Debunking common myths about health-care reform

By Glenn Kessler
Tuesday, January 18, 2011; 7:22 PM

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 pledged a veto. So this is mostly a symbolic act. But it does provide an opportunity to look back at some of the persistent myths about the legislation.

"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 fact, labeled this claim the 2010 "lie of the year," but that has not stopped lawmakers from using it.

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 but adds 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 - but 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 existing 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 after the GOP won back control of Congress in 1994 and attempted to pass a balanced budget that 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 is the venerable government-run health-care plan for Americans older than 65 and 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 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 (R), has been thoroughly debunked and was labeled "lie of the year" in 2009 by Yet it persists in the popular imagination. A Kaiser Family Foundation poll in September found that 30 percent of seniors still believed this to be the case - and 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.

"Repealing the bill will increase the deficit."

This is technically true - it comes from a Congressional Budget Office estimate - but we've previously documented the problems with this statement and the estimate. Democrats are sure to make this claim as they fight a repeal, but it's a pretty shaky one. The health-care law was not really intended to reduce the deficit, but to reduce the number of uninsured Americans.

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