House Republicans plan to press forward Wednesday with their effort to repeal the health-care law enacted last year. They have the votes, so the bill’s passage is not in doubt. But the Democrats who control the Senate have no interest in following suit, and President Obama has pledged a veto. So this is mostly a symbolic act. But it’s an issue that comes with a number of popular myths that persist and are worth revisiting.
“This is a ‘government takeover’ of the health-care system.”
Republicans repeatedly use this snappy talking point to bash Obama’s crowning legislative achievement – but it is simply not true.
In many ways, the health-care law resembles the reform legislation that Massachusetts enacted in 2006 under then-Gov. Mitt Romney (a Republican and potential presidential rival of Obama in 2012). It builds on the existing private insurance system, adding requirements and incentives to ensure that most people have some form of health insurance.
Under the nation’s new law, the private system has no government alternative – this was a potential provision that was dropped during the congressional tussle.
The number of people who qualify for the existing federal-state Medicaid program for the poor will be expanded. States (or the federal government) will run “exchanges,” or marketplaces, in which private insurers will sell coverage to individuals and small businesses. But this should mean that more, not fewer, people will get private insurance. Tax credits will also be offered to people who have trouble buying private insurance.
Certainly, the law bolsters government regulation of the health-care system, such as forcing insurance companies to no longer deny coverage to people who have existing medical conditions. People who do not have insurance will be required to buy it. But the core of the health-care system in the United States will remain the private insurance market.
“Medicare benefits will be cut – and payments will be cut to Medicare doctors.”
This was another GOP attack line during the 2010 midterm campaign, though in many ways it was payback for the Democrats’ effective use of the same charge against Republicans in 1994, when they sought to restrain growth in Medicare spending.
The politically radioactive word “cut” is a misnomer. Under the health-care law, Medicare spending will continue to increase year after year, but at a slower pace than anticipated. Both parties, in theory, agree that this is a good thing. Medicare, the venerable government-run health-care plan for Americans older than 65, is one of the fastest-growing parts of the federal budget.
The health-care bill will cut projected Medicare spending by $575 billion over 10 years, primarily by lowering projected fees paid to hospitals and other providers and by reducing payments to private Medicare Advantage insurance plans. Benefits have also been added, eating into the overall projected savings, but the effect on the Medicare Advantage plans is unclear.
“A secretive government committee [‘death panels’] will be created to make end-of-life decisions about people on Medicare.”
This claim, first made by former Alaska governor Sarah Palin, has been thoroughly debunked. Yet it persists. A Kaiser Family Foundation poll in September found that 30 percent of seniors still believed this to be the case and that 22 percent were not sure – meaning that fewer than half knew the claim was false.
The charge stemmed from a proposed amendment to the bill that would have covered the cost of end-of-life planning discussions. Democrats quickly dropped the provision after the firestorm created by Palin’s assertion, even after it was proved incorrect.