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Health care debate claims vs. facts

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WASHINGTON In promoting the health care law, President Barack Obama is repeating his persistent and unsubstantiated assurance that Americans who like their health insurance can simply keep it. Republican rival Mitt Romney says quite the opposite, but his doomsday scenario is a stretch.

After the Supreme Court upheld the law last week, Obama stepped forward to tell Americans what good will come from it. Romney was quick to lay out the harm. But some of the evidence they gave to the court of public opinion was suspect.

A look at their claims and how they compare with the facts:

OBAMA: If youre one of the more than 250 million Americans who already have health insurance, you will keep your health insurance. This law will only make it more secure and more affordable.

ROMNEY: Obamacare also means that for up to 20 million Americans, they will lose the insurance they currently have, the insurance that they like and they want to keep.

THE FACTS: Nothing in the law ensures that people happy with their policies now can keep them. Employers will continue to have the right to modify coverage or even drop it, and some are expected to do so as more insurance alternatives become available to the population under the law. Nor is there any guarantee that coverage will become cheaper, despite the subsidies many people will get.

Americans may well end up feeling more secure about their ability to obtain and keep coverage once insurance companies can no longer deny, terminate or charge more for coverage for those in poor health. But particular health insurance plans will have no guarantee of ironclad security. Much can change, including the cost.

The non-partisan Congressional Budget Office has estimated that the number of workers getting employer-based coverage could drop by several million, as some workers choose new plans in the marketplace or as employers drop coverage altogether. Companies with more than 50 workers would have to pay a fine for terminating insurance, but in some cases that would be cost-effective for them.

Obamas soothing words for those who are content with their current coverage have been heard before, rendered with different degrees of accuracy. Hes said nothing in the law requires people to change their plans, true enough. But the law does not guarantee the status quo for anyone, either.

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Health care debate claims vs. facts

Health Care Reform: Questions and Answers

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WebMD's Health Insurance Navigator Answers Your Questions

By Lisa Zamosky WebMD Health News

Reviewed by Louise Chang, MD

June 29, 2012 -- The Supreme Court's decision on the health care reform law left many people confused about their health insurance and what will happen in the future. Here, WebMD answers some of the most common questions that came in from readers after the ruling.

Starting in 2014, insurers will no longer legally be allowed to deny coverage to anyone because of their medical condition or charge them more for that coverage.

If you already have private insurance or you're enrolled in Medicare or Medicaid, you will not be required to buy new or additional insurance because of the health reform law. Generally, you can stay with your current plan if you're happy with it.

Many people who buy insurance on their own (meaning they don't get it at work) and have a preexisting medical condition, however, have held onto pricey coverage because their health condition prevents them from switching plans. Starting in 2014, these people will have greater freedom to shop for coverage and to determine if another plan better suits their needs, because insurers will no longer be allowed to deny people coverage based on prior medical diagnoses.

One of the law's major goals is to make health insurance more affordable.

If you don't get insurance through your job, you will be eligible to buy coverage through state-based insurance marketplaces scheduled to be up and running for open enrollment by fall 2013 for insurance coverage that will start in January 2014. To make insurance affordable for millions of Americans, tax credits will be available for people with incomes that are between 133% and 400% of the poverty level (up to $92,200 annually for a family of four in 2012).

There will also be caps placed on how much people will be required to spend in total out-of-pocket costs, including deductibles, co-pays, and co-insurance. These amounts will also be determined based on a person's income.

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Health Care Reform: Questions and Answers

FACT CHECK: Can you keep your health plan under 'Obamacare'?

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WASHINGTON -- In promoting the health care law, President Barack Obama is repeating his persistent and unsubstantiated assurance that Americans who like their health insurance can simply keep it. Republican rival Mitt Romney says quite the opposite, but his doomsday scenario is a stretch.

After the Supreme Court upheld the law last week, Obama stepped forward to tell Americans what good will come from it. Romney was quick to lay out the harm. But some of the evidence they gave to the court of public opinion was suspect.

A look at their claims and how they compare with the facts:

---

OBAMA: "If you're one of the more than 250 million Americans who already have health insurance, you will keep your health insurance. This law will only make it more secure and more affordable."

ROMNEY: "Obamacare also means that for up to 20 million Americans, they will lose the insurance they currently have, the insurance that they like and they want to keep."

THE FACTS: Nothing in the law ensures that people happy with their policies now can keep them. Employers will continue to have the right to modify coverage or even drop it, and some are expected to do so as more insurance alternatives become available to the population under the law. Nor is there any guarantee that coverage will become cheaper, despite the subsidies many people will get.

Americans may well end up feeling more secure about their ability to obtain and keep coverage once insurance companies can no longer deny, terminate or charge more for coverage for those in poor health. But particular health insurance plans will have no guarantee of ironclad security. Much can change, including the cost.

The non-partisan Congressional Budget Office has estimated that the number of workers getting employer-based coverage could drop by several million, as some workers choose new plans in the marketplace or as employers drop coverage altogether. Companies with more than 50 workers would have to pay a fine for terminating insurance, but in some cases that would be cost-effective for them.

Obama's soothing words for those who are content with their current coverage have been heard before, rendered with different degrees of accuracy. He's said nothing in the law requires people to change their plans, true enough. But the law does not guarantee the status quo for anyone, either.

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FACT CHECK: Can you keep your health plan under 'Obamacare'?

Health care law takes center stage in Vitter town hall

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Vitter to hold town hall in St. Bernard Monday morning

Vitter to hold town hall in St. Bernard Monday morning

It was an open discussion, but nearly every other questioned centered around the subject of health care, at a town hall meeting Monday.

Sen. David Vitter, R-Louisiana, hosted the event at the St. Bernard Parish council chambers.

He took questions from the audience while flanked by two posters. One showed a map of the health care bureaucracy. The other offered negative statistics on the impact of "Obamacare".

The meeting comes just four days after the Supreme Court upheld key provisions of the health care law. The decision galvanized many Republican voters.

Vitter is one of many Republicans making the rounds of public appearance to try and rally support for repeal efforts. On Sunday, Republican Governor Bobby Jindal appeared on NBC's "Meet the Press" to discuss the Supreme Court ruling.

Vitter said he was the first lawmaker to file a repeal bill after the health care law passed.

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Health care law takes center stage in Vitter town hall

Thinking through health care reform: a compilation of diverse perspectives

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When it comes to health care, people can have very strong opinions. Conversations can get heated and personal. Understandably so; we are talking about something that directly and inevitably affects us, our families, and all Americans. No one, after all, is safe from illness.

From my discussions with others, Ive found there are two basic routes to a strong conclusion. One is by gathering as much evidence as possible, from as many angles as possible, and reasoning throughideas with a critical eye to form a decision. The other is by having a conclusion in mind first and then looking, after the fact, for evidence to support it.

In the second case, where might those preconceived conclusions come from? Perhaps they are based on what group a person identifies with: Im a Democrat, and most Democrats support the reform, so I probably do, too, or Im a registered Republican, so Ill probably think Obamacare is a bad idea. Or, maybe everyone around you tends to believe one thing. Or, maybe a person whose knowledge you generally trust believes something, and its easier to listen to one person who has already worked it all out.

Compounding the problem is that people have a natural tendency to surround themselves with friends, coworkers, and news sources that largely confirm, rather than dispute, what they already believe. Its simply more pleasant to interact with someone who agrees with you.

While the two routes are not so black and white, I do think its all too easy to fall into the second type of reasoning. And its much more difficult to come to a new conclusion if youre cornered by everyone chirping in unison.

So, I decided to compile my selections for the some of the most clear, thoughtful, and diverse pieces about theSupreme Courtruling and its implications Ive come across. Taken alone, each is insightful and well-written. Taken together, they portray health care reform issues from valuably distinct perspectives. I hope youll give them a read, and that youll power through the ones that dont immediately resonate with your political instincts.

Because the Internet is a vast, vast space, and its hard to triage.

Something Wicked This Way Comes, by Atul Gawande, published in the New Yorker. Gawande takes a step back and captures the uncertainty in any health reform initiative an inherently complex and wicked problem in which Trade-offs are unavoidable. Unanticipated complications and benefits are both common. And opportunities to learn by trial and error are limited. No step forward will be perfect, Gawande reminds us, but taking no action comes with its own risks. All that leaders can do is weigh the possibilities as best they can and find a way forward.

Chief Justice Roberts and His Apologists, by John Yoo, published in the Wall Street Journal. Even though the Affordable Care Act was upheld, the reasoning behind the decision has been interpreted as a victory for fiscal conservatives, too. But the restrictions on congressional coercion may not be as significant as they appear, Yoo argues, with Chief Justice John Roberts not the hero for both sides some are making him out to be. Congress may not be able to directly force us to buy electric cars, eat organic kale, or replace oil heaters with solar panels. But if it enforces the mandates with a financial penalty then suddenly, thanks to Justice Robertss tortured reasoning in Sebelius, the mandate is transformed into a constitutional exercise of Congresss power to tax.

Unpopular Mandate, by Ezra Klein, published in the New Yorker. Two years ago, the odds that the individual mandate would be overturned were considered slim to none; yet a few days before the decision, experts predicted them at closer to fifty-fifty. Why did the Republican party change its opinion, making the clause they once supported the main target to oppose? Thats the question at hand, but to answer it, Klein expands beyond the Republican party into why people change their opinions and how in politics, on both sides, it has to do more with adhering to the beliefs of the group than rational reasoning. But parties, though based on a set of principles, arent disinterested teachers in search of truth, he writes. Theyre organized groups looking to increase their power. Or, as the psychologists would put it, their reasoning may be motivated by something other than accuracy.

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Thinking through health care reform: a compilation of diverse perspectives

Health Care Ruling Turns 'Tax' Into A Four-Letter Word (The Note)

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By MICHAEL FALCONE (@michaelpfalcone) and AMY WALTER (@amyewalter) NOTABLES: WORD SEARCH: Based on interviews with Obama administration officials and Republican leaders over the weekend, it was evident that the race to define last week’s Supreme Court decision — on favorable terms for each side —...

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Health Care Ruling Turns 'Tax' Into A Four-Letter Word (The Note)

Health Care Ruling Turns 'Tax' Into A Four-Letter Word

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Credit: Tetra images/Getty Images

By MICHAEL FALCONE (@michaelpfalcone) and AMY WALTER (@amyewalter)

NOTABLES:

And another group, Crossroads GPS, announced this weekend they would be unveiling specific ads targeting House and Senate candidates on the health care issue. Heres one calling on North Dakota Senate candidate Heidi Heitkamp to support repeal of the law. The ad is titled Tax, and was updated to reflects the courts ruling. WATCH: http://bit.ly/LUFyaE

THE NOTE:

Its a bird, its a plane! Its a tax, its a penalty!

Ever since last Thursdays Supreme Court decision that ruled the Obama administrations signature health care reform law constitutional, both Democrats and Republicans laced up their running shoes for a sprint to the dictionary.

The keyword: tax.

Republicans want to bake the idea that the health care law imposes a tax into the cake. While Democrats, on the other hand, are loathe to refer to it in those terms.

White House Chief of Staff Jack Lew insisted, repeatedly, in interviews this weekend that under the law refusal to buy insurance would amount to a penalty and Obama campaign aides echoed the White House line, calling it a a free loader penalty.

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Health Care Ruling Turns 'Tax' Into A Four-Letter Word

We The People: 'Be your own advocate' in health care

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REEDSBURG Emily Rogers has progressed so much during her three-year battle with a rare autoimmune disease that she can write her name again and hold a sandwich without squeezing it so tightly that it squishes between her fingers.

Those are major milestones for Emily, 45, a former teacher and mother of three who has been limited to a wheelchair since Devic's disease took over her body by producing antibodies that attack her spine.

Much of the credit for her progress goes to an expensive drug and the surgical insertion of a pump that sends a muscle relaxer directly into her spinal fluid. But equally important, say Emily and her husband, Phil, was learning to navigate the health care maze before, during and after those treatments.

While the debate over national health care policy rages on following last week's Supreme Court ruling upholding the Affordable Care Act, the efforts the Rogerses have made at being personally involved in their care has been both harder and more effective than any government policy.

"Your health care is a 'we' thing," Phil said, adding that Americans must learn about their illnesses and how to work with their providers and insurers to get the care they need.

"You have to be engaged in your health care just like you should be engaged in your education."

The couple believe health care, whether administered privately or publicly, is a life game that is won or lost by attitudes, work ethic, knowledge and persistence.

They know Emily's quality of life and recovery depends on how they play it.

"This is the lot that we have," said Phil, a principal and teacher at the St. Peter's Lutheran Church school in Reedsburg. "We pray about it. Our church continues to support us and pray for her and for us through it."

But they know they can't sit still and wait for miracles to occur.

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We The People: 'Be your own advocate' in health care

Health-care bill one of many historic social laws

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by J. Craig Anderson and Ryan Randazzo - Jun. 30, 2012 11:12 PM The Republic | azcentral.com

With the U.S. Supreme Court's approval last week, the Affordable Care Act entered an elite canon of laws that have rewritten the social contract between American citizens and their government.

They include the Social Security Act of 1935, Civil Rights Act of 1964, Voting Rights Act of 1965 and the amendment to the Social Security Act that created Medicare and Medicaid, also in 1965.

Each added or altered social protections for large groups of Americans, but not without passionate debate and fierce constitutional challenges.

While the Affordable Care Act's ultimate place in history has yet to be determined, historians and legal scholars said if the past is a guide, the legislation will eventually become an accepted part of American society.

The health-care law "will have implications for tens of millions, including 30 million who will get access to health insurance and many more millions that will be affected by insurance-regulation reforms," said Lawrence Jacobs, a political-science professor at the Humphrey School of Public Affairs at the University of Minnesota.

Upheld Thursday by the Supreme Court in a 5-4 decision, it requires almost everyone to obtain health coverage and guarantees it will be available to those previously uninsured or uninsurable.

Jacobs said the scope of the program places it in the same league as the programs of President Franklin D. Roosevelt's New Deal and President Lyndon B. Johnson's Great Society.

"The Supreme Court has signed off on a piece of legislation that is as sweeping and perhaps more sweeping than any social-welfare legislation in half a century and perhaps since the New Deal," said Jacobs, co-author of the 2010 book "Health Care Reform and American Politics: What Everyone Needs to Know."

"The number of people impacted by this health policy is enormous," he said. "It really opens a new day for financing and delivery of health care."

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Health-care bill one of many historic social laws

Boehner defends Romney over health care ruling

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(CBS News) In an interview on "Face the Nation," House Speaker John Boehner said he was surprised that the Supreme Court upheld the constitutionally of the health care mandate, but he defended Republican presidential candidate Mitt Romney's opposition to it, even though the former Massachusetts governor also passed a mandate in his state.

"This is an issue that was in Massachusetts - one state," Boehner said. "That's why we have 50 different states. They're laboratories of democracy. Gov. Romney understands that 'Obamacare' will bankrupt our country and ruin the best health care delivery system in the world."

Boehner said the president's health care plan "is far more than anything, any state had ever comprehended or even tried to do."

The Speaker said the Supreme Court ruling, which defined the mandate as a tax, strengthened his "resolve" to get rid of the law.

"All it really does is strengthen my resolve and resolve of Republicans here in Washington to repeal this awful law," Boehner said.

Boehner told host Norah O'Donnell that the House is going to vote - which it already has more than two dozen times - to repeal the law. "We'll do it one more time!" he told O'Donnell, "to show people we are resolved to get rid of this."

"This is the wrong direction. And while the court upheld it as constitutional, they certainly didn't say it was a good law," Boehner said. "Republicans believe in a common sense, step-by-step approach that will lower health care costs and allow the American people to choose the health insurance they want, not the health insurance the government wants them to have."

In response to questions by O' Donnell on whether Boehner likes any part of the law, he said, "There's always going to be parts of it that are good." The only provision he admitted to liking is the provision that people under 26 can stay on their parents' insurance plan. He pointed to the fact that some health insurance companies independently implemented that provision recently.

However, Speaker Boehner said the entire health care bill needs "to be ripped out by its roots," and that he would repeal the entire bill, even the parts he likes.

"We can replace, when we replace this we can have a common sense debate about which of these provisions ought to stay and which ought to go," he said.

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Boehner defends Romney over health care ruling

Health care overhaul gets mixed reactions locally

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Its not perfect, but we need to change health care and this is a start in the right direction, said Dr. Robert Morgan. Staying the same is not the answer.

Morgan who is a board certified family practitioner and senior managing partner of Oswego Family Physicians said that although the parts of the law that were upheld will do a lot of good, there is still years of work ahead to right the nations health care system.

It was very interesting because the sentiment I got on both sides was that the law was going to be found unconstitutional, Uva said.

Even though Congress called it a penalty, not a tax, Roberts said, The payment is collected solely by the IRS through the normal means of taxation.

Stocks of hospital companies rose after the decision was announced, while shares of insurers fell sharply. Shares of drug makers and device makers fell slightly.

The justices rejected two of the administrations three arguments in support of the insurance requirement. But the court said the mandate can be construed as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness, Roberts said.

The court found problems with the laws expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states entire Medicaid allotment if they dont take part in the laws extension.

Although they said certain elements of the law such as not having pre-existing conditions and allowing students to remain on their parents insurance until age 26 were steps forward, Uva and Morgan also found problems with many of its components.

Independent advisory boards with no accountability and cuts to Medicare in particular were a sticking point for Uva.

Its going to be very hard to practice now in private practice, he said.

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Health care overhaul gets mixed reactions locally

Control of costs a test for overhaul

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Just as the health care overhaul in Massachusetts is widely accepted as the model for the national bill upheld as constitutional Thursday by the US Supreme Court, it is also seen by many as a model and a caution for the necessary sequel to much broader insurance coverage: cost control.

Bringing almost everyone under the umbrella of health insurance is considered by advocates of the 2006 Massachusetts law, and of President Obamas 2010 plan, as the essential precondition for reining in medical expenses. All consumers, employers, hospitals, and insurers now abruptly, with the laws implementation, have a major stake in that goal.

But nothing about the journey is easy as six years experience in Massachusetts shows.

Consumers should not expect to see Obamas plan lead to lower medical bills, at least not anytime soon. What they can expect is a vigorous clash of interests, leading eventually, the hope is, toward accommodation and compromise.

That has been the Massachusetts story so far. With Governor Deval Patrick threatening the states robust health care industry with aggressive intervention, a patchwork coalition of hospitals, insurers, businesses, doctors, and lawmakers has been working to come up with ways to make care more affordable.

Some large teaching hospitals have signed contracts with insurers that call for lower fee increases than in the past. More than 1.2 million people about 1 in 5 residents are already covered by plans that put providers on a budget in an effort to restrain health spending. And insurers are offering more tiered plans that limit consumers choice of hospitals.

House and Senate leaders are privately negotiating over their two competing plans to control medical spending by tying it to the growth of the state economy. They hope to reach an agreement by the end of July, an agreement that Patrick must also sign on to.

Massachusetts, more than any other state, is having an aggressive dialogue about how to reduce the rate of growth in health care spending, said John McDonough, director of Harvards Center for Public Health Leadership, who helped craft the federal legislation. The health reform law created such a spotlight on the states health care system and right away, everybody business and insurers recognized the most destabilizing thing that could happen to undermine reform was if health care costs continued to spiral out of control.

To its advantage, Massachusetts already had the preexisting network of often competing interests that worked together in 2006 to bring about health reform, a coalition that does not exist on the national stage or in many other states.

The state also faced acute pressure to tackle the cost containment problem, which predated the 2006 reform law championed by then-governor Mitt Romney (although he has since renounced it as a flawed template for national legislation, and says he will repeal it, if elected). Massachusetts individual insurance premiums are the highest in the country, more than double the national average in 2010, according to the Kaiser Family Foundation, which tracks the data.

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Control of costs a test for overhaul

Kurtz calls health care decision setback

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State Rep. Ken Kurtz, R-Coldwater, weighed in on the Supreme Court ruling upholding the Affordable Care Act, calling it a difficult day for Michigan residents and a setback for our countrys system of free-market principles. He said in a press release The ruling is very disappointing, and I believe we must now respond swiftly to make sure that we, the people of Michigan not the federal government are in charge of our own system. The historic health care overhaul narrowly survived an election-year battle at the Supreme Court Thursday with the improbable help of conservative Chief Justice John Roberts. Said the Associated Press, But the ruling, by a 5-4 vote, also gave Republicans unexpected ammunition to energize supporters for the fall campaign against President Barack Obama. We are ecstatic. This is great news for all Michiganders who are one accident, one tumor or one layoff away from health and financial disaster. The Affordable Care Act was a century in the making to provide all Americans with access to affordable, quality healthcare, said Karen Holcomb-Merrill of the Michigan League for Human Services. Everyone wants the security of knowing they can see a doctor when they are ill or have the medications or treatments that they need. U.S. Rep. Tim Walberg, R-Tipton released a statement saying Today the Supreme Court ruled that President Obama broke his pledge of the law not increasing taxes and that there does not seem to be a limit to what the federal government can force us to do. He said the ruling in no way prevents Congress from repealing and replacing the law in the future. I remain committed to defunding, dismantling and repealing the law. Health care decisions should be made by patients, families and their doctors, not by bureaucrats in Washington who are burdening seniors and future generations with less choice, fewer services and more debt, Walberg said. Let it also be noted that the burden includes increased taxes on all and especially those with the least ability to pay. State Sen. Bruce Caswell said he had not had time yet Friday to study the decision, but that he believes the federal government should not be in the health care business. Like Kurtz, he noted Medicaid is going to be up to the state. That should be interesting, he said. As for the overall ruling, he said it is what it is, and noted there are elections in November. Kurtz said The Legislature will consider every option that makes the lives of Michigan residents better and prevents the federal government from micromanaging our health-care decisions. He noted the court found problems with the laws expansion of Medicaid, but he was pleased the feds do not threaten to withhold states entire Medicaid allotment if they dont take part. Reaction to the High Court decision was in abundance both pro and con. A statement from the National Federation of Independent Business (NFIB) said the ruling is a deep disappointment to small businesses everywhere. While we are certainly disappointed, NFIB respects the decision to uphold the individual mandate by the Supreme Court. Clearly this mandate has now become a tax on all Americans and a broken campaign promise from President Obama not to raise taxes, said Dan Danner, NFIB president. National Farmers Union President Roger Johnson said Farmers, ranchers and rural residents face significant barriers to obtaining accessible, affordable health care. He continued, The ACA contains significant, necessary reforms that help all Americans, including those who are self-employed and purchasing expensive care from the individual market, afford insurance and the preventive care they need; provides resources to rural health care providers and incentives to physicians serving in rural areas; bars health care companies from denying coverage to individuals with pre-existing conditions; and closes the Medicare prescription drug coverage donut hole. More information about this issue can be found at http://www.hillsdale.net.

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Kurtz calls health care decision setback


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