the surveys are forgeries, or that they are counting more people than actually answered the survey, or that the researchers purposefully overestimated their conclusions using questionable statistical methods. They aren’t contesting the data itself, only which data is more reliable; that collected from individuals, or that collected from insurance companies.

There is a right answer to how many people gained insurance because of the ACA, but the frustrating thing about living in our day and age is that even with all the information readily available, all we have are best guesses. Fortunately, even these guesses can narrow down unknown information to manageable estimates. In this case, debating about facts gives us relative confidence knowing that Obamacare has provided between 14 and 20 million people with medical insurance.

Explore the map below to follow the analysis from this article.

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