AAN's Bogus Attack On Health Care Reform Is A Complete "Mess"

October 25, 2010 7:19 pm ET

Norm Coleman's American Action Network has set the standard for deceptive advertising this election season, and the organization's latest ad against Rep. Chris Murphy (D-CT) is no exception. In attacking Murphy's support of the Affordable Care Act, AAN's attacks range from the ludicrous to the flat-out false. Contrary to AAN's assertions, the law does not provide "free health care for illegal immigrants," "jail time for anyone without coverage," or $500 billion in cuts to Medicare. Likewise, AAN's attempts to scare voters about higher premiums and increased government intervention ring hollow.

American Action Network: "Murphy Healthcare Mess"

A government health care mess thanks to Nancy Pelosi and Chris Murphy. $500 billion in Medicare cuts, free health care for illegal immigrants, thousands of new IRS agents, jail time for anyone without coverage, and now a 47 percent increase in Connecticut health care premiums. 47 percent! Call Chris Murphy. Tell him to repeal his government health care mess. American Action Network is responsible for the content of this advertising.

Health Care Reform Explicitly Excludes Undocumented Immigrants...

Washington Post: Affordable Care Act "Goes Out Of Its Way To Exclude" Unauthorized Immigrants. From the Washington Post:

President Obama's health law has brought the Democrats closer than ever to achieving their dream of universal coverage, with their plan predicted to insure some 95 percent of Americans who are legally in the country. But even if everything goes according to plan, there will still be some who will face major barriers to accessing coverage -- including groups that the Affordable Care Act goes out of its way to exclude.

As the AP points out today, there are about 7 million unauthorized immigrants who will be prohibited from buying insurance on the newly created exchanges, even if they pay out of their own pocket. And the exclusion of this group from health reform -- along with other restrictions that affect fully legal immigrants as well -- could create a massive coverage gap that puts a strain on the rest of the health system as well.

[Washington Post, 5/5/10]

...Does Not Dramatically Increase The Size Of The IRS...

FactCheck.org: Claim That IRS Will Add Thousands Of Agents "Based On Guesswork And False Assumptions." According to FactCheck.org:

Q: Will the IRS hire 16,500 new agents to enforce the health care law?

A: No. The law requires the IRS mostly to hand out tax credits, not collect penalties. The claim of 16,500 new agents stems from a partisan analysis based on guesswork and false assumptions, and compounded by outright misrepresentation.

This wildly inaccurate claim started as an inflated, partisan assertion that 16,500 new IRS employees might be required to administer the new law. That devolved quickly into a claim, made by some Republican lawmakers, that 16,500 IRS "agents" would be required. Republican Rep. Ron Paul of Texas even claimed in a televised interview that all 16,500 would be carrying guns. None of those claims is true. [FactCheck.org, 3/30/10; emphasis original]

...And Will Not Lead To Jail Time For Those Who Don't Buy Insurance

Taxpayers Will NOT Be Subject "To Any Criminal Prosecution" For Failing To Buy Health Care Insurance. According to the non-partisan PolitiFact.com:

Neither the initial health care bill introduced in the House (H.R. 3200) nor the one that passed the House in November 2009 (H.R. 3962) had specific language ruling out prison for those who failed to pay penalties for not having health insurance. However, many experts considered the likelihood of prison time remote. On Sept. 29, 2009 -- at a time when H.R. 3200 was the only detailed health care bill under consideration in either chamber -- PolitiFact concluded that "the notion that one could go to prison for not buying insurance is certainly attention-grabbing, but based on past patterns of prosecution, the likelihood of it happening is extremely small."

Even that slight chance disappeared after the Senate got involved. The outline of a bill introduced on Sept. 16, 2009, by Senate Finance Chairman Max Baucus, D-Mont., didn't specify how penalties would be enforced but by the time the measure had made it into official language and been passed by his committee on Oct. 19, 2009, it included the following provision: "In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure."

That provision made it into the bill passed by the Senate in December 2009, and also into the final version of the law that was passed by both chambers and signed by President Barack Obama. [PolitiFact.com, 4/13/10; emphasis added]

Premiums Remain The Same For Existing Plans In Connecticut, While New Plans Add "Robust New Benefits"

CT Insurance Commissioner: Individuals Already Enrolled In Aetna And Anthem Plans Will Not See A Rate Increase. According to NBC/Connecticut: "[Insurance Commissioner Thomas] Sullivan responded to [a letter sent by Attorney General Richard] Blumenthal saying the new rates included 'very rich benefits' mandated by federal law. 'There is not one person in the state of Connecticut who will see an increase in their current premiums based on what the department approved for Anthem and Aetna,' Sullivan said in a release. ... People who were enrolled in the Anthem program prior to the increase will not see a change, according to the agency. The increased rates will be applied to new customers." [NBC/Connecticut, 10/15/10; emphasis added]

Not All Plans Will See A 47% Increase. According to NBC/Connecticut: "The new rates took effect Oct. 1, and include increases from 19 percent all the way to 47 percent depending on the individual, the Hartford Courant reported." [NBC/Connecticut, 10/15/10]

Anthem Spokeswoman: Plans Compliant With The Affordable Care Act "Include Expanded Benefits." According to the Hartford Courant's Insurance Capital blog:

In terms of higher rates, Anthem spokeswoman Sarah Yeager attributed the rising price to robust new benefits which the plans hadn't offered before federal reform.

"Our [Patient Protection and Affordable Care Act] compliant individual products include expanded benefits such as elimination of lifetime dollar maximums, no cost share for preventive coverage, and extension of dependent coverage to age 26. With this enhanced coverage, pricing levels have also been adjusted to make sure that the cost of claims incurred is offset by the premiums collected, and that we anticipate the cost of future, expected claims. Low cost low benefit plans experienced a higher rate adjustment because with the health care reform provisions the plans now offer richer benefits. Other plans that already offered rich benefits did not experience as much of an adjustment." [Hartford Courant, 10/14/10; emphasis added]

Insurance Premiums For Most Americans Will Stay The Same Or Decrease Under The Affordable Care Act

PolitiFact: "For Most People, Premiums Would Stay About The Same, Or Slightly Decrease." According to PolitiFact.com: "The CBO reported that, for most people, premiums would stay about the same, or slightly decrease. This was especially true for people who get their insurance through work. (Health policy wonks call these the large group and small group markets.) People who have to go out and buy insurance on their own (the individual market) would see rates increase by 10 to 13 percent. But more than half of those people -- 57 percent, in fact -- would be eligible for subsidies to help them pay for the insurance. People who get subsidies would see their premiums drop by more than half, according to the CBO. So most people would see their premiums stay the same or potentially drop." [PolitiFact.com, 1/27/10; emphasis added]

PolitiFact: 10-13% Premium Increase Is For Individual, Subsidized Market. According to PolitiFact.com: "People who have to go out and buy insurance on their own (the individual market) would see rates increase by 10 to 13 percent. But more than half of those people -- 57 percent, in fact -- would be eligible for subsidies to help them pay for the insurance. People who get subsidies would see their premiums drop by more than half, according to the CBO. So most people would see their premiums stay the same or potentially drop." [PolitiFact.com, 1/27/10]

Washington Post's Ezra Klein: Analysis Assumes People Will Buy Better Insurance, "Premiums For The Same Policy...Fall By 14 To 20 Percent." According to the Washington Post's Ezra Klein, in his analysis of the CBO report:

The confusion comes in the CBO's analysis of the individual market, which serves about a tenth of the population. CBO expects prices in the individual market to rise by 10 or 12 percent, an expectation driven entirely by predictions that individuals will purchase policies that are much more comprehensive, and thus somewhat more expensive, then the insurance they can afford now. Then the CBO turns to look at the impact of the subsidies, which will cut premium costs by a bit over 50 percent for a bit over 50 percent of the market.

But as the CBO explains on page five, part of the increase in the type of insurance being purchased is the result of "people's decisions to purchase more extensive coverage in response to the structure of subsidies." In other words, the change is driven by the subsidies, not offset by them.

To see this more clearly, imagine that the University of Florida decided to give incoming students who receive financial aid an $800 credit to purchase a laptop computer. You'd expect that the average computer purchased by students on financial aid would become a bit more expensive. But that wouldn't be because computers had become more expensive. It would be because people now had money to buy better computers.

So too for health-care reform. Premiums for the same policy in the individual market fall by 14 to 20 percent. But people in the individual market, who are largely low-income, will now have the opportunity to purchase better policies that cover more expenses and provide more security. That's a good thing. It's one of the reasons for health-care reform, in fact. And it is not analogous to health-care insurance becoming more expensive, any more than the fact that I could buy a nicer car after getting a better job suggests that cars are becoming more expensive. [Washington Post, 12/1/09; emphasis added]

The Affordable Care Act Strengthens Medicare Without Cutting Benefits

FactCheck.org: Cost Saving Provisions "Not A Slashing Of The Current Medicare Budget Or Benefits." According to FactCheck.org, "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." [FactCheck.org, 3/19/10]

Changes To Medicare Advantage Come With Extra Benefits For All Medicare Enrollees. FactCheck.org reported: "The CBO has estimated that the move would change the value of the extra benefits Medicare Advantage participants get, but they would not receive fewer benefits than the rest of seniors who aren't on the Advantage plans. The bill does add some extras for Medicare beneficiaries, eliminating copays and deductibles for preventive services, for example." [FactCheck.org, 12/2/09; emphasis added]

Health Care Reform "Will Keep Paying Medical Bills For Seniors." According to PoliFact.com: "The government-run Medicare program will keep paying medical bills for seniors, but it will begin implementing cost controls on health care providers, mostly through penalties and incentives. The legislation would reduce payments for hospital-acquired infections or preventable hospital admissions. For Medicare Advantage, the federal government intends to reduce extra payments, taking away subsidies to private insurance companies. Insurers will likely cut benefits in order to not lose profits. The bill does not address the 'doctor's fix,' an expected proposal that Congress usually passes to prevent doctors' Medicare payments from severe cuts." [PoliFact.com, 3/18/10; emphasis in original]

Health Care Reform Fills The "Doughnut Hole." According to the Kaiser Family Foundation: "In 2010, Part D enrollees with any spending in the coverage gap will receive a $250 rebate. Beginning in 2011, enrollees with spending in the coverage gap will receive a 50 percent discount on brand-name drugs, provided by the pharmaceutical industry. The law phases in Medicare coverage in the gap for generic drugs beginning in 2011, and for brand-name drugs beginning in 2013. By 2020, Part D enrollees will be responsible for 25 percent of the cost of both brands and generics in the gap, down from 100 percent in 2010." [Kaiser Family Foundation, accessed 8/25/10]

Health Care Reform Improves Medicare's Coverage Of Preventive Benefits. According to the Kaiser Family Foundation: "Beginning in 2011, no coinsurance or deductibles will be charged in traditional Medicare for preventive services that are rated A or B by the U.S. Preventive Services Task Force (USPSTF). Medicare will cover a free annual comprehensive wellness visit and personalized prevention plan." [Kaiser Family Foundation, accessed 8/25/10]

Click HERE for details on the trillions of dollars Republicans have voted to cut from Medicare.

Medicare "Cuts" Are Actually Savings From Phasing Out "Substantial Overpayment" To Medicare Advantage

CBO: Cost Changes To Medicare Made From Savings. According to the Congressional Budget Office: "Changes to the Medicare program and changes to Medicaid and CHIP other than those associated directly with expanded insurance coverage: Savings from those provisions are estimated to total $93 billion in 2019, and CBO projects that, in combination, they will increase by 10 percent to 15 percent per year in the next decade." [CBO.gov, 10/7/09]

New England Journal of Medicine: The Affordable Care Act Phases Out "Substantial Overpayments" To Medicare Advantage Plans. From the New England Journal of Medicine:

A phased elimination of the substantial overpayments to Medicare Advantage plans, which now enroll nearly 25% of Medicare beneficiaries, will produce an estimated $132 billion in savings over 10 years.

[...]

The ACA also produces nearly $200 billion in savings by assuming that providers can improve their productivity as firms in other industries have done. On the basis of this presumed improvement, the law reduces Medicare's annual "market basket" updates for most types of providers - a provision that has generated controversy. [New England Journal of Medicine7/8/10]

Cuts Would Only Affect Medicare Advantage Plans. As reported by Kaiser Health News:

The new health law will cut $136 billion in spending on the Advantage program by 2019, which currently pays private plans to administer Medicare benefits and pays them about 14 percent more than the per-patient cost of the traditional Medicare program. Plans use that subsidy to lure members with lower premium costs or extra benefits not normally paid for by Medicare, such as vision care or better prescription drug coverage. Some Democrats and analysts have argued the higher rates are wasteful. 

Even experts who support the change concede that the impact of the cuts could be evident. Robert Berenson, a scholar at the Urban Institute and former Medicare official, said some Advantage plan members will notice skimpier benefits, "but the Republicans have really exaggerated that this will wipe out the Advantage plans." 

Marsha Gold, a health policy analyst for the private research group Mathematica, said, "Over time, there will be less rich benefits or higher premiums, but it's going to be gradual," noting that the largest cuts do not begin until 2015. 

[Kaiser Health News, 4/6/10]

Medicare Advantage Costs Taxpayers 14% More Than Traditional Medicare. As reported by PolitiFact.com:

Let's back-up for a minute and explain Medicare Advantage: There are two basic ways most people get Medicare coverage. They enroll in traditional Medicare and a prescription drug plan through the government and maybe buy a supplemental policy to cover most out-of-pocket costs. Or they enroll in Medicare Advantage programs (they include drug plans), which are run by private insurers. Medicare Advantage programs typically have more generous benefits such as dental and vision coverage. Some plans even pay the patient's monthly Medicare premium, which can amount to about $100.

The Medicare Advantage program was intended to bring more efficiency from the private sector to the Medicare program, but it hasn't worked as planned. A June 2009 analysis from the Medicare Payment Advisory Commission said that the Advantage programs costs taxpayers on average of 14 percent more than the traditional Medicare plan. President Barack Obama has said repeatedly that the Medicare Advantage plan wastes public money that could be put to better use.

[PolitiFact.com, 9/20/10]

The "Government Health Care Mess" Actually Leaves The Private System In Place

PolitiFact: "Obama's Plan Leaves In Place The Private Health Care System." Analyzing Sen. Tom Coburn's claim that President Obama's health care reform plan amounted to a government takeover of health care, PolitiFact.com wrote:

[H]e's wrong that Obama's plan offers government-run health care.

In fact, Obama's plan leaves in place the private health care system, but seeks to expand it to the uninsured. It increases eligibility for the poor and children to enroll in initiatives like Medicaid and the State Children's Health Insurance Program, and creates pools for individuals to buy their own cheaper insurance. It also outlines strategies to rein in costs for everyone, such as electronic medical records and preventive care.

[...]

That may be Sen. Coburn's opinion on what could happen, but it's definitely not part of Obama's plan. And Coburn was very specific in saying that "under the Obama plan, all the health care in this country is eventually going to be run by the government." That gives the incorrect impression that Obama is promoting a government-run health care system. He's not. We rate Coburn's statement False.

[PolitiFact.com, 3/4/10, emphasis added]

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