ObamaCare Fact Check

Presented for your consideration, a series of (unfortunately lengthy) factual palate cleansers in preparation for Baron Hill's town hall Monday evening.

Where to begin?

First of all, the nonpartisan Congressional Research Service says that ObamaCare will, indeed and in fact, cover illegal aliens.

The Washington Examiner:

In what he called the “first myth” being spread by critics of his proposal for a government-run health care system, Obama said they are wrong in claiming illegal immigrants will be covered: “That is not true. Illegal immigrants would not be covered. That idea has not even been on the table.” Obama said.

Well, Mr. President, that idea must have been tucked under a stack of background briefing papers over there in the corner of the table because the Congressional Research Service (CRS) says this about H.R. 3200, the Obamacare bill approved just before the recess by the House Energy and Commerce Committee chaired by Rep. Henry Waxman, D-CA:

“Under H.R. 3200, a ‘Health Insurance Exchange’ would begin operation in 2013 and would offer private plans alongside a public option…H.R. 3200 does not contain any restrictions on noncitzens—whether legally or illegally present, or in the United States temporarily or permanently—participating in the Exchange.”

CRS also notes that the bill has no provision for requiring those seeking coverage or services to provided proof of citizenship. So, absent some major amendments to the legislation and a credible, concrete enforcement effort in action, looks like the myth on this issue is the one being spread by Obama, Reid, Pelosi, et. al.

The San Francisco Examiner:

In its subsection on health insurance subsidies (known as "affordability credits"), HR 3200 does state, "Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States." That would seem to solve the problem, but it's more rhetoric than reality. The bill contains no verification requirement or enforcement process for citizenship or legal residency, as exists for other federal benefit programs. The only verification required for the subsidies pertains to family income. Beyond that, as the CRS report notes, everything is left in the hands of the Health Choices Commissioner.

House Democrats defeated all attempts in committee to add an enforcement mechanism that would require proof of citizenship or legal residency for those getting subsidies.

Additionally, they are not only covered under the system, they are required to have coverage (bought or provided by Medicaid):

CRS also notes that “undocumented aliens” who have a “substantial presence” in the US would be required to buy health insurance (page 4) through the exchanges in HR3200. They would also become eligible for “emergency Medicaid,” although not normal Medicaid (page 6) for up to five years.

And the entire CRS report itself can be read here (PDF warning).

Second, Factcheck.org, which has been cited by Baron Hill as a source for debunking "myths" and "lies" about health care reform, says that ObamaCare will pay for abortions.

From their website:

Will health care legislation mean "government funding of abortion"?

President Obama said Wednesday that’s "not true" and among several "fabrications" being spread by "people who are bearing false witness." But abortion foes say it’s the president who’s making a false claim. "President Obama today brazenly misrepresented the abortion-related component" of health care legislation, said Douglas Johnson, legislative director for the National Right to Life Committee. So which side is right?

The truth is that bills now before Congress don’t require federal money to be used for supporting abortion coverage. So the president is right to that limited extent. But it’s equally true that House and Senate legislation would allow a new "public" insurance plan to cover abortions, despite language added to the House bill that technically forbids using public funds to pay for them. Obama has said in the past that "reproductive services" would be covered by his public plan, so it’s likely that any new federal insurance plan would cover abortion unless Congress expressly prohibits that. Low- and moderate-income persons who would choose the "public plan" would qualify for federal subsidies to purchase it. Private plans that cover abortion also could be purchased with the help of federal subsidies. Therefore, we judge that the president goes too far when he calls the statements that government would be funding abortions "fabrications."

Abortion foes quickly denounced Obama’s statement as untrue. The NRLC’s Johnson said “the bill backed by the White House (H.R. 3200) explicitly authorizes the government plan to cover all elective abortions.” And our analysis shows that Johnson’s statement is correct. Though we of course take no position on whether the legislation should allow or not allow coverage for abortions, the House bill does just that.

As for the House bill as it stands now, it’s a matter of fact that it would allow both a “public plan” and newly subsidized private plans to cover all abortions.

H.R. 3200, it's worth noting, was the bill that Baron voted to approve out of committee just before Congress recessed.

Baron has spoken quite highly of Factcheck.org in the past, particularly as a part of his recent Q & A with the Madison Courier. It will be interesting to see his opinion of their judgment of the facts about this aspect of ObamaCare.

Third, serious questions have been raised in no less than the Washington Post about the constitutionality of ObamaCare's "individual mandate" requiring that all Americans have health insurance.

The piece in question notes:

President Obama has called for a serious and reasoned debate about his plans to overhaul the health-care system. Any such debate must include the question of whether it is constitutional for the federal government to adopt and implement the president's proposals. Consider one element known as the "individual mandate," which would require every American to have health insurance, if not through an employer then by individual purchase. This requirement would particularly affect young adults, who often choose to save the expense and go without coverage. Without the young to subsidize the old, a comprehensive national health system will not work. But can Congress require every American to buy health insurance?

In short, no. The Constitution assigns only limited, enumerated powers to Congress and none, including the power to regulate interstate commerce or to impose taxes, would support a federal mandate requiring anyone who is otherwise without health insurance to buy it.

Although the Supreme Court has interpreted Congress's commerce power expansively, this type of mandate would not pass muster even under the most aggressive commerce clause cases.

The federal government does not have the power to regulate Americans simply because they are there. Significantly, in two key cases, United States v. Lopez (1995) and United States v. Morrison (2000), the Supreme Court specifically rejected the proposition that the commerce clause allowed Congress to regulate noneconomic activities merely because, through a chain of causal effects, they might have an economic impact. These decisions reflect judicial recognition that the commerce clause is not infinitely elastic and that, by enumerating its powers, the framers denied Congress the type of general police power that is freely exercised by the states.

This leaves mandate supporters with few palatable options. Congress could attempt to condition some federal benefit on the acquisition of insurance. States, for example, usually condition issuance of a car registration on proof of automobile insurance, or on a sizable payment into an uninsured motorist fund. Even this, however, cannot achieve universal health coverage. No federal program or entitlement applies to the entire population, and it is difficult to conceive of a "benefit" that some part of the population would not choose to eschew.

The other obvious alternative is to use Congress's power to tax and spend. In an effort, perhaps, to anchor this mandate in that power, the Senate version of the individual mandate envisions that failure to comply would be met with a penalty, to be collected by the IRS. This arrangement, however, is not constitutional either.

Like the commerce power, the power to tax gives the federal government vast authority over the public, and it is well settled that Congress can impose a tax for regulatory rather than purely revenue-raising purposes. Yet Congress cannot use its power to tax solely as a means of controlling conduct that it could not otherwise reach through the commerce clause or any other constitutional provision.

Although the court's interpretation of the commerce power's breadth has changed since that time, it has not repudiated the fundamental principle that Congress cannot use a tax to regulate conduct that is otherwise indisputably beyond its regulatory power.

Of course, these constitutional impediments can be avoided if Congress is willing to raise corporate and/or income taxes enough to fund fully a new national health system. Absent this politically dangerous -- and therefore unlikely -- scenario, advocates of universal health coverage must accept that Congress's power, like that of the other branches, has limits. These limits apply regardless of how important the issue may be, and neither Congress nor the president can take constitutional short cuts. The genius of our system is that, no matter how convinced our elected officials may be that certain measures are in the public interest, their goals can be accomplished only in accord with the powers and processes the Constitution mandates, processes that inevitably make them accountable to the American people.

Fourth, the infamous Section 1233 of the bill, the so-called "death panels" remains a concern until it is completely removed from the legislation.

This is not a concern for the sometimes hyperbolic reasons that are often cited, but for more practical reasons (which I have discussed in the past) relating to it being a slippery slope and the serious potential unintended consequences of that sort of policy.

Fifth, by Baron's own admission, there have been no Republican negotiations in the House on this legislation.



It is entirely a Democratic work.

Sixth, according to the Washington Post and USA Today, the House bill will cut funding to Medicare (in particular Medicare Advantage) by some $160+ billion, particularly harming the 20,000+ seniors in the 9th District here in southern Indiana that use Medicare Advantage.

The Washington Post:

More than one-fifth of the 45 million Medicare beneficiaries are in Medicare Advantage plans operated by insurance companies like Aetna, Humana and UnitedHealth. The House bill would cut payments to private plans by more than $160 billion over 10 years.

In the past, insurers reacted to such cuts by increasing premiums, reducing benefits or pulling out of the Medicare market, and beneficiaries complained loudly.

In effect, Mr. Obama says he can cut bloated Medicare payments to inefficient health care providers without adversely affecting any beneficiaries. Many doctors are dubious.

USA Today:

About 10.2 million Medicare recipients are in Medicare Advantage. Under that program, the government pays insurers a set amount per Medicare beneficiary. Obama ridiculed it as costly and redundant, but the plan provides additional benefits, such as vision, dental and hearing, to seniors and helps coordinate health care for those with chronic conditions, says Robert Zirkelbach at the trade association, America’s Health Insurance Plans.

How many of those seniors on Medicare Advantage do you think are going to vote for a Congressman that took their health care plan away from them?

Seventh, it is not true that you will be able to keep your health care plan.

Again, a fact check by USA Today, looking into Obama's claim:

“Under the reform we’re proposing, if you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan.”

Not necessarily. In an analysis of the Senate Health, Education, Labor and Pensions Committee bill, the non-partisan Congressional Budget Office estimated that 10 million workers could lose employer-provided benefits and would have to find other insurance.

The Washington Post has also debunked this Obama claim:

However, under legislation drafted by House and Senate Democrats, that [you can keep your existing health care plan] would not necessarily be true.

The legislation could also prompt some employers to drop coverage, congressional budget analysts say.

In a report last month on a bill advanced by House Democrats, the Congressional Budget Office said millions of people would gain employment-based coverage and millions would lose it.

Obama's promise is not just at odds with legislative proposals -- it is also at odds with reality. Under the current system, employers can drop coverage, alter benefit packages and switch insurers.

Nothing in ObamaCare guarantees that people satisfied with their current coverage will be able to keep it, and there are powerful (and perverse) incentives for employers to dump employees onto (potentially inferior) public plans rather than keep them on their health care existing plans.

Eighth, AARP has not endorsed any of the legislation currently being considered by Congress, despite claims at times to the contrary.

ABC News debunks this one:

President Obama today suggested that the health care reform legislation for which he’s pushing has been endorsed by the American Association of Retired Person.

“We have the AARP on board because they know this is a good deal for our seniors,” the president said.

At another point he said: “Well, first of all, another myth that we've been hearing about is this notion that somehow we're going to be cutting your Medicare benefits. We are not. AARP would not be endorsing a bill if it was undermining Medicare, okay?”

The problem?

The AARP hasn't endorsed any plan yet.

The country's largest advocacy group for Americans over 50 issued a statement after the event saying, "While the President was correct that AARP will not endorse a health care reform bill that would reduce Medicare benefits, indications that we have endorsed any of the major health care reform bills currently under consideration in Congress are inaccurate."

In other words, their opposition is in large measure because the proposed legislation does indeed contain cuts to Medicare.

Ninth and lastly, the bill requires that the IRS divulge all manner of private individual tax records and personal financial information to the friendly-sounding "Health Choices Commissioner."

From CBS News come three troubling provisions:

Section 431(a) of the bill says that the IRS must divulge taxpayer identity information, including the filing status, the modified adjusted gross income, the number of dependents, and "other information as is prescribed by" regulation. That information will be provided to the new Health Choices Commissioner and state health programs and used to determine who qualifies for "affordability credits."

Section 245(b)(2)(A) says the IRS must divulge tax return details -- there's no specified limit on what's available or unavailable -- to the Health Choices Commissioner. The purpose, again, is to verify "affordability credits."

Section 1801(a) says that the Social Security Administration can obtain tax return data on anyone who may be eligible for a "low-income prescription drug subsidy" but has not applied for it.

Over at the Institute for Policy Innovation (a free-market think tank and presumably no fan of Obamacare), Tom Giovanetti argues that: "How many thousands of federal employees will have access to your records? The privacy of your health records will be only as good as the most nosy, most dishonest and most malcontented federal employee.... So say good-bye to privacy from the federal government. It was fun while it lasted for 233 years."

If you're going to Baron Hill's town hall, arm yourself with facts.

Baron claims that he's read the bill.

Ask him about its more troubling provisions, such as the ones above, and ask him why he voted for them.

If he indeed read what he voted for, he must presumably have found these measures to meet with his approval and he owes his constituents an explanation as to why.

And that explanation can't simply be a dismissal about "propaganda" or "myths" or "lies."

Every single one of these nine items comes from reputable media outlets that have done hard factual reporting about this legislation.

I'd trust them before I'd trust a career politician. Indeed, in some cases Baron Hill has in the past cited these very sources himself, so he can hardly find them to be unacceptable now.