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Myth vs. Fact on Health Reform |
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A Dose of Reality:
Myth vs. Fact on Health Reform
GOP MYTH: Health reform means fewer choices for Americans.
FACT: The House proposal will increase choice among an array of high-quality private and public health insurance options. Most importantly, if you like what you have, you can keep it. More Americans will have access to greater choices in doctors and plans by taking away the insurance industry's ability to deny coverage and care.
GOP MYTH: Health reform means bureaucrats will ration health care.
FACT: The House proposal will expand and improve the availability of quality health care for all Americans, not ration it. Under this proposal, doctors, nurses and patients will make medical decisions, not big insurance companies or the government. Republicans content with the status quo want to leave patients at the mercy of big insurance companies that make decisions to protect profits not patients.
GOP MYTH: Health reform means raising taxes, or making coverage more expensive.
FACT: Under the status quo, middle-class families pay an enormous “hidden tax” of nearly $1,100 per year to provide care for the uninsured and underinsured. The House proposal will end this tax by containing overall costs and expanding access to affordable care for all Americans. Additionally, the House proposal invests in reforms to contain the costs of health insurance overburdening businesses, families and the federal deficit. Republicans can either continue to be the “Party of No” and defend the status quo that is costing American families and businesses more every year, or they can be part of the solution.
GOP MYTH: Health reform means Americans will be forced out of their current plans.
FACT: The House proposal builds on what works – the employer-based system – while giving every American the peace of mind of knowing that their health needs will be covered by insurance. No one will have to worry about being denied insurance based on a pre-existing condition, or being without coverage if their employer drops coverage, they lose their job, or change employers. Republicans make this claim based on a study of a proposal that is nothing like the House proposal.
GOP MYTH: Health reform means individuals will be forced to buy insurance they can't afford.
FACT: Millions of Americans cannot afford insurance today or are locked out of the system because of a pre-existing condition. The House proposal emphasizes shared responsibility among individuals, businesses and the government and helps make coverage affordable and available to all. Affordability credits will be available to help low- and moderate- income working families afford coverage, regardless of the plan they choose.
GOP MYTH: Health reform will force businesses to cut jobs and squeeze small businesses.
FACT: All businesses will benefit from insurance market reforms and a high performing health system that will reduce costs of health care. The status quo is unsustainable for businesses. Under the House proposal, employers will continue to offer their employees health care or contribute towards coverage. Certain very small businesses would be exempt from this requirement. With tax credits and a reformed market that ensures access to affordable coverage, small business owners and their employees will have new options to purchase affordable health insurance that are not available to them now.
GOP MYTH: Health reform that builds on Medicare and Medicaid will only hurt the programs' long-term sustainability, and cost state and federal governments more.
FACT: Health reform is a critical first step toward containing health care costs for business, individuals, and the federal government in Medicare and Medicaid. By eliminating wasteful overpayments to private plans under Medicare, reforming how doctors are reimbursed, and creating new incentives for coordinated, high quality care we will extend Trust Fund solvency and improve Medicare for generations to come.
Myth Vs. Fact On Republican Leader’s Op-Ed On Health Insurance Reform Legislation
July 22nd, 2009 by Office of the Speaker
On Monday, Republican Leader Boehner published an Op-Ed on Yahoo! on America’s Affordable Health Choices Act – the House health insurance reform bill. This Op-Ed contained many myths about the bill:
BOEHNER’S MYTH: More than 100 million Americans would be forced onto a government-run health plan under the House bill.
First of all, under our bill, no one can ever be “forced onto a government-run health plan.” Under our bill, the public health insurance plan is available to all those using the Exchange. All those using the Exchange will have a choice of options – various private plans, as well as the public plan. If an employer is providing their employees health insurance through the Exchange, it is the employee – not the employer – choosing the plan. (Under the bill, in the first two years of the Exchange, small employers may participate; in later years, the Administration has the discretion to permit larger employers to participate but there is no timeline for this participation.)
Second, the nonpartisan Congressional Budget Office predicts the number of Americans in private insurance plans will actually increase under the bill (rather than millions being forced out of private plans and into a public plan).
Thirdly, the nonpartisan CBO has estimated that, by 2019, about 9 or 10 million Americans – or 90 million fewer Americans than claimed by Republican Leader Boehner – will be enrolled in the public plan. CBO projects that two-thirds using the Exchange will choose a private plan – not the public plan. Even if more Americans end up choosing the public plan, it will be their choice – no one can force them into the plan.
BOEHNER’S MYTH: Millions of Americans would lose the employer-provided health care they have now, under the House bill.
The nonpartisan CBO has found that, under the bill, not only would millions of Americans not lose their employer-provided coverage, employer-provided coverage would actually increase. Specifically, the CBO projects that under the House bill, by 2019, 164 million people would be covered by employer-provided insurance, compared to 162 million under current law. The House bill builds on the current employer-provided health care system, rather than eroding it.
BOEHNER’S MYTH: The House bill makes cuts in Medicare that are damaging to seniors and takes away choices for millions of seniors.
The bill requires hospitals, doctors, and pharmaceutical companies to achieve key efficiencies and eliminate waste in Medicare (including eliminating overpayments that are driving up profits for Medicare Advantage plans) and toughens our ability to root out fraud and abuse – but does not make cuts that hurt seniors. It also does nothing to take away choices for seniors.
On the contrary, the bill includes several key provisions that improve Medicare benefits for seniors, including the following:
Phases in completely filling in the “donut hole” in the Medicare prescription drug benefit (where drug costs are not reimbursed at certain levels), potentially savings seniors thousands of dollars a year.
Eliminates co-payments and deductibles for preventive services under Medicare.
Limits cost-sharing requirements in Medicare Advantage plans to the amount charged for the same services in traditional Medicare coverage.
Improves the low-income subsidy programs in Medicare, such as by increasing asset limits for programs that help Medicare beneficiaries pay premiums and cost-sharing.
BOEHNER’S MYTH: The House bill does nothing to control health care costs.
To the contrary, the House bill includes numerous provisions to both achieve cost savings over the next 10 years, as well as to “bend the cost curve” over the long-term. First of all, according to the nonpartisan CBO, our bill achieves net savings in Medicare and Medicaid of $465 billion over the next 10 years. For example, these savings include:
$156 billion in savings by eliminating overpayments to private Medicare Advantage plans over 10 years;
$102 billion in savings by incorporating productivity adjustments into Medicare payment updates to hospitals; and
About $110 billion in savings by codifying the White House-PhRMA agreement and also requiring that drug companies provide rebates for individuals enrolled in Medicare and Medicaid that are at least as large as the Medicaid rebates that were provided prior to the enactment of Medicare Part D.
The bill includes numerous provisions to “bend the cost curve” over the long-term. These provisions are particularly aimed at changing the incentive structure so that instead of rewarding the quantity of care, we are rewarding the quality of care. These reforms – which will also improve care — include:
Promotes Accountable Care Organizations that provide for hospitals and doctors working together to manage and coordinate care;
Creates incentives to reduce preventable hospital readmissions that reward transition planning and coordination for patients.
Establishes pilot projects to test “bundling” payment methodology under which one payment would be made – rather than separate payments – to any combination of a physician, acute and post-acute providers.
Promotes “medical homes” where physicians and nurse practitioners focus on ensuring patient care is coordinated and comprehensive.
Promotes “shared decisionmaking” with physicians and patients, which has been shown to keep health care costs down and patients fully involved in their care.
The bill also includes numerous other provisions to control costs, such as provisions for improving payment accuracy in Medicare and Medicaid; significantly expanding investments in prevention and wellness programs; strengthening primary care; and investing in the health care workforce.
BOEHNER’S MYTH: The House bill pays for health care reform with a “small business tax” that will kill 1.6 million jobs.
Roughly half of the cost of the bill is paid for by achieving significant efficiencies and savings in Medicare and Medicaid; roughly the other half is paid for through a graduated surcharge on a portion of the income of the top 1%.
This graduated surcharge is not a “small business tax.” Only the wealthiest 1.2% of American households will pay the surcharge, on just a portion of their income.
This surcharge will have only a modest impact on America’s small business community. According to the nonpartisan Joint Committee on Taxation, only 4.1 percent of all small business owners would pay the surcharge, using the broadest definition of a small business owner (i.e., any individual with as little as $1 in small business income).
Of the 4.1 percent paying the surcharge, half earn less than one-third of their income from small businesses – not what we think of as truly “small business owners.”
Only 1.1 percent would pay the top rate – among them, hedge fund managers, private equity fund managers, lawyers and lobbyists making millions of dollars a year.
Finally, recent history contradicts the claim that a surtax on the wealthiest Americans kills jobs. Critics of President Clinton’s economic plan made this argument in the early 1990s. Subsequent history, however, contradicted this claim: average annual small business job growth was 2.3% in the Clinton years, when taxes on the wealthiest households were increased, and was 1.0% in the Bush years, when they were cut.
BOEHNER’S MYTH: The health care reforms in the House bill will add to the deficit.
On July 17, the CBO released estimates confirming that the health insurance reform policies in the bill are deficit-neutral over the 10-year budget window — even producing a $6 billion surplus. CBO estimated that the cost of the bill’s insurance reforms was $1.042 trillion, while the bill’s cost savings and revenues totaled $1.048 trillion. CBO estimated that these reforms will provide affordable coverage for 97 percent of Americans two years after the program starts.
As was reported in the press, CBO also estimated that the overall bill had a net cost of $239 billion over 10 years — but this is entirely due to additional provisions in the bill to maintain current Medicare physician payment rates, costing $245 billion over 10 years (by preventing scheduled draconian cuts.) The House agreed earlier this year that this $245 billion cost should be exempt from PAYGO. Indeed, maintaining current Medicare physician payment rates has bipartisan support. If Congress fails to act, physician payments under Medicare will be slashed by 21 percent on January 1st – which would likely result in millions of seniors losing access to their doctor.
Health Care Checkup: Wall Street Journal Health Care Editorial Wrong on the Facts
The Wall Street Journal ran an editorial yesterday that advanced false and misleading information regarding the House’s health reform bill, America’s Affordable Health Choices Act, (H.R. 3200).
While most Americans are satisfied with their health insurance coverage now, most Americans are concerned that they will either lose their insurance or face staggering increases in premiums, co-pays or other costs. The America’s Affordable Health Choices Act is about giving all American families more choices of quality, affordable health care and the peace of mind that they will be covered with quality, affordable care no matter of their job or economic situation.
Claim: Workers won’t be able to keep health coverage they like because Washington bureaucrats will change what employers can offer.
* In 2018, all employer-provided plans will have to meet the minimum standard benefit offered as part of the Exchange. These minimum benefits will be based on 70 percent of the typical health insurance plan offered by employers today.
* More than 90 percent of all employer health insurance plans already meet or exceed these standards. Employers that do not meet these minimum standards will have until 2018 to meet the minimum standards.
Claim: Analysis by the Lewin Group analysis shows that 88 million of Americans will be thrown off of their employer plans.
* The Lewin Group (a wholly-owned subsidiary of UnitedHealthcare) analysis was requested by the right-wing Heritage Foundation has been widely discredited for its flawed review of the House legislation.
* The House bill actually protects and increases employer-sponsored insurance. According to official CBO numbers, 2 million more people would be covered under employer-sponsored insurance than is projected to be the case today – 164 million compared to 162 under current law.
Claim: The House bill removes current law that prevents employee lawsuits over employer provided benefits.
* The legislation does not change current law regarding lawsuits.
Claim: High deductible plans and health savings accounts will be illegal under the House bill
* Nothing in the legislation prevents employers from offering health savings accounts. In fact, according to the nonpartisan Congressional Research Service, the average HSA today will meet or exceed the minimum benefits standards.
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