. . . The fog of controversy may have lifted. But contrary to the confident predictions of some, the contents of the health-care bill are even worse than anyone expected. A year after Democrats passed it on a party-line vote, it looks even worse than it did then. And that's saying something.”
— Senate Minority Leader Mitch McConnell (R-Ky.)
McConnell wished the health-care law a not-so-happy birthday a week early — the Senate is on recess next week — in a floor speech Thursday.
The rhetoric is pretty strong, but he also made a number of factual assertions about what Americans have learned about the bill since its passage. Let’s take a tour through some of his comments and explain where they come from.
“We now know that those who promised us that `if you like your plan, you can keep your plan' were dead wrong. The Obama administration has already admitted that at least 7 million seniors will now lose their Medicare Advantage plans. And one of the administration's own top health care analysts recently admitted that this oft-repeated pledge was `not true in all cases.' ”
Both of these statements — the 7 million number and the pledge being “not true in all cases” — comes from testimony by Richard Foster, the chief actuary for Medicare and Medicaid, before the House Budget Committee. But to suggest that this is an Obama administration estimate or even that Foster is an administration analyst is a stretch worthy of perhaps a Pinocchio. (About our rating scale)
Here’s how Foster introduced himself at the start of the hearing:
“The Office of the Actuary at CMS [Centers for Medicare and Medicaid Services] provides actuarial economic and other technical assistance to policy makers, both in the administration and in Congress. We do this on an independent basis, objectively and also on a nonpartisan basis. The Office of the Actuary has performed this role for more than the last 45 years, since even before the enactment of the Medicare program. I'm appearing today in my role as an independent adviser to Congress. My statements are my own and do not necessarily represent an official position of the Department of Health and Human Services.”
Foster is a fairly independent person — the Wall Street Journal once called him a “health-care party pooper” — who also caused headaches for Republicans during the debate over the Bush administration’s effort to add a prescription drug plan to Medicare.
Medicare Advantage gives beneficiaries the option to get their benefits through private health plans and has been long promoted by Republicans. But the Obama administration has taken issue with Foster’s estimate, saying his prediction is mistaken.
When CMS administrator Donald M. Berwick was asked in February about Foster’s prediction, he did not dispute it outright but replied: “I lead an agency in which the growth rate of Medicare Advantage this year is 6 percent and the actuary predicted a decrease. So, the actuary's prediction was incorrect. Our Medicare Advantage is healthier now than it ever was before.”
A McConnell spokesman said it makes the senator’s case stronger to call Foster an independent analyst and he will do so in the future.
“One recent study suggests that as many as 35 million American workers could see their employer-based health insurance plans dropped in this way.”
This claim is from a study, released last May, by former Congressional Budget Office director Douglas Holtz-Eakin (2003-2005) and Cameron Smith. Holtz-Eakin was an adviser to the McCain presidential campaign and has long been a critic of Obama’s health-care approach, so one has to take his analysis with a grain of salt.
“And today, even the administration itself predicts that more than half of all American workers will see their current employee-sponsored health care plans changed within a couple of years time. Shortly after the health-care bill became law, the Department of Labor acknowledged all this. Small businesses would be most affected, it said, with as many as 80 percent expected to have to change their coverage to comply with the new law. For all remaining businesses, the administration now estimates that somewhere between 39 percent and 69 percent will be forced to change their plans to comply with costly and burdensome new dictates from health-care bureaucrats in Washington.”
Obama is indeed on shaky ground with his pledge that “if you like your health care plan, you will be able to keep your health care plan, period.” Labor Department regulations issued in June did say that existing plans would be exempted from some of the health bill’s requirements, but if health care plans violate parameters set by the administration, they would forfeit that exemption.
McConnell accurately cited the administration’s estimates of what might happen. As The Post put it at the time: “The administration estimated that by 2013, health plans covering as few as 39 percent and as many as 69 percent of employees could lose protected status. For small employers, the total could be as high as 80 percent; for large ones, it could reach 64 percent.”
Foster, in his January testimony, was asked where Obama’s pledge was true. He replied: “Not true in all cases.”
“According to the independent CBO, the health-care bill will result in the loss of more than 800,000 jobs over the next 10 years.”
We’ve written before about how many Republicans have mischaracterized this estimate by the Congressional Budget Office; House Republicans recently ended up with three Pinocchios.
But in this speech McConnell gets it right. The CBO was talking about people not seeking jobs — a reduction of jobs — and so his phrasing is appropriate, even though he casts it in a negative light.
The positive spin on this estimate is that people no longer are working simply because they need the health care coverage; they can retire early, for instance. But it is not as if the CBO is saying that others will step up to fill those now-empty positions. The CBO really is saying the jobs will disappear as people drop out of the labor force. Whether this is a half-full or half-empty glass depends on your perspective.
COMING MONDAY: An examination of Democratic “Happy Birthday” claims for the bill