RNC Fact Sheet Omits The Facts

CBO Analysis Is Incomplete

CBO Director's Blog: CBO Analysis Is Incomplete.  According to the CBO Director's Blog on July 18, 2009: "The figures released yesterday do not represent a complete cost estimate for the legislation. In particular, the estimated impact of the provisions related to health insurance coverage is based on specifications provided by the committee staff, rather than on a detailed analysis of the legislative language." [CBOblog.CBO.gov, 7/18/09]

RNC Only Used Part Of CBO Director's Testimony

RNC: "But CBO Says Government-Run Health Care Won't Make 'Fundamental Changes' To Reduce Costs. 'Under questioning by members of the Senate Budget Committee, CBO director Douglas Elmendorf said bills crafted by House leaders and the Senate health committee do not propose 'the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount.' 'On the contrary,' Elmendorf said, 'the legislation significantly expands the federal responsibility for health care costs.' (Lori Montgomery, 'CBO Chief Criticizes Democrats' Health Reform Measures,' The Washington Post, 7/16/09)" [GOP.com, 7/21/09]

CBO Director: Long Term Projections Difficult To Predict Accurately.  During a question and answer period following his testimony in front of the Senate Budget Committee, CBO Director Douglas Elmendorf said: "But it is very hard to look out over a very long term and say very accurate things about growth rates.  So most health experts that we talk with focus particularly on what is happening over the next 10 or 20 years, still a pretty long time period for projections..." [Hearing on CBO Long-Term Budget Outlook, 7/16/09]

RNC Quotes An Editorial That Discounts Orszag's Full Opinion

RNC: "Obama's Budget Director Admits Government-Run Health Care Does Nothing To Reduce Costs. 'The rapidly rising cost of health care, Obama has said, is 'a threat to our economy' ... So a critical test of the health reform proposals lumbering through Congress is whether they defuse that bomb. The answer, so far, is no. That was the message ... Peter Orszag sent to the chairs of three House committees that released a 'discussion draft' of legislation last month ... As Mr. Orszag put it, 'Adopting a deficit-neutral health reform that expands coverage ... is not enough, because it would perpetuate a system in which best practices are far from universal and costs are too high.'' (Editorial, 'Health Care Savings,' The Washington Post, 7/13/09)" [GOP.com, 7/21/09]

Orszag: "The Legislation Does Not Include Some Important Things."  During an interview on FOX News Sunday with Chris Wallace, Director of the Office of Management and Budget Peter Orszag said: "Well, let's look at the facts here. President said yesterday he will not sign a bill that expands the deficit. Look at the report that came out from the Congressional Budget Office on Friday night with regard to the House legislation. Once you take into account the - just maintaining current payments for Medicare doctor - for doctors under Medicare, that bill is deficit neutral. Third point is the legislation does not include some important things that we'd like to put in place with regard to the fiscal trajectory after the first decade. For example, we have a proposal for an independent commission made up of doctors to help bring down costs over the long term." [FoxNews.com, 7/19/09]

RNC Uses Partial Paragraphs To Achieve The Numbers That Work Best For Them

RNC: "Obama Pledges Government-Run Health Care Will Not Add To Deficit. 'What I have said is I'm not going to add to the deficit. We have got to pay for whatever we're doing ...' (PBS's 'The Newshour With Jim Lehrer,' 7/20/09)" [GOP.com, 7/21/09]

RNC: "But CBO Says $1 Trillion Government-Run Health Care Plan Creates $219 Billion Deficit. "[E]nacting H.R. 3200 would result in a net increase in the federal budget deficit of $239 billion over the 2010-2019 period. That estimate reflects a projected 10-year cost of the bill's insurance coverage provisions of $1,042 billion, partly offset by net spending changes that CBO estimates would save $219 billion over the same period ..." (Douglas W. Elmendorf, 'Preliminary Analysis Of The Insurance Coverage Specifications Provided By The House Tri-Committee Group,' Letter To Chairman Rangel, 7/17/09)" [GOP.com, 7/21/09]

In Proper Context, The CBO Letter Paints A Much Different Picture

CBO: House Bill Would Increase Revenue By $83 Billion And Result In A $65 Billion Net Increase In The Federal Deficit Over Ten Years.  In its letter to Chairman Rangel, the Congressional Budget Office wrote: "According to CBO's and JCT's assessment, enacting H.R. 3200 would result in a net increase in the federal budget deficit of $239 billion over the 2010-2019 period.  That estimate reflects a projected 10-year cost of the bill's insurance coverage provisions of $1,042 billion, partly offset by net spending changes that CBO estimates would save $219 billion over the same period, and by revenue provisions that JCT estimates would increase federal revenues by about $583 billion over those 10 years.  By the end of the 10-year period, in 2019, the coverage provisions would add $202 billion to the federal deficit, CBO and JCT estimate.  That increase would be partially offset by net cost savings of $50 billion and additional revenues of $86 billion, resulting in a net increase in the deficit of an estimated $65 billion. It is important to note that the figures presented here do not represent a complete cost estimate for the coverage provisions of the legislation." [CBO.gov, 7/17/09; emphasis added]

RNC Perpetuates "Research" Conducted By An Insurance Industry-Funded Group And Commissioned By The Heritage Foundation

RNC: "Obama Promises Americans Can Keep Their Current Health Care Coverage. 'You know, the interesting thing is we've actually been very clear on what we want. I've said I want to make sure if you have health care are you going keep it ...' (PBS's 'The Newshour With Jim Lehrer,' 7/20/09)" [GOP.com, 7/21/09]

RNC: "But New Analysis Shows Over 88 Million People To Lose Current Insurance Under Government Health Care Takeover. 'Under current law, there will be about 158.1 million people who are covered under an employer plan as workers, dependents or early retirees in 2011. If the act were fully implemented in that year, about 88.1 million workers would shift from private employer insurance to the public plan.' (John Shelis, Vice President, Lewin Group, 'Analysis Of The July 15 draft Of The American Affordable Health Choices Act Of 2009,' 7/17/09)" [GOP.com, 7/21/09]

The Lewin Group Is Owned By Ingenix.  NPR reported that "the Lewin Group, [is] a number-crunching consulting group owned by Ingenix, which is a subsidiary of UnitedHealth Group." [NPR, All Things Considered, 6/10/09]

• UnitedHealth And Ingenix Used Skewed "Data To Under-Reimburse Its Own Policyholders." During testimony given during a Senate Commerce Committee hearing, John D. Rockefeller, IVA said: "Everywhere experts have looked at this data, they have found what statisticians call a 'downward skew' in the numbers. For ten years or even longer, this skewed data was used to stick consumers with billions of dollars that the insurance industry should have been paying. Ingenix markets two 'usual and customary' database products that every major payer in the health insurance industry used to calculate their reimbursement payments. Ingenix is a wholly-owned subsidiary of Mr. Hemsley's company, UnitedHealth Group. UnitedHealth not only owns Ingenix, but it also used the skewed Ingenix data to under-reimburse its own policyholders." [Commerce.Senate.gov, 3/31/09]

CBO: America's Affordable Health Choices Act Of 2009 Will Result In 37 Million Fewer Uninsured. According to page 6 of the CBO letter to Chairman Rangel, under "Current Law Coverage," by 2019, 162 million Americans will be covered by employer-based health coverage and 54 million Americans will be uninsured.  With the passage of the House bill, by 2019, 164 million Americans would be covered by their employer-based health coverage and the number of uninsured Americans would decrease by 37 million.  [CBO.gov, 7/17/09]

[CBO.gov, 7/17/09]

RNC Twists Article Discussing Payment Structure Into Bullet On The Doctor-Patient Relationship

RNC: "Obama Pledges Americans Can Keep Their Doctor. 'If you like your plan and you like your doctor, you won't have to do a thing. You keep your plan. You keep your doctor ... We're not going to mess with it.' (President Barack Obama, Remarks At White House Press Conference, The White House, 6/23/09)" [GOP.com, 7/21/09]

RNC: "Yet Hospitals Say Government-Run Health Care Will Force Doctors To Drop Patients. '[L]awmakers are on track to approve across-the-board federal payment reductions of $155 billion over 10 years for hospitals ... Mayo and similar health systems object to the sweeping cuts. 'Across-the-board cuts will be harmful to everyone and we think it is particularly bad to penalize the high-value organizations,' said Jeff Korsmo, executive director of the Mayo Clinic Health Policy Center. 'We will have to violate our values in order to stay in business and reduce our access to government patients.'" (Phil Galewitz, ''Model' Health Systems Press Case For Medicare Fix In Reform,' Kaiser Health News, 7/20/09)" [GOP.com, 7/21/09]

The Article Does Not Refer To Government-Run Health Care, It Is A Discussion Of The Possible Effects Of A Changed Payment System.

Additionally, The Same Article The RNC Used Said That "Integrated Health Systems," Like The Mayo Clinic, "Make Up Just A Sliver Of All The Nation's Hospitals."

Current Payment Structure Inefficient And Unlikely To Change Soon.  According to Kaiser Health News, "it's unlikely that Congress will restructure its payment system any time soon, experts say. One reason is that the integrated health systems pushing for a rejiggering make up just a sliver of all the nation's hospitals. Another is that most institutions aren't ready to be more financially tied to their doctors or fear a payment change would hurt them...In most communities, doctors work independently of their local hospitals and are paid by Medicare and most private insurers under fee-for-service arrangements. Hospitals, meanwhile, are typically reimbursed based on patients' diagnoses, so they get paid for doing less for each patient. The incentives are sometimes at cross purposes, and aren't based on how well patients do." [Kaiser Health News, 7/20/09]

And Yet Another Conservative "Research Document" With Citation Errors

RNC: "Obama Promises No Additional Taxes On Middle Class. 'What I've said is, and I have stuck to this point, I don't want to see additional tax burdens on people making $250,000 a year or less.' (NBC's 'Today Show,' 7/21/09)" [GOP.com, 7/21/09]

RNC: "Democrats' Plan Imposes 2.5% Tax On Uninsured Individuals. 'The penalty assessed on people who would be subject to the mandate but did not obtain insurance would equal 2.5 percent of the difference between their adjusted gross income (modified to include tax-exempt interest and certain other sources of income) and the tax filing threshold ...' (Douglas W. Elmendorf, 'Preliminary Analysis Of The Insurance Coverage Specifications Provided By The House Tri-Committee Group,' Letter To Chairman Rangel, 7/17/09)" [GOP.com, 7/21/09]

The letter from CBO Director Elmendorf on July 17, 2009 does not include the "quote" used by the RNC. The RNC bullet citation links to the following document: http://www.cbo.gov/ftpdocs/104xx/doc10464/hr3200.pdf

The CBO letter from Director Elmendorf to Chairman Rangel that contains that specific quote is from a July 14, 2009 letter, found here: http://www.cbo.gov/ftpdocs/104xx/doc10430/House_Tri-Committee-Rangel.pdf

CBO: Analysis Is Incomplete.  According to the July 14, 2009 letter: "The analysis presented here does not take into account other parts of the proposal that would raise taxes or reduce other spending...in an effort to offset the federal costs of implementing those coverage specifications." [CBO.gov, 7/14/09]