The Republican presidential candidates met Sunday evening in Florida for a forum hosted by the Spanish-language media company Univision Communications. We found a few missteps in what the candidates had to say to Spanish-speaking voters:
- Former Arkansas Gov. Mike Huckabee made some incorrect and questionable claims about Americans who don’t have health insurance, hypothesizing that a third don’t have coverage because "the think they’re healthy and invincible" – a claim for which we find no support – and that another third are self-insured – which is the definition of all people who don’t have health insurance and must pay their own bills. He also understated the number who can’t afford insurance.
- Mitt Romney said the Massachusetts universal health care plan he signed into law as governor didn’t include an "employer mandate," but the plan includes a number of employer "requirements" with penalties for noncompliance. He also claimed subsidies for low-income individuals were completely financed by a state fund for care of the uninsured. It’s not clear if that will be the case just yet.
- New York Mayor Rudy Giuliani falsely stated that the performance of K-12 students, including Hispanics, in the country has declined. Actually, it has improved.
Rep. Tom Tancredo of Colorado, who has built his campaign on stopping illegal immigration, boycotted the Dec. 9 debate at the University of Miami in Coral Gables, Fla., because it was being broadcast in Spanish. The rest of the pack, whom Tancredo accused of "pandering" to Spanish-speaking voters, attended: Rudy Giuliani, Mike Huckabee, Duncan Hunter, John McCain, Ron Paul, Mitt Romney and Fred Thompson.
Former Arkansas Gov. Huckabee hypothesized about the motivations of the 47 million people in the nation without health insurance, making some wild leaps in the process:
Huckabee: Of those 47 million, one-third don’t have it because they are self-insured. Another one-third don’t have it because they think they’re healthy and invincible. There is one-third that don’t have it because they can’t afford it.
We asked Huckabee’s campaign how he knew that a third of uninsured people "think they’re healthy and invincible," but we’ve received no response. We can find no studies or reports that support his statement about the self-perceived invincibility of the uninsured. It’s a bit easier to measure how many people turn down available insurance, without speculating on motives: The National Academies report that "only 4 percent of all workers ages 18 to 44 (roughly 3 million people) are uninsured because they decline available workplace health insurance, and many do so because they cannot afford the cost." The Academies do acknowledge that young adults, age 19 to 34, are more likely to be uninsured than other groups, but offer other reasons besides a sense of invulnerability: They are more likely to be new at their jobs and ineligible for employer-sponsored coverage. Nor do young people make up the bulk of uninsured adults – the majority (61 percent) are over 30.
We also judge that Huckabee errs in claiming that only one-third of individuals who lack insurance do so because they can’t afford it. About two-thirds of the uninsured are considered low-income families (that is, they have an income below 200 percent of the federal poverty level), according to the Kaiser Commission on Medicaid and the Uninsured. Huckabee would be correct to say that a third of the nonelderly uninsured (36 percent) are living below the poverty level, but it would be a stretch to assume that only those with incomes below federal poverty guidelines would be unable to afford insurance. The Kaiser Commission reports that the average annual health-policy premium for a family of four was $12,106 this year. That would consume about 30 percent of total income for a family that’s at 200 percent of the poverty level.
Huckabee’s claim that one-third of the uninsured are self-insured is a meaningless statement. In fact, anyone without health insurance must rely on their own resources to pay medical bills. That’s what being self-insured means.
Romney: And I found a way to do that without requiring raising taxes, without a government mandate, without a government takeover. Instead, I didn’t want to have a – when I said government mandate, I meant employer mandate. … [Individuals] that couldn’t afford them, we helped them buy their policies. … It cost us no more money to help people buy insurance policies that they could afford than it was costing us before, handing out free care.
Massachusetts may not call its rules for employers a “mandate,” but the state health care plan includes several “obligations” or “requirements,” as the state dubs them, for employers, along with fees for noncompliance. Michael Widmer, president of the Massachusetts Taxpayers Foundation and a participant in state discussions before the health care law was enacted, says the requirements for employers are much narrower than those for individuals, who indeed, according to the state, face a “mandate” to get health insurance. But is a “requirement” a “mandate”? You be the judge: Under the state plan, employers with more than 10 full-time employees must pay at least 33 percent of employee premium costs or have a group health plan in which at least 25 percent of workers participate. Those that fail to do so must pay a fee of $295 per full-time employee per year. Employers must also have an insurance plan that meets regulations set forth by a state agency overseeing the implementation of the health care law and that allows employees to pay for coverage with pre-tax dollars. If not, the employer will pay another fee. A proposal for a stricter requirement with a sizable payroll-tax penalty failed in the Massachusetts Legislature.
Individuals in the state must have health insurance. If not, they’ll lose their personal exemption on state income taxes in 2007 – a penalty of $219 – and face a higher penalty, of up to half the cost of a monthly insurance premium, in 2008. Some individuals who have low incomes or financial hardships can get an exemption from this “mandate.”
As for the cost of the program, Romney can’t yet make the claim that it has been completely paid for with the state’s “free care” money – funds used to pay for emergency health care for the uninsured. The Massachusetts Taxpayers Foundation estimated that the state would need an extra $200 million each year for 2007, 2008 and 2009 to finance the health care plan. Widmer says the latest numbers show that shortfall may be $150 million in 2008, a gap created as more people enrolled in subsidized care than anticipated. That shortfall, however, is a projection, and a Boston Globe article on the budget gap said some money could be shifted from the free care fund, if there is money in that fund to do so. Additional dollars for Massachusetts’ plan came from a Medicaid waiver granted by the federal government, which is set to expire in 2009. The Massachusetts government is negotiating with federal officials to renew that waiver, says Widmer.
Former New York Mayor Rudy Giuliani was wrong when he said that "we have a weakening K-12, including for Hispanic students." Just the opposite is true. Nationally, all four 2007 scores for the National Assessment of Education Progress tests for Hispanics were higher than the 2005 scores, and all but one were higher than at any time since 1992. (The only score that wasn’t at its highest level was for 8th grade reading, which was tied with the record score in 2002.) Tests for all U.S. students in 2007 were higher than in 2005.
– by Lori Robertson, with Brooks Jackson, Viveca Novak, Justin Bank and Jess Henig
Presidential Forum Transcript. Transcript. Univision Communications. 7 Dec 2009.
Kaiser Commission on Medicaid and the Uninsured. "The Uninsured and Their Access to Health Care," Oct. 2007.
Snyder, Lynn Page. "The Uninsured: Myths and Realities." Issues in Science and Technology, Winter 2001.
State of Massachusetts. Commonwealth Connector. "Find Insurance: Individuals & Families," 10 Dec. 2007.
State of Massachusetts. Commonwealth Connector. "Find Insurance: Employers," 10 Dec. 2007.
State of Massachusetts. Commonwealth Connector. "The Employer Handbook," Updated 1 May 2007. 10 Dec. 2007.
Dembner, Alice. "Success could put health plan in the red." The Boston Globe, 18 Nov. 2007.