More Spurious Claims about Health Reform

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By Consumers Union on Monday, August 10th, 2009

Factually incorrect claims about the bill

You may have seen an email circulating that would make good fodder for Snopes.com, but the fact checkers over there haven’t gotten to this one yet. It looks like it “must be true” because it cites page numbers for its claims. I guess they thought no one would actually check. But quite a few people are checking, and the fabrications stack pretty high. So high, in fact, that we’ve only debunked the claims we know matter a lot to you. Here’s our analysis (based on the Energy and Commerce bill of July 14th).

For an additional fact checkers’ take, PolitiFact (a project of the St. Petersburg Times) did a very good review. The folks over at Healthcare for All have responded to every single point, so check here if you want to learn their response to a particular item not listed here. Or please, take a look at the bill for yourself.

Here’s an AARP overview. Consumer Reports has already debunked the widely circulated myth that health reform will mandate counseling for seniors about “how to end their life sooner.” So on to the other misleading or actually false statements.

• Page 42: The ‘Health Choices Commissioner’ will decide health benefits for you. You will have no choice. None.
Well, that’s not true at all. It appears that, on page 42, the bill says that the Health Choices Commissioner will review and approve health plans to make sure they meet some new standards. They can’t be “junk insurance” (something Consumer Reports has discussed extensively); they don’t exclude people with pre-existing conditions; and they have a way for you to fight for your benefits if the insurance company denies your claim. Does that mean someone is deciding your benefits? No. Does it mean that there’s a minimum standard beneath which insurance companies cannot go? Yes.

• Page 29: Admission: your healthcare will be rationed! False. As noted above, the bill makes insurance companies sell you plans that will actually benefit you when you get sick. Within these basic rules, there will be lots of different plans available from which to choose. The bill has no provisions that would ration or limit treatment. Quite the contrary. It holds all insurance companies, which, as you probably know, already ration your care and deny you benefits based on fine print exclusions, to a higher standard.

• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process). Wow, this one is a whopper. The bill does (on page 30) create a Health Benefits Advisory Committee to finalize the minimum and enhanced benefit plans, but the Committee is not deciding what treatments you will get. The bill is very clear (starting on page 27) that everyone will get hospitalization, outpatient hospital and clinic services, emergency services, doctor and specialist services at home and in offices or hospitals, prescription drugs, rehab services, preventive services, maternity and well baby care, and dental and vision for children. Today, your health insurance plan does not have to provide these basic services, and you may find after you purchase it that your needs are not met. That’s the kind of rationing the bill will eliminate.

• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services. False. Just like now, anyone will be able to purchase health insurance from private insurance companies, but insurance companies won’t be able to deny people based on their age, where they live, their credit record or any other “personal characteristics extraneous to the provision of high quality healthcare or related services.” If you are undocumented, you will not be eligible for the discounts that will help millions of others purchase insurance at affordable rates. Here’s the exact language. “Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.” Its on page 143.

• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange. Finally, something on the list is true! This is one of the key reforms. If insurance companies get to keep doing what they’ve been doing, we don’t actually solve any of the problems that today lead people to ration their own care (not go to doctors, avoid preventive visits, cut pills in half and more) or drive them into bankruptcy.

• Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Healthcare plan. Back to falsehoods. The Health Choices Commissioner must publicize all the options in the healthcare exchange and may privatize some of this public education by working with “other appropriate entities to facilitate the dissemination of information.” The mental leap to ACORN or Americorps is entirely in the imagination of the writer of these falsehoods. We fully expect this will work much as Medicare Advantage does now. Medicare itself provides information, but so do networks of insurance agents, nonprofit policy groups and many others.

• Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter. Yikes, this is completely untrue. If you qualify for Medicaid, you will be automatically enrolled only if you have “not elected to enroll in an Exchange-participating health benefits plan.” That means people who do qualify for Medicaid (and therefore will also qualify for significant discounts on the cost of private coverage) will end up in Medicaid only if they choose that option. In general, we find that any claim that you will lose choices should be viewed skeptically. Opponents know that loss of choice is a major concern for families, and the authors of this bill know that too. The bill is designed to increase and improve your choices, not limit them.

• Page 124: No company can sue the government for price-fixing. No “judicial review” is permitted against the government monopoly. Put simply, private insurers will be crushed. This one takes some mental gymnastics to get from the rate setting process to the crushing of private insurance companies, but it is in a small part true. Doctors won’t be able to sue for higher fees from the public plan–although the fees seem to be set plenty high enough. The bill says doctors who currently participate in Medicare (most doctors do so) will automatically be able to get payments from the public plan option, and they will get paid more. That’s just common sense. The public plan will only serve you well if your doctor will accept payment from it. And Medicare is the highly contested “floor” for what many doctors deem the minimum acceptable rate. The public plan will actually pay more than that, to ensure full participation. To encourage better care for the dollar, the plan may also create some payment incentives to encourage preventive care and improved management of chronic diseases like diabetes. Why private insurance companies will be crushed under this scenario, when they can do all these same things in a presumably more efficient and business like way eludes us. One clarification, discounts available under the proposal will apply to private and public plans alike to make sure there’s a level playing field on price–the key factor for many families. We’ve blogged on this larger argument here.

There’s a LOT more of this stuff, but I think this gives you an idea of its veracity. We want to follow up on any claims you’ve heard that still bother you, so please add your comments. If you want to know what something means on a particular page, or how a particular section might affect your coverage, take a moment to ask your question. We’ll be keeping an eye here and try to respond, but we want to make sure our response is perfectly accurate so if you don’t see a response right away, check back later. We will respond to similar questions only once.

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