Health insurance reform opponents continue to spread myths about components of the America’s Affordable Health Choices Act, this time about the bill’s impact on doctors. However, the fact is that the America’s Affordable Health Choices Act will put the power back into the hands of doctors and other health care professionals.
Myth: Under the House bill, treatments will be decided by government boards, and doctors would be forced to participate in a government-run public option.
Fact: In the current health care system, insurance companies hold more power than doctors and patients. America’s Affordable Health Choices Act would empower physicians to make better decisions for their patients. That is why the American Medical Association, the leading voice for America’s physicians, supports the bill’s provisions.
Providers are NOT forced to participate in the public health insurance option, even if they take Medicare patients. Just as it is for patients, participation in the public option is completely voluntary for doctors.
The comparative effectiveness research enabled by the bill will give doctors the best information, thus helping them make the best decisions. The goal is simply to inform doctors and their patients of the latest research on which treatments work best. It is NOT cost-effectiveness research. The bill specifically states that the government cannot mandate coverage or care decisions.
These facts are some of the reasons why the American Medical Association (AMA) “…express[es]…appreciation and support for H.R. 3200, the America’s Affordable Health Choices Act of 2009″:
This legislation includes a broad range of provisions that are key to effective, comprehensive health system reform…The AMA wants the debate in Washington to conclude with real, long overdue results that will improve the health of America’s patients.
The goal of health insurance reform is to provide quality, affordable health care for every American while preserving what works in today’s system, expanding choice, and containing costs. America’s Affordable Health Choices Act provides a public health insurance option that would compete with private insurers within the Health Insurance Exchange — giving consumers more choices, keeping insurance companies honest and increasing competition.
Learn more about the importance of the public option from health care experts:
John Holahan, Director and Linda J. Blumberg, Senior Fellow - Urban Institute Health Policy Center, 6/09:
A public plan would not destroy the private insurance market but would make it more competitive and lead to the benefits associated with competition. Many private plans would remain attractive because of their ability to be responsive to consumer demands and to be innovative in care management. Public plans are attractive because they can offer better access to necessary care for diverse populations, have lower administrative costs, and have strong negotiating power with providers. The presence of both types of plans should make each perform better in a reformed insurance marketplace. Most importantly, faced with competition from a public plan, private alternatives will become more efficient, leading to declines in their own costs. The net effect would be reduced growth in health care costs.
Jacob S. Hacker, Ph.D., Professor - UC Berkeley Department of Political Science and School of Law, 4/09:
The goal is a system in which private insurance and public insurance are encouraged to compete side by side to attract enrollees on a level playing field that rewards plans that deliver better value and health to their enrollees. Public insurance can be a benchmark for private plans and a source of stability for enrollees, especially those with substantial health needs. Private plans can provide an alternative for those who feel that public insurance does not serve their needs and a source of continuing pressure for innovation in benefit design and care management. And both should have a chance to prove their strengths and improve their weaknesses in a competitive partnership….Allowing public insurance and private plans to compete on a level playing field is the key to cost control and quality coverage.
Karen Davis, President and Cathy Schoen, Senior Vice President - The Commonwealth Fund, 3/09:
In recent years, the market for health insurance has become increasingly concentrated. In most states, three or fewer insurers account for over half of all enrollment. Indeed, in many states one carrier dominates, accounting for half or more of enrollment in the under-65 market. Insurance company margins increased rapidly in the early 2000s as market consolidation occurred and premiums outstripped increases in medical outlays…One advantage of a public health insurance plan is that it ensures markets work in the public interest and serves as a counterbalance to undue market power by insurers or providers. By offering a public health insurance plan that does not aim to make a profit and employing provider payment methods and rates that reward efficient providers, it protects the public interest against concentrated market power.
Uwe E. Reinhardt, Ph.D., Professor of Political Economy, Economics and Public Affairs - Princeton University, 4/09:
Many Americans may now seek the comfort of permanence that a fully portable, reliable and permanent government-run health insurance plan would offer them, side-by-side with the possibility of choosing a private health insurance plan instead. To deny them that opportunity would require a compelling justification… a public plan would not have to include in its premiums an allowance for profits and probably have low or no marketing costs.
Economic Policy Institute, 4/09:
Far too much of our health care system is characterized by limited or non-existent competition, both in the market for insurers as well as the market for providers. This lack of competition is a major source of the United States’ uniquely high and rising health costs. A public plan option would force private insurers to compete on efficiency and quality, rather than on their ability to enroll the lowest-cost workers and firms. Furthermore, a public plan would introduce competition to currently monopolistic or oligopolistic insurer and provider markets – three or fewer insurers account for at least 65% of market share in 36 states.
Myth: The House Democrats’ health insurance reform bill will harm small businesses – undermining their ability to create new jobs.
Fact: Far from undermining small businesses, the bill would significantly cut the costs of health care coverage for small businesses – thereby reducing the cost of doing business for many small business owners and allowing them to help their employees while saving and creating jobs. As the New York Times has pointed out, “The small business community would be one of the biggest winners from health care reform.”
Reform dramatically reduces small business health costs. The Small Business Majority recently released a report that showed that without reform, small businesses will pay nearly $2.4 trillion in health care costs over the next 10 years. If health insurance reform is enacted, the report found that small businesses could save as much as $855 billion over 10 years, nearly 36 percent. This money can be reinvested in the business and jobs.
Reform eliminates price and benefit discrimination against small businesses. A Commonwealth Fund study found the smallest firms pay an average of 18 percent more in health insurance premiums for the same benefits than larger firms. By creating a pool and offering assistance, the House health insurance reform bill will lower small business costs and increase options. As the New York Times states, “[Under the bill,] the smallest employers would gain quick access to new insurance exchanges – where plans would compete for their business with rates comparable to those enjoyed by large employers.”
Reform exempts most small firms from the employer responsibility to cover workers; others are subject to lower rate. In recognition that providing health insurance is unaffordable for many small businesses, the bill exempts most small businesses from the employer responsibility requirement – exempting all firms with payrolls of $500,000 and below. In addition, small businesses with payrolls between $500,000 and $750,000 would face a graduated fee if no health coverage is provided – rather than the 8 percent payroll fee that mid-sized and large firms not providing coverage would pay. Furthermore, many small firms already offer worker health coverage today – and will have better and more affordable options under the bill.
Reform also provides a substantial tax credit for many small businesses to make providing worker health coverage more affordable. The bill creates a permanent tax credit for small businesses to help them offer coverage to their employees – which phases out as employers’ size and average wages increase. Specifically, the bill provides a tax credit of up to 50 percent of the costs of providing health insurance to their employees for small businesses with 25 or fewer employees and average wages of less than $40,000.
Reform will not result in a loss of small business jobs. An analysis by Professor Jonathan Gruber, a respected health economist at MIT, concluded that the minority of small businesses that are subject to the requirement to provide health coverage under the bill would see little impact on their employment and profits. Furthermore, most small businesses are exempt from the requirement under the bill and instead will receive much help if they choose to offer such coverage.
Myth: The House Democrats’ health insurance reform bill will impose large tax hikes on America’s small businesses, taking a big chunk out of their hard-earned income.
Fact: Under the bill, 96 percent of small business owners would pay NO increased taxes. While the 4.1 percent wealthiest small business owners would pay a graduated “health care surcharge” on part of their income, the bill helps ALL small business owners with lower health care costs.
Only 4.1 percent of all small business owners would pay the surcharge, using the broadest definition of a small business owner. Under the bill, the wealthiest 1.2 percent of Americans would pay a graduated surcharge on income over certain levels, to help make health insurance affordable for the middle class and small businesses. For small business owners, the surcharge is only on net profits (what you take out of the business) – receipts minus expenditures (payroll, capital expenses, etc.) – above $280,000 (for single filers) and $350,000 (for married filers). The nonpartisan Joint Committee on Taxation estimates that only 4.1 percent of small business owners would net that much and therefore pay the surcharge, using the broadest definition of a small business owner (i.e., any individual with as little as $1 in small business income).
Half of the “small business owners” paying the surcharge earn less than one-third of their income from small businesses – not what we think of as truly “small business owners.”
Only 1.1 percent of “small business owners” would pay the top rate – among them, hedge fund managers, private equity fund managers, lawyers, and lobbyists making millions of dollars a year.
The facts are why employers of all sizes are supporting the America’s Affordable Health Choices Act. The Main Street Alliance, a small business group, supports the bill because it “will help make America’s small business more competitive by giving them greater control over one of the most costly and unpredictable aspects of doing business: the spiraling costs of providing quality health coverage.”
Problems with the analysis of the new NBC News/Wall Street Journal poll:
Wording of Poll Changed – Choice is kept out of the poll: In July, NBC News/Wall Street Journal changed their description of the public option, eliminating “choice” from the question. When “choice” was included in the June 12-15, 2009 version of the poll, 76 percent of respondents felt giving “people a choice” of a “public plan administered by the federal government” was important (“extremely” or “quite”) while only 20 percent responded “not that important” or “not at all important”.
No statistically significant change: The 3 percent change from last month is less than the poll’s 3.5 percent margin of error.
A public plan generates barely a ripple of controversy among voters. In the last two months, no fewer than eight polls have found strong majorities favoring a public plan. When different pollsters, using different methods and different wording, all converge on the same answer, you can bet the public really does support a public option.
Time and again polls have found support for a public option, including:
A recent Quinnipiac University poll found 62 percent in favor of giving people the option of a government insurance plan. Only 32 percent are opposed.
The latest Kaiser Family Foundation poll found 59 percent support “creating a government-administered public health insurance option similar to Medicare to compete with private insurance plans.”
Latest New York Times/CBS News poll found 66 percent favor the government “offering everyone a government administered health insurance plan… that would compete with private health insurance plans.”
Monday, August 17th, 2009 by Office of the Speaker
This weekend, some members of the media repeated a myth opponents of health insurance reform have been spreading: that people would be “forced” to choose a public health insurance option, and falsely attributes it to the Congressional Budget Office (CBO). In fact, the public option in America’s Affordable Health Choices Act simply provides those using the Health Insurance Exchange a choice between various private plans and a public plan – with the choice being made by the individual, never an employer.
Repeated Myth:
Rep. Tom Price (Associated Press, 8/16/09):
Rep. Tom Price, R-Ga., said the Democrats’ option would force individuals from their private plans to a government-run plan, a claim that the nonpartisan Congressional Budget Office supports.
ABC’s Jake Tapper on This Week with Stephanopoulos (8/16/09):
How can the Administration make the promise that if you like your insurance plan you can keep it, when CBO and other analysts estimate that some people will be switched from private to public?
Chris Wallace on Fox News Sunday (8/16/09):
…a study by the nonpartisan Congressional Budget Office which found that by 2016, 9 million people will no longer have their employer-based plan under health care reform because businesses would decide in many cases that it’s cheaper simply to pay the penalty and push people into a public plan.
NBC’s David Gregory on Meet the Press (8/16/09):
Does he [the President] undermine his credibility when he makes some claims like, if you like your insurance you can keep your insurance, when a lot of people have said not really; employers could drop people from insurance if they wanted to move people into a public plan, if that existed?
Fact:
The CBO does not support the assertion that individuals could be forced into the public option. Under the bill, no one can ever be forced onto the public plan. The only way someone would be in the public plan is the person’s own individual choice. All those using the Health Insurance Exchange will have a range of options – various private plans, and the public plan. If the employer is providing their employees health insurance through the exchange, it is the employee – not the employer – choosing what plan is best for them. CBO estimates that about 30 million people will be using the exchange by 2019 and that about one-third of them – or 11 to 12 million people – would choose the public option.
Under the proposal, small employers could allow their workers to choose among the plans available in the exchanges—including the public plan … Approximately 6 million people would obtain coverage in that way, with roughly a third choosing the public plan, so total enrollment in the public plan would equal about 11 million or 12 million, counting both individually purchased policies and employer-sponsored enrollees.
The goal of health insurance reform is to provide quality, affordable health care for every American while preserving what works in today’s system, expanding choice, and containing costs. America’s Affordable Health Choices Act provides a public health insurance option that would compete with private insurers within the Health Insurance Exchange.
Speaker Pelosi issued the following statement today on recent discussions about health insurance reform:
As the President stated in March, ‘The thinking on the public option has been that it gives consumers more choices and it helps keep the private sector honest, because there’s some competition out there.’
We agree with the President that a public option will keep insurance companies honest and increase competition.
There is strong support in the House for a public option. In the House, all three of our bills contain a public option, as does the bill from the Senate HELP Committee.
A public option is the best option to lower costs, improve the quality of health care, ensure choice and expand coverage.
The public option brings real reform to lower costs over the 10-year period of the bill.
The public health insurance option will be available in the new Health Insurance Exchange along with all of the private health insurance plans. The public option:
LEVELS THE PLAYING FIELD
Requires public option to meet the same benefit requirements and comply with the same insurance market reforms as private plans.
Establishes the public option’s premiums for the local market areas that are designated by the Exchange, just as other insurers do.
Individuals with affordability credits can choose among the private carriers and the public option.
IS SELF-SUFFICIENT
The public option must be financially self-sustaining, as private plans are.
The public option will need to build start-up costs and contingency funds into its rates and adjust premiums annually in order to assure its financial viability, as private plans do.
IS INNOVATIVE AND CONTAINS COSTS
Promotes primary care, encourage coordinated care and shared accountability, and improve quality.
Institutes new payment structures and incentives to promote these critical reforms.
And as the following polls show, Americans support having a public option to compete with private insurance plans:
Today, Rules Chair Louise Slaughter met and held a press conference with Wendell Potter, a former CIGNA Vice President who left the insurance industry after a 20 year career. Potter has since become a whistleblower, testifying before a Senate committee in June about insurance company practices such as hiking up premiums for small businesses and cutting people’s coverage off altogether if they make minor mistakes or omissions in their application paperwork.
At today’s press conference, Wendell Potter talked about the insurance industry “dirty tricks” Americans can expect to see as America’s Affordable Health Choices Act moves through Congress, including “industry-funded front groups” and “scare tactics.” Potter explained:
The industry has conducted duplicitous and well-financed PR and lobbying campaigns every time Congress has tried to reform our health care system–and how its current behind-scenes-efforts may well shape reform in a way that benefits Wall Street far more than average Americans. I noted that, just as they did 15 years ago when the insurance industry led the effort to kill the Clinton reform plan, it is using shills and front groups to spread lies and disinformation to scare Americans away from the very reform that would benefit them most. Make no mistake, the industry, despite its public assurances to be good-faith partners with the President and Congress, has been at work for months laying the groundwork for devious and often sinister campaigns to manipulate public opinion.
The industry goes to great lengths to keep its involvement in these campaigns hidden from public view. I know from having served on numerous trade group committees and industry-funded front groups, however, that industry leaders are always full partners in developing strategies to derail any reform that might interfere with insurers’ ability to increase profits.
…With this history, you can rest assured that the insurance industry is up to the same dirty tricks, using the same devious PR practices it has used for many years, to kill reform this year, or even better, to shape it so that it benefits insurance companies and their Wall Street investors far more than average Americans.
Potter also discussed the tactics that the insurance industry will use to scare us:
Americans and the media need to pay close attention to the efforts insurers and their ideological buddies will undertake…they must realize that every time they hear that by creating a public insurance option, we will be heading down “the slippery slope toward socialism,” some insurance flack like I used to be wrote that, too.
Every time you hear about the shortcomings of what they call “government-run” health care, remember this: what we have now in this country, and what the insurers are determined to keep in place, is Wall Street-run health care. And know that for all practical purposes we already have one of the most insidious means of rationing care in the world—not by people we can hold accountable on election day but by insurance company accountants, underwriters and executives who are held accountable by a few wealthy investors and hedge fund managers who care far more about earnings per share than your health and well-being.
Chair Louise Slaughter concluded:
The industry has a vested interest in the status quo and protecting its profit margin. This is just what they did in 1993 the last time we tried to reform health care. The public must be aware that the industry is not going to willingly change the way it does things and I hope the public understands what’s at stake. As Wendell Potter said, these insurance companies do what’s good for Wall Street, not main street.
Watch video highlights of today’s press conference:
How someone could take an end of life directive or a living will as [euthanasia] is nuts. You’re putting the authority in the individual rather than the government… It empowers you to be able to make decisions at a difficult time rather than having the government making them for you.
…The problem you got is that there’s so much swirling around about health care and people are taking bits and pieces out of this. This was thoroughly debated in the Senate committee. It’s voluntary. Every state in America has an end of life directive or durable power of attorney provision…
Q: Does the health care legislation bill promote “mercy killing,” or euthanasia?
A: No.
Q: Does the bill advocate assisted suicide?
A: No. It would block funds for counseling that presents suicide or assisted suicide as an option.
Q: Should the federal government be getting involved with living wills and end-of-life questions — decisions that are highly personal and really difficult?
A: It already is.
The government requires hospitals to ask adult patients if they have a living will, or “advance directive.” If the patient doesn’t have one, and wants one, the hospital has to provide assistance. The mandate on hospitals was instituted during a Republican administration, in 1992, under President George H.W. Bush.
Health insurance reform opponents continue to spread myths about components of America’s Affordable Health Choices Act. Time and again this week, the facts have disproven opponent’s claims.
The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they’ve given up any pretense of being the loyal opposition.
Myth: “A government-run plan would… force employers to drop their coverage, creating a death spiral for private insurance and financial catastrophe for many hospitals and doctors.” - Karen Ignagni, President and CEO of America’s Health Insurance Plans
Fact: The public health insurance option available in America’s Affordable Health Choices Act would provide consumers with a choice and encourage innovation and cost containment, especially in regions where one or two private insurance companies dominate the market and could use a little competition. Find out why>>
Myth: “Independent analysis by the Lewin Group shows that 2 out of every 3 people would lose their current coverage, including up to 114 million people who receive health benefits through their employer or other current coverage if a government-run plan ‘competes’ with private companies.” –House Republican Whip Eric Cantor’s “Key Facts”
Fact: While news reports have discredited the Lewin Group as a wholly-owned subsidiary of the insurance industry, the non-partisan Congressional Budget Office (CBO) confirmed the provisions in America’s Affordable Health Choices Act would result in dramatically increased coverage without crowding out private insurance. Find out why>>
Myth: “Medicare Services For Seniors Will Be Cut To Pay For Government Takeover.” Congressman Cantor’s “Key Facts”
Fact: While achieving new efficiencies, fighting fraud, and ending wasteful overpayments to Medicare Advantage providers, America’s Affordable Health Choices Act includes several key provisions that improve Medicare benefits and health care for seniors. Find out why>>
Myth: “Record High Taxes To Be Paid By Small Businesses.” Congressman Cantor’s “Key Facts”
Fact: Small businesses benefit enormously from America’s Affordable Health Choices Act. Find out why>>
Myth: “The American people know what government-run health care will mean: … bigger deficit…” – Republican Congressman Mike Pence of Indiana
Fact: The non-partisan CBO found America’s Affordable Health Choices Act is deficit neutral. Find out why>>
Myth: “Under the current draft of the Democrat health care legislation, members of Congress are curiously exempt from the government-run health care option, keeping their existing health plans and services on Capitol Hill.” – Republican Congressman John Fleming of Louisiana.
Fact: Members of Congress’ health care plan will be subject to the same rules as all other employer-sponsored plans. Nothing in the legislation exempts the Federal Employee Health Benefits plan (the plan members of Congress and staff enroll in) from the reforms. Find out why>>
Myth: The Republican reform effort, unlike the Democrats proposal, “is pro-life because it will not put seniors in a position of being put to death by their government.” – Republican Congresswoman Virginia Foxx of North Carolina
Fact: America’s Affordable Health Choices Act extends Medicare coverage to cover the cost of patients voluntarily speaking with their doctors about their values and preferences regarding end-of-life care—empowering older Americans on this critical issue. These are deeply personal decisions that take thoughtful consideration, and it is only appropriate that doctors be compensated for their time. Find out why>>
In our current health care system, women often face higher health costs than men and multiple other barriers to health insurance. Fewer women are eligible for employer-based coverage, and comprehensive coverage in the individual health care market is often unavailable or prohibitively expensive. As a result, many women are under- or uninsured, and simply can’t afford the services they need.
This afternoon, Chair of the Joint Economic Committee Carolyn Maloney (D-NY), Rep. Elijah Cummings (D-MD) and Rep. Jim Moran (D-VA) released a new report examining what’s at stake for women in the health insurance reform debate. The report, Comprehensive Health Insurance Reform: An Essential Prescription for Women, details how our current health insurance system isn’t working for women and how women are more vulnerable to high health care costs than men. The JEC also found that since the recession began in December 2007, American women have lost 1.6 million jobs — many seeing their health insurance disappear with their jobs — and over a million women have lost insurance because their husband lost his job:
Other key findings in the report:
As a consequence of single mothers’ job loss, at least 121,000 children have lost health insurance coverage since December 2007.
75% of women between age 55 and 64 report delaying health care because their own coverage was jeopardized by a spouse’s transition onto Medicare.
28% of all young women (ages 19-24) do not have health insurance coverage. The weak job market has hit young workers particularly hard, with the unemployment rate amongst young women at 15.7% in June 2009, the highest in a quarter century and substantially higher than the national unemployment rate of 9.5%.
An estimated 64 million women lack adequate health insurance.
Over half of all medical bankruptcies are filed by female-headed households.
While many Americans are taking desperate measures to cope with the medical bills that pile up following an illness, women are more likely than men to deplete their savings accounts in order to pay medical bills. One-third (33%) of under-insured women deplete their savings to pay medical bills, as compared to 25% of under-insured men.
The health consequences of inadequate coverage are more severe for women than for men and women are more likely than men to run into problems receiving adequate medical care. Over a quarter (27%) of women had health problems requiring medical attention but were not able to see a doctor, compared to 21% of men. Similarly, nearly a quarter (22%) of women reported that they were unable to fill a needed prescription, as compared to 15% of men.
18% of all women report that they delayed or did not receive needed medical care because they were unable to take time off work. Over a quarter (27%) of all low-income women report that an inability to take time off work prohibited them from obtaining needed medical care.
Because women are less likely than men to be employed full-time, they are less likely to be eligible for employer-provided health benefits. 26% of employed women work part-time, and are therefore excluded from their employers’ health insurance benefit plans. In contrast, just 13% of working men are part-time employees.
At the press conference, Sarah Wildman of Washington, DC shared her experience with discriminatory health insurance practices. As a self-employed woman, Sarah had an insurance policy she bought through the individual market (her only option for coverage) and when she and her husband had a baby, they were shocked to receive bills for well over $20,000 in hospital expenses. The policy Sarah had been paying for capped her birth-related expenses at $3,000–covering only 15% of her maternity costs:
America’s Affordable Health Choices Act is critical to women’s physical and fiscal health — addressing not only the current lack of access to quality affordable health care, but also skyrocketing health care costs. Key provisions in the bill for women:
Eliminates co-pays on recommended preventive services such as breast cancer screenings delivered by Medicare, Medicaid, the new public health insurance option and private plan options in the Health Insurance Exchange. Over a number of years, all private health plans would be required to cover preventive benefits without cost-sharing.
Prohibits new plans from charging women more than men by banning gender rating. This protection will extend to health plans offered by employers over time as well.
Includes coverage of maternity services as a benefit category in the new basic benefit package. All plans in the Exchange would be required to cover maternity services and over time, plans outside the Exchange would be required to do so as well.
Bans the insurance industry practice of rejecting applicants with pre-existing conditions, which has kept women with histories of health problems — even survivors of domestic violence — from accessing individual coverage.
Requires employers to offer adequate insurance coverage to their employees or pay into the system to help their workers afford coverage through the Health Insurance Exchange.
Offers affordability credits to ensure that insurance available in the Exchange is affordable for women and everyone with an income below 400% of poverty.
All plans within the Exchange, and outside the Exchange over time, will be required to contain a standardized annual out-of-pocket spending limit (yearly caps on what you pay) to prevent women and their families from facing bankruptcy due to medical expenses.
Quality, affordable health care is vital for all Americans, but as the JEC report documents, American women face unique challenges and burdens in our current health care system. America’s Affordable Health Choices Act ensures that if you like your plan, you keep it — but provides long overdue insurance reforms for everyone and new solutions for the 64 million uninsured, and millions more who are under-insured, American women.