With the House preparing for a final vote on the Senate health care legislation, with revisions, Sunday afternoon, we thought we’d give our readers a wrap-up of the top falsehoods of late. The debate over this bill has stretched on almost as long as a presidential campaign, and we suspect this weekend will be filled with politicians and third-party groups making their final — and faulty — pitches. There’s little doubt they’ll repeat wrong and misleading statements about premium costs, a government takeover, keeping your plan, Medicare cuts and more. Keep reading for details.
Americans’ premiums will go up. Americans’ premiums will go down.
The battle over what happens to insurance premium costs under the bill was most pronounced during President Obama’s health care summit Feb. 25. Obama and Republican Sen. Lamar Alexander of Tennessee argued over whether premiums would increase (Alexander’s view) or decrease (Obama’s), compared with what premiums would do in the absence of legislation. The truth is that for most people, premiums wouldn’t change significantly.
The Congressional Budget Office estimated that for those in the group market — those who get insurance through their employers — premiums would largely stay the same. The change in the average premium in the large group market would be between 0 percent and a 3 percent decrease, for instance, compared with where they’d be under current law in 2016. The average premiums for those who buy insurance on their own would go up, however, by 10 percent to 13 percent. The reason is that benefits would become a lot better for this market under the bill. Also, most people buying their own coverage would receive subsidies that make their net costs for these plans substantially lower than they otherwise would be.
Health Care Summit Squabbles, Feb. 25
It’s government-run health care.
Despite the fact that the federal health insurance plan (a.k.a. the “public option”) is now gone from the bill, Republicans and conservative groups have continued to claim that the bill institutes a system like the one in the United Kingdom, or Canada, or otherwise amounts to a government takeover. It doesn’t. A pure government-run system was never among the leading Democratic proposals, much to the chagrin of single-payer advocates. Instead, the bill builds on our current system of private insurance, and in fact, drums up more business for private companies by mandating that individuals buy coverage and giving many subsidies to do so. There would be increased government regulation of the insurance industry, however, to require companies to cover preexisting conditions, for example. These “government-run” claims have also included heavy criticism of health care in the U.K., such as the outrageous assertion by former U.S. Surgeon General C. Everett Koop that seniors would be “too old” to qualify for artificial joints and pacemakers in the U.K. The majority of those getting joint replacements and pacemakers in the U.K. are, not surprisingly, seniors.
Koop’s False Claims, Feb. 1
Breast Cancer Ballyhoo, March 12
If you like your plan, you can keep your plan.
Obama has repeatedly made this claim, and it’s true for the most part. But not for everyone. Employers could still drop coverage under the bill — just as they can now — and, in fact, the CBO estimates that some would. Under the Senate bill, the CBO said that 8 million to 9 million people who would be expected to have employer-sponsored insurance under current law wouldn’t be offered such benefits by 2019. These would mainly be low-income workers, CBO said, who would be eligible for subsidies to buy their own plans. Others would gain coverage through their jobs under the bill, resulting in a net decrease of 4 million people on employer-sponsored insurance. That figure holds for the final legislation.
Obama’s Glowing Assessment, March 4
The bill cuts Medicare by $500 billion.
Whether these are "cuts" or much-needed "savings" depends on the political expedience of the moment, it seems. When Republican Sen. John McCain, then a presidential candidate, proposed similar reductions to pay for his health care plan, it was the Obama camp that attacked the Republican for cutting benefits. Whatever you want to call them, it’s a $500 billion reduction in the growth of future spending over 10 years, not a slashing of the current Medicare budget or benefits. It’s true that those who get their coverage through Medicare Advantage’s private plans (about 22 percent of Medicare enrollees) would see fewer add-on benefits; the bill aims to reduce the heftier payments made by the government to Medicare Advantage plans, compared with regular fee-for-service Medicare. The Democrats’ bill also boosts certain benefits: It makes preventive care free and closes the "doughnut hole," a current gap in prescription drug coverage for seniors.
The health care plan would be the largest middle-class tax cut for health care.
Note the “for health care" part of this claim that has been made by President Obama and other Democrats. This may be true, given the qualifier. But we’re not sure who would even maintain a list of the biggest “middle-class” tax cuts, since there is no agreed upon definition of who’s “middle class.” (The vast majority of Americans say they’re "middle-class," making this a popular buzzword for politicians.) This grandiose-sounding assertion, however, is only being made about tax cuts for health care. The bill includes about $460 billion over 10 years in subsidy money. Incidentally, President Bush’s 2001 tax cut totaled about $1.3 trillion over 10 years, with about 42 percent of the benefits going to the middle 60 percent of all income earners, according to a breakdown by the Tax Policy Center. That amounts to $566 billion over 10 years, a bigger cut for the middle earners than the health care tax cut.
Obama’s Glowing Assessment, March 4
Medical malpractice is the biggest driver of health care spending.
Economic studies simply do not support this claim. Many Republicans strongly back limiting liability awards in medical malpractice cases, and it’s true that doing so would save money. The CBO said measures that conservatives have proposed would save $54 billion over 10 years and "reduce total U.S. health care spending by about 0.5 percent (about $11 billion in 2009)."
That’s real money, but it’s a tiny part of the more than $2 trillion spent on health care annually in the U.S. There’s disagreement over what exactly the biggest drivers of spending are, but medical malpractice doesn’t top the list. About 75 percent of spending, for instance, goes to taking care of chronic disease.
Summit Extras: Medical Malpractice, Feb. 26
Cadillac plans and a sweetheart deal for unions
The controversy over those cushy Cadillac insurance plans just keeps on running. Here are the details: The bill places a tax on high-cost employer-sponsored plans – specifically there’s a 40 percent tax on the value of plans above $10,200 for individuals and $27,500 for families, starting in 2018. The tax falls on insurers, but would be passed along to policyholders one way or another. First, the thresholds were increased after union leaders lobbied for them, which led Republican leaders to charge that the new tax was a sweetheart deal for labor — and they were increased again for the final bill. But the tax would affect mainly nonunion workers, according to an analysis partly authored by a former Bush adviser. Under even lower thresholds than the bill has now, union workers would have made up only 17 percent of those affected by the tax in 2019, the analysis said.
Of course, liberal groups and union leaders have made misleading claims about this Cadillac tax, saying it would really hit middle-class workers – lots of them. But economists in general back this idea, and the thinking behind it isn’t to raise money by slamming workers with a 40 percent tax. On the contrary, the Joint Committee on Taxation and the Congressional Budget Office believe the tax will boost paychecks. They say the existence of the tax will prompt employers and employees to choose less expensive health plans. In lieu of the higher cost benefits, employers will raise salaries. And that’s how the government really makes its revenue here: on payroll and income taxes on those higher paychecks.
Cadillac Plans and the Middle Class, Oct. 20
— by Lori Robertson