When it comes to the politics of Obamacare, there's really only one question that matters: How many Americans are benefiting from the new health care system, and how many are hurting? Problem is, we know more about the first part of the question than the second.
Obamacare's advocates have pushed hard against Republican attempts to highlight Americans who have been particularly hard hit by the new law. "There's plenty of horror stories being told," Senate Majority Leader Harry Reid said in February. "All of them are untrue."
Those advocates have hit back so hard that it appears they are trying to discredit the notion that anyone has been hurt by the system. "I'm beginning to think there's not actually a single person in America who's been harmed by Obamacare," Mother Jones' Kevin Drum wrote in February.
So who has, in fact, been harmed by Obamacare? The first question, of course, is what "harmed" means. But let's define it as anyone who faces higher premiums, or higher deductibles -- adding up to a total higher cost -- and/or a narrower choice of hospitals, doctors and prescription drugs than they had before. For them, health care is a more expensive and troublesome proposition than it was before Obamacare.
Everything we know about the system suggests there are millions of Americans in that position, but how many? "There is no hard number," says health care analyst Bob Laszewski. The reasons are as complicated as Obamacare itself.
"When carriers converted their old policies to Obamacare-compliant, it was typical for the insurance company to increase costs about 35 percent to comply," Laszewski says. "That increase could come in the form of higher premiums, more co-pays and deductibles, and narrower networks. A carrier might have only increased rates 15 percent but then created a narrow network worth another 25 percent, for example. Even when they did the above, some individuals might have seen a 15 percent decrease and others a 50 percent increase -- many demographic issues skewed the rate result. So, getting any simple 'it went up 34.7 percent' answer just isn't possible."
The bottom line, according to Laszewski: "We have literally millions of people each impacted a bit differently." That's hard to quantify and turn into a neat political argument.