A Project of The Annenberg Public Policy Center

All Those in Favor…


Keeping up with ads about the pending health care overhaul legislation, pro and con, is like trying to fill one’s glass from the proverbial fire hose. Today, we bring you three ads from groups that are urging passage of the bill, each of which needs a little context or correction.

First up is one from Americans for Stable Quality Care, which is an agglomeration of pro-overhaul organizations such as the American Medical Association, the Service Employees International Union and the Pharmaceutical Research Manufacturers Association.

Much of this ad is true. People with preexisting conditions who are now denied coverage would be able to buy insurance, and lifetime caps on coverage would be a thing of the past if the legislation becomes law.

But when viewers hear the narrator refer to "the 30 million Americans who don’t have health care today, but will tomorrow," they could be led astray. All of those currently uninsured Americans won’t get insurance overnight if the bill is signed. In fact, the Congressional Budget Office doesn’t foresee 30 million gaining coverage until 2016. Why not? Because most of the provisions of the bill that have to do with expanding coverage wouldn’t go into effect right away.

There are some measures that would kick in quickly. For instance, a high-risk pool must be set up within 90 days of enactment, under the terms of the bill, to offer insurance to people with preexisting conditions who aren’t covered through their employers; some subsidies would be given to help them afford the policies. Individuals up to age 26 could be claimed as dependents for purposes of getting health insurance within six months of the law being signed, and the same is true of the ban on insurance companies’ imposing a lifetime dollar-value cap on what they’ll pay under someone’s policy.

But the main provisions that would bring people under the insurance umbrella — such as the expansion of Medicaid and the creation of insurance "exchanges" where individuals could shop for coverage — wouldn’t fire up until 2013 or 2014. That’s why CBO doesn’t expect a big drop in the number of uninsured until 2014, when it predicts 17 million of them would gain coverage. In 2015, that number would grow to 24 million, and by 2016 it would hit 30 milion, CBO figures.

Perhaps the narrator of this ad was using "tomorrow" as a rhetorical device, to convey the idea of "some time in the future." We’ll grant that poetic possibility. But political ads are so rarely mistaken for poetry.

United for Jobs

The liberal group Americans United for Change put out a spot at the end of last week, saying that "Congress can make history by voting to make health care a right." But would the bill "help create jobs," as the narrator says?

The bill likely would create jobs, but it would likely lead to job losses as well. We have reported before on this issue, and more than once. Some liberal sources do make the argument that the health care overhaul would create jobs. And the Urban Institute’s Linda Blumberg believes that the increased demand for health care caused by more people with coverage would bring an expansion of jobs in that sector large enough to offset any losses caused by the bill’s employer requirements. On the other side, conservative groups have projected significant job losses.

More neutral sources have predicted that job losses would outweigh gains – but the decrease in jobs would be "small," according to the Congressional Budget Office, which said last summer  in a report to Congress that "[r]equiring employers to offer health insurance—or pay a fee if they do not—is likely to reduce employment." The Senate bill doesn’t have a blanket mandate on employers, but it does require some to offer coverage or pay a $750 fee per full-time employee.

An analysis by the Lewin Group of an early version of the House health care bill showed that as many as 600,000 low-income jobs could evaporate. But the Senate bill has much milder employer penalties and would result in far fewer job losses, says John Sheils, senior vice president at the company.

Update, March 18: Sheils was able to give us figures specific to the Senate bill. He estimates job lossses of between 150,000 and 300,000 under that legislation. However, neither this number nor the one for the House bill factors in any jobs that would likely be added in the health care sector.

Fat Cat Insurers?

Finally, we have this ad from Americans United for Change (again) and the American Federation of State, County and Municipal Employees, a labor union. The ad paints insurance companies as the scoundrels and villains that, well, practically everyone else is also painting them to be. They "deny our claims, drop us when we’re sick," the narrator intones. Um, yes.

But have they been "taking in record profits" as well, as we’re told here? Attentive FactCheck.org fans may recall that we addressed that claim not long ago. According to a report from the liberal Health Care for America Now, the 2009 combined profits for five major health insurance companies totaled $12 billion. But not all of those five had record profits, and even though the combined number may have set a record dollar-wise, an industry-sponsored Web site showed that the five largest companies had an average profit margin for the year of 5.2 percent – less than in 2005, 2006 or 2007.