Steve GannMyths and Truths About The Health Care Reform Bill
March 23rd 2010 05:35
Hat tip to firedoglake.com for the fact sheet.
1. This is a universal health care
bill.
The bill is neither universal health care nor
universal health insurance.
Per the CBO:
• Total uninsured in 2019 with no bill: 54 million
• Total uninsured in 2019 with Senate bill: 24
million (44%)
2. Insurance companies hate this
bill
This bill is almost identical to the plan written by
AHIP, the insurance company trade association, in
2009.
The original Senate Finance Committee bill was
authored by a former Wellpoint VP. Since Congress
released the first of its health care bills on October 30,
2009, health care stocks have risen 28.35%
3. The bill will significantly bring
down insurance premiums for
most Americans
The bill will not bring down premiums significantly,
and certainly not the $2,500/year that the President
promised.
Annual premiums in 2016, status quo / with bill:
Small group market, single: $7,800 / $7,800
Small group market, family: $19,300 / $19,200
Large Group market, single: $7,400 / $7,300
Large group market, family: $21,100 / $21,300
Individual market, single: $5,500 / $5,800*
Individual market, family: $13,100 / $15,200*
4. The bill will make health care
affordable for middle class
Americans.
The bill will impose a financial hardship on middle
class Americans who will be forced to buy a
product that they can’t afford to use.
A family of four making $66,370 will be forced to pay
$5,243 per year for insurance. After basic necessities,
this leaves them with $8,307 in discretionary income
— out of which they would have to cover clothing,
credit card and other debt, child care and education
costs, in addition to $5,882 in annual out-of-pocket
medical expenses for which families will be
responsible.
5. This plan is similar to the
Massachusetts plan, which makes
health care affordable.
Many Massachusetts residents forgo health care
because they can’t afford it.
A 2009 study by the state of Massachusetts found that:
• 21% of residents forgo medical treatment
because they can’t afford it, including 12% of
children
• 18% have health insurance but can’t afford to
use it
6. This bill provides health care to
31 million people who are currently
uninsured.
This bill will mandate that millions of people who
are currently uninsured must purchase insurance
from private companies, or the IRS will collect up
to 2% of their annual income in penalties. Some
will be assisted with government subsidies.
7. You can keep the insurance you
have if you like it.
The excise tax will result in employers switching to
plans with higher co-pays and fewer covered
services.
Older, less healthy employees with employer-based
health care will be forced to pay much more in out-ofpocket
expenses than they do now.
8. The “excise tax” will encourage
employers to reduce the scope of
health care benefits, and they will
pass the savings on to employees
in the form of higher wages
There is insufficient evidence that employers pass
savings from reduced benefits on to employees.
9. This bill employs nearly every
cost control idea available to bring
down costs
This bill does not bring down costs and leaves out
nearly every key cost control measure, including:
• Public Option ($25-$110 billion)
• Medicare buy-in
• Drug reimportation ($19 billion)
• Medicare drug price negotiation ($300 billion)
• Shorter pathway to generic biologics ($71
billion)
10. The bill will require big
companies like WalMart to provide
insurance for their employees
The bill was written so that most WalMart
employees will qualify for subsidies, and taxpayers
will pick up a large portion of the cost of their
coverage.
11. The bill “bends the cost curve”
on health care.
The bill ignored proven ways to cut health care
costs and still leaves 24 million people uninsured,
all while slightly raising total annual costs by $234
million in 2019.
“Bends the cost curve” is a misleading and trivial claim,
as the US would still spend far more for care than
other advanced countries.
In 2009, health care costs were 17.3% of GDP.
Annual cost of health care in 2019, status quo:
$4,670.6 billion (20.8% of GDP)
Annual cost of health care in 2019, Senate bill:
$4,693.5 billion (20.9% of GDP)
12. The bill will provide immediate
access to insurance for Americans
who are uninsured because of a
pre-existing condition
Access to the “high risk pool” is limited and the
pool is underfunded. It will cover few people, and
will run out of money in 2011 or 2012
Only those who have been uninsured for more than six
months will qualify for the high risk pool. Only 0.7% of
those without insurance now will get coverage, and the
CMS report estimates it will run out of funding by 2011
or 2012.
13. The bill prohibits
dropping people in individual
plans from coverage when they get
sick.
The bill does not empower a regulatory body to
keep people from being dropped when they’re
sick.
There are already many states that have laws on the
books prohibiting people from being dropped when
they’re sick, but without an enforcement mechanism,
there is little to hold the insurance companies in check.
14. The bill ensures consumers
have access to an effective internal
and external appeals process to
challenge new insurance plan
decisions.
The “internal appeals process” is in the hands of
the insurance companies themselves, and the
“external” one is up to each state.
Ensuring that consumers have access to “internal
appeals” simply means the insurance companies have
to review their own decisions. And it is the
responsibility of each state to provide an “external
appeals process,” as there is neither funding nor a
regulatory mechanism for enforcement at the federal
level.
15. This bill will stop insurance
companies from hiking rates 30%-
40% per year.
This bill does not limit insurance company rate
hikes. Private insurers continue to be exempt from
anti-trust laws, and are free to raise rates without
fear of competition in many areas of the country.
16. When the bill passes, people
will begin receiving benefits under
this bill immediately
Most provisions in this bill, such as an end to the
ban on pre-existing conditions for adults, do not
take effect until 2014.
Six months from the date of passage, children could
not be excluded from coverage due to pre-existing
conditions, though insurance companies could charge
more to cover them. Children would also be allowed to
stay on their parents’ plans until age 26. There will be
an elimination of lifetime coverage limits, a high risk
pool for those who have been uninsured for more than
6 months, and community health centers will start
receiving money.
17. The bill creates a pathway for
single payer.
Bernie Sanders’ provision in the Senate bill does
not start until 2017, and does not cover the
Department of Labor, so no, it doesn’t create a
pathway for single payer.
Obama told Dennis Kucinich that the Ohio
Representative’s amendment is similar to Bernie
Sanders’ provision in the Senate bill, and creates a
pathway to single payer. Since the waiver does not
start until 2017, and does not cover the Department of
Labor, it is nearly impossible to see how it gets around
the ERISA laws that stand in the way of any practical
state single payer system.
18 The bill will end medical
bankruptcy and provide all
Americans with peace of mind.
Most people with medical bankruptcies already
have insurance, and out-of-pocket expenses will
continue to be a burden on the middle class.
• In 2009, 1.5 million Americans declared
bankruptcy
• Of those, 62% were medically related
• Three-quarters of those had health insurance
• The Obama bill leaves 24 million without
insurance
• The maximum yearly out-of-pocket limit for a
family will be $11,900 (PDF) on top of
premiums
• A family with serious medical problems that
last for a few years could easily be financially
crushed by medical costs
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