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| - “Issa wouldn’t protect us from a bill that raises premiums and causes 24 million to lose their insurance.”
— new “Save My Care” ad attacking Rep. Darrell Issa (R-Calif.)
Let’s walk through the claims in the ad aimed at Issa. As attack ads go, this one is relatively careful about its language.
“Congressman Issa promised to protect our health care. But when right-wing politicians tried to pass a disastrous health-care repeal bill that raises costs and cuts coverage, Issa wouldn’t oppose them…”
We’ll get into the specifics about raising costs and cutting coverage below. But whether Issa “wouldn’t oppose” the health-care replacement backed by President Trump is a matter of dispute. Save My Care pointed to a variety of news articles in which Issa indicated that changes made in the bill to attract votes had swung him toward a “yes” position. The right-leaning American Action Network even ran an ad thanking Issa even though a vote never took place.
But Calvin Moore, Issa’s communications director, said Issa never supported the bill: “The congressman said that the bill wasn’t ‘in a form that I can approve of,’ then followed it up later on Fox News, telling the network that he’s ‘not prepared to vote for it as is right now.’” He said that Issa raised concerns that the bill wouldn’t do enough for mental health, that it could leave many — particularly those nearing retirement — worse off, and that it didn’t do enough to expand the risk pools to help curb some of the premium increases in Obamacare. Issa has proposed to open the Federal Employees Health Benefits Plan (FEHBP) to all Americans.
Moore said the AHCA had been improved, which is why Issa said he was leaning toward a yes, but it still had not won Issa’s support when it was pulled from a vote. He noted that after the bill was pulled, Issa issued a statement calling the bill “imperfect” and said lawmakers need to get “back to the drawing board.”
In the end, Issa never pledged his support for the bill. One presumes that’s why the ad says he did not oppose it, which is technically correct.
“… Issa wouldn’t protect us from a bill that raises premiums and causes 24 million to lose their insurance…”
We’ve criticized Democrats for seizing on a Congressional Budget Office report to claim that the bill would “throw 24 million people off health insurance,” “take away health care for 24 million,” or make 24 million “lose their insurance.” Here, the ad more conservatively says “causes 24 million to lose their insurance.” But it still could be confusing to ordinary people.
The CBO projected the impact of the AHCA compared to existing law, and concluded that 24 million fewer people would have health insurance by 2026. As the CBO put it, “the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026.” But that does not mean that all of those people involuntarily lost their insurance, as the ad suggests.
Initially, CBO said, many of the people who would be uninsured would choose not to have insurance because they had decided to obtain health insurance only to avoid a penalty under the ACA’s individual mandate; the replacement bill eliminated the mandate. Others, such as elderly Americans, would not get insurance because the premiums would become higher for the elderly. But by 2026, 14 million of the uninsured people would lose insurance because of reductions in Medicaid enrollment — after some states discontinue the Medicaid expansion under Obamacare. By 2026, 7 million fewer people also would have health insurance through their employers, CBO estimated.
As for raising premiums, again the CBO projected the impact versus current law. Premiums would initially be higher, but by 2026 premiums would be about 10 percent lower. (This does not mean that premiums would decline by 10 percent, just that they would increase at a lower rate than now projected.)
But the reasons for the decrease were not necessarily favorable for the proposed law. That’s because insurance premiums would spike for older people (20 to 25 percent higher for a 64-year-old) and many older people would drop out of the insurance markets. Then the pool of people getting insurance would be younger and healthier, leading to lower premiums than currently projected. The Brookings Institution, in an effort to come up with an apples-to-apples comparison, estimated that premiums under the proposed law would actually be 13 percent higher if adjusted for coverage and age.
Save My Care pointed to the Brookings study to justify the phrasing on “raising premiums.” Given that the premiums were projected to decrease mainly because older people were being priced out of the market, the language in the ad about premiums is acceptable.
“… wouldn’t oppose a massive ‘age tax’ on people over 50…”
“Age tax” is a phrase coined by AARP, the old-age interest group, to refer to the fact that proposed law would have changed the Obamacare requirement that older people could pay no more than three times a young person. Under the AHCA, the 3:1 ratio would have become 5:1. The result, as noted above, would have meant premiums would have dropped for younger Americans, relative to current law, but increased sharply for older Americans.
So it’s not really a tax, but an increase in health-care premiums.
“… and isn’t fighting to protect coverage for preexisting conditions.”
One of the most popular features of the ACA is its ban on insurance companies considering preexisting conditions. But conservative Republicans have pushed for changes that experts say could undermine that aspect of the law, such as allowing states to opt out of a requirement to provide certain benefits and charge the same price to everyone the same age. Save My Care says this line is based on the fact that Issa has not stated a position on these proposals. The bill was amended just before Congress went on recess, but the amendment did not include the broader changes sought by conservatives.
Moore noted that the AHCA contained protections for preexisting conditions, as does Issa’s own health-care proposal. “Preexisting conditions coverage is a part of his FEHBP-based bill which he said should be part of the conversation when we ‘go back to the drawing board,'” he said.
The Pinocchio Test
The ad is carefully worded, apparently in an effort to avoid becoming fact-checker bait. We noted our concern about the phrasing concerning the 24 million losing insurance, but even that did not push the envelope as much as many Democrats have in the past. The ad also leaps to a conclusion that Issa “isn’t fighting” to provide coverage for preexisting conditions, when he has indeed been a supporter of that aspect of Obamacare.
Also missing, of course, is any notion that there are serious problems with the Affordable Care Act, including higher premiums and shrinking insurance options, that Congress at some point needs to tackle. Issa certainly has been a critic of Obamacare, but unlike the suggestion in this ad, he never fully embraced the House Republican bill either. Readers should always be wary of the claims made in 30-second attack ads, as the truth often is much more complex.
One Pinocchio
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