Administration officials say more than 476,000 health insurance applications have been filed through federal and state exchanges. The figures mark the most detailed measure yet of the problem-plagued rollout of the insurance market place. However, the officials continue to refuse to say how many people have actually enrolled in the insurance markets. And without enrollment figures, it's unclear whether the program is on track to reach the 7 million people projected by the Congressional Budget Office to gain coverage during the six-month sign-up period.
So much for a slow news month. August feels like campaign season, with claims on health care coming at us daily. Does the House bill call for mandatory counseling on how to end seniors' lives sooner? Absolutely not. Will the government be dictating to doctors how to treat their patients? No. Do the bills propose cutting Medicare benefit levels? No on that one, too. But on the other hand, has Congress figured out how to pay for this overhaul? Not yet. Or will it really save families $2,500 a year as the president keeps claiming? Good luck on that one, too. In this article we offer a run-down of seven falsehoods we've taken on recently, with some additional updating and research thrown in.
False: Government Decides What Care I Get (a.k.a. they won't give grandma a hip replacement)
This untrue claim has its roots in the American Recovery and Reinvestment Act of 2009 (the stimulus bill), which called for the creation of a Federal Coordinating Council for Comparative Effectiveness Research. The council is charged with supporting and coordinating research that the government has been funding for years into which treatments work best, and in some cases, are most cost-effective. Supporters of this type of research say it can provide valuable information to doctors, improving care and also lowering cost. Betsy McCaughey, a former Republican lieutenant governor of New York (and now a professing Democrat), wrote in an opinion piece that the government would actually tell doctors what procedures they could and couldn't perform. The claim took off from there, popping up in chain e-mails and Republican press conferences. It's not true. The legislation specifically says that the council can't issue requirements or guidelines on treatment or insurance benefits:
At least, it isn't paid for yet. President Obama has repeatedly said that a health care overhaul "will be paid for" and that he won't sign a bill that isn't deficit-neutral. But neither the House bill nor the Senate HELP Committee bill meets that criteria. According to the nonpartisan Congressional Budget Office and Joint Committee on Taxation, the House bill as introduced would add a net $239 billion over 10 years to the deficit, while the HELP Committee bill racks up more, $597 billion over 10 years. Obama has also said he has "identified two-thirds of those costs to be paid for by tax dollars that are already being spent right now." But "identified" is the operative word. These savings are estimates and whether around $650 billion (about two-thirds of the cost of health care over 10 years) can be saved remains to be seen. Most of the money would come from Medicare, but cuts in payments to insurers and practitioners aren't popular measures that move easily through Congress. So the big questions remain. Will the president break his promise and sign a bill that piles up hundreds of billions of additional debt? Will the legislation have to be scaled back to cost less, and perhaps cover fewer of the uninsured? Who will pay additional taxes? Can pain-free reductions in other government programs be found?
In July, Investor's Business Daily published an editorial in which it claimed that H.R. 3200 would make private insurance illegal. But IBD was mistaken. It was citing the part of the bill that ensures people with individually purchased coverage don't have to give up that coverage unless they want to. Under the House bill, people who want to buy new individual, nongroup coverage will have to purchase it through a new health insurance exchange. They can still buy private insurance – the exchange, in fact, would offer a range of private plans, in addition to a new federal health insurance option. However, those who were already buying their own insurance before the bill went into effect – about 14 million Americans – will have their plans grandfathered in. The part of the bill IBD cites doesn't forbid insurers from issuing new plans. It says that new individual plans will not be considered grandfathered, and will have to be purchased through the exchange.
False: The House Bill Requires Suicide Counseling
This claim is nonsense. In an appearance on former Sen. Fred Thompson's radio show, McCaughey also enthusiastically pushed the bogus claim that the House bill will require seniors to have regular counseling sessions on how to end their lives:
Proponents speak constantly of holding down rising medical costs. As recently as May 13, the president said legislation plus some voluntary measures by the private sector "could save families $2,500 in the coming years – $2,500 per family," echoing a claim he made countless times on the campaign trail last year. Don't start spending that $2,500 just yet. For one thing, Obama isn't actually promising to reduce health care spending below current levels, only to cut the rate of growth in spending. And even that is proving to be far tougher to accomplish than Obama led voters to believe. We've already mentioned that the Congressional Budget Office says "savings" in Medicare spending resulting from the House bill would fall short of what is needed to pay for two-thirds of its cost, which is Obama's goal. And those savings come only in what the government pays, not in what families pay. Squeezing more savings, even from Medicare, is proving difficult. On July 17, Obama's lead man on the subject, Office of Management and Budget Director Peter Orszag, wrote to congressional leaders seeking legislation setting up an independent agency, the Independent Medicare Advisory Council (IMAC). It would be made up of health care experts with the power to make a package of annual changes in the amounts Medicare would pay to doctors. The president must either approve or disapprove the entire package as offered; if he approves, it goes into effect unless Congress passes a joint resolution stopping it. But when CBO took a look, it estimated that the new agency would save a total of only $2 billion over the next decade. As for saving $2,500 for families, as opposed to saving money for the government, the CBO's letter, signed by Director Douglas W. Elmendorf, said:
As an example of the "fundamental" changes that might do the trick: CBO suggested moving away from the current system of paying doctors and hospitals for performing medical procedures and paying them instead a fixed fee per patient or some other payment based on "value." Another CBO suggestion: "higher cost-sharing requirements." So far we don't see those ideas in the bills being considered.
False: Medicare Benefits Will Be Slashed
The claim that Obama and Congress are cutting seniors' Medicare benefits to pay for the health care overhaul is outright false, though that doesn't keep it from being repeated ad infinitum. The truth is that the pending House bill extracts $500 billion from projected Medicare spending over 10 years, as scored by the Congressional Budget Office, by doing such things as trimming projected increases in the program's payments for medical services, not including physicians. Increases in other areas, such as payments to doctors, bring the net savings down to less than half that amount. But none of the predicted savings – or cuts, depending on one's perspective – come from reducing current or future benefits for seniors. The president has promised repeatedly that benefit levels won't be reduced, reiterating the point recently in Portsmouth, N.H.:
AARP: Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.
One Republican congressman issued a press release claiming that "5,600,000 Illegal Aliens May Be Covered Under Obamacare," and we've been peppered with queries about similar claims. They're not true. In fact, the House bill (the only bill to be formally introduced in its entirety) specifically says that no federal money would be spent on giving illegal immigrants health coverage:
H.R. 3200: Sec 246 — NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS
Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the
Also, under current law, those in the country illegal don't qualify for federal health programs. Of interest: About half of illegal immigrants have health insurance now, according to the nonpartisan Pew Hispanic Center, which says those who lack insurance do so principally because their employers don't offer it.
Congressional Budget Office. Letter to Rep. Charles B. Rangel. 17 Jul 2009.
Agency for Healthcare Research and Quality. "Advance Care Planning: Preferences for Care at the End of Life." Mar 2003.
"AARP Responds to Health Reform Scare Tactics." Press release. AARP 24 Jul 2009.
Keyserling, Jon. Interview with FactCheck.org 29 Jul 2009.
Patient Self-Determination Act. 42 USC 1395cc.
Collins, Sara. Interview with FactCheck.org. 21 Jul 2009.
"It's Not an Option." Editorial. Investor's Business Daily. 15 Jul 2009.
Orszag, Peter. Letter to House Speaker Nancy Pelosi. Office of Management and Budget. 17 Jul 2009.
Congressional Budget Office. Letter to Rep. Steny Hoyer. 25 Jul 2009.