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Cruz’s Obamacare Whopper

Sen. Ted Cruz claimed that “Obamacare is discouraging people from going to medical school.” Actually, medical school applicants and enrollees are at an all-time high.

“We have not seen any indication of declining interest in medicine since the [Affordable Care Act] took effect,” Atul Grover, an executive vice president at the Association of American Medical Colleges, told us in a phone interview.

In fact, Grover said, “We have many more qualified applicants than we have room for” at the nation’s medical schools.

Cruz, a Texas Republican, and Sen. Bernie Sanders, an independent from Vermont, debated the future of the nation’s health care system on CNN on Feb. 7. Cruz argued that Congress should “move swiftly to repeal Obamacare.”

At one point, Cruz criticized the Affordable Care Act for having a chilling impact on prospective medical school students.

Cruz, Feb. 7: Obamacare is discouraging people from going to medical school and training to be doctors.

But there is no evidence that the Affordable Care Act has discouraged “people from going to medical school.” And, as we explain later, Cruz is wrong that it has discouraged students from “training to be doctors.”

Total medical school enrollment has increased every year since President Obama signed the Affordable Care Act into law on March 23, 2010.

There are 88,304 students enrolled in medical school this school year — up from 77,371 in 2009-2010, a 14 percent increase, according to the AAMC.

The senator’s office initially did not respond when we asked for supporting evidence. But after we provided the enrollment data, a Cruz spokesperson acknowledged a “gradual increase” in enrollment.

However, Cruz’s office pointed to a March 2015 report prepared for the AAMC that said the U.S. is facing a 90,000 shortfall in physicians by 2025. Cruz’s spokesperson argued the Affordable Care Act has increased the demand for more physicians but interest in medical schools has not kept up with the demand. He blamed the Affordable Care Act without providing any evidence.

In an email to us, Cruz’s spokesperson wrote: “While one could argue this point based on economic theory, and it’s difficult to ‘prove’ through the numbers exactly why the increased demand brought on by the ACA has not been reflected in a proportionate increase in doctors, the claim was not false from a fact-check perspective, and to say so would be misleading conjecture.”

The “misleading conjecture” is on his part, not ours.

The authors of the report cited by Cruz’s office said they projected the physician shortfall at 130,600 in the 2010 report. They revised that estimate down to 90,400 in the 2015 report, citing several reasons. One reason: The “number of physicians completing their graduate medical education has risen from about 27,000 to about 29,000 annually,” the report said.

Cruz’s office is right about physician shortfall, but wrong about the cause, said Grover, the AAMC’s executive vice president. He said an aging population, not the Affordable Care Act, is the primary reason for the shortage.

Grover said his organization in 2006 set a goal of increasing first-year medical student enrollment by 30 percent by 2015-2016 (from the 2002-2003 level) to address the physician shortage. That was nearly accomplished on schedule. “Between 2002 and 2016, U.S. medical school enrollment has risen by more than 27 percent,” Darrell G. Kirch, AAMC president and CEO, said in a Nov. 1, 2016, press release announcing a new record for medical school enrollees.

First-year enrollment is expected to reach the 30 percent goal by 2017-2018, according to the organization’s 2015 enrollment report.

So, medical schools have done their part, Grover said.

“The medical school growth is not an issue” in meeting the physician shortage, Grover told us. “It’s the lack of residency positions” at teaching hospitals.

The Balanced Budget Act of 1997 set caps on the number of residency positions that the federal government funds. The AAMC has been lobbying Congress ever since to raise them.

Kirch, the AAMC president and CEO, said in an Oct. 22, 2015, press release that U.S. medical schools set records for applicants and first-year enrollment in 2015. He said those figures “show that medical schools are doing their part to prepare the next generation of health care professionals,” but he called on Congress to lift the residency caps and “increase federal support for residency training.”

In short, Cruz blames the Affordable Care Act for “discouraging people from … training to be doctors,” when in fact it is the Balanced Budget Act of 1997 that is to blame, according to the AAMC.

In addition, we find that medical school applicants are rising even more quickly than enrollment, despite the claim by Cruz’s spokesperson that “interest in medical schools has not kept up with the demand for more physicians.”

In its 2015 press release, the AAMC said the number of first-time medical school applicants is “an important indicator of interest in medicine.” This year it has reached a new high at 38,773 — up from 30,998 in 2009-2010. That’s a 25 percent increase.

When asked why applications outstrip enrollment, Grover said medical schools are limited in the number of applicants that they can accept. “We have many more qualified applicants than we have room for,” Grover said.

The total number of applicants increased by 25 percent, from 42,265 in 2009-2010 to 53,029 in 2016-2017. The largest increases in applicants over the last 10 years came in the 2014 school year (6.1 percent) and 2016 (6.2 percent), as the chart below shows.

In the end, there’s simply no evidence for Cruz’s claim that “Obamacare is discouraging people from going to medical school and training to be doctors.” In fact, medical school enrollment and applications continue their upward climb.

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“Obamacare is discouraging people from going to medical school and training to be doctors.”

CNN health care debate
Tuesday, February 7, 2017