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Health Care Blog

  • Health Insurance Reform vs. Medicare Part D

    Posted by Dan Pfeiffer on November 21, 2009 at 5:08 PM EDT

    Opponents of health insurance reform have spent hours on the Senate floor today attacking the Senate's efforts to provide stability and security for those with insurance, affordable coverage for those without, and lower costs for families, small businesses and the government. To provide a little perspective on these attacks, let’s compare today's legislation with the 2003 Medicare Part D effort, which many of these same critics supported:

     
    Senate Health Reform
    Medicare Part D
    Effect on the Deficits over First 10 years
    Decreased by $130 billion
    Increased by $395 billion
    Cost from 2010-2019
    $848 billion
    $600 billion
    Length
    2,074 pages
    1,044 pages

    Learn more about Fiscal Responsibility, Health Care

  • Speaking of Page Numbers...

    Posted by Dan Pfeiffer on November 21, 2009 at 12:30 AM EDT

    Since some opponents of reform seem too obsessed with the length of the Senate health insurance reform bill to even bother looking at what's in it for American families, we thought we'd make it a little easier for them to find some key of provisions they're working so hard to kill:

    • On page 78 you’ll learn that the Patient Protection and Affordable Care Act ends discrimination based on pre-existing conditions.
    • On page 17, it makes preventive care completely free, with no cost-sharing.  (This might be of particular interest to those who have chosen to seize on concerns about the U.S. Preventive Services Task Force Recommendations on mammograms to spread baseless myths and advance their own political agenda.)
    • Flipping back to page 16, you’ll find that insurance companies are prohibited from dropping your coverage or watering it down when you get sick and need it most.
    • Also on page 16, you might notice that it puts an end to lifetime caps on coverage.
    • Page 18 is where the bill extends family coverage eligibility for young Americans through the age of 26.
    • On page 83 it requires insurance companies to renew any policy as long as the policyholder pays their premium in full – that means they can’t refuse to renew your coverage just because you get sick.
    • Page 307 is home to tax credits for small businesses to help them afford insurance for their employees.
    • And folks looking to scare our senior citizens about what reform means for them might be interested to check out page 923 and learn that it provides a 50% discount on drugs for seniors in the so-called donut hole.

    Learn more about Health Care

  • Reality Check: The "Rationing" Smear... Again?

    Posted by Dan Pfeiffer on November 20, 2009 at 4:03 PM EDT

    Reality Check

    When people use arguments they know are bogus, it's probably because they know they don't have any valid arguments at their disposal. So it would seem with opponents of reform in the Senate spending today obsessed with arguments about "rationing" that were debunked months ago.

    Their attacks are focused on the fact that the legislation supports research into what treatments work best for patients. Before we go any further, let's just say this as plainly as possible:

    Under health insurance reform, this research cannot be used to dictate coverage.

    In fact, this objective medical research empowers doctors and patients and helps them fight insurance company decisions to deny treatment and ration care.  Maybe this is why opponents of reform are trying so hard to keep updated medical information out of the hands of our nation's doctors.

    What this patient-centered health research does specifically is provide doctors and patients with the best medical information to help them make the best decisions, and it is even written into the law that the Secretary of Health and Human Services cannot deny coverage of a treatment based solely on this research. When you consider that this research is intended only to make sure you get the most effective care, opposition seems outright bizarre, and twisting it into some "rationing" attack seems outright low.

    In case anybody wants an objective source on this, the independent watchdog Politifact gave such claims an unambiguous “False” rating back in August. Yes, August:

    But in this case, there actually are provisions in the bill about comparative research to make sure it is not used for rationing. Language in the House version of the health bill specifically states: "Nothing in this section shall be construed to permit the Commission or the Center to mandate coverage, reimbursement, or other policies for any public or private payer."

    And let's be clear, comparative effectiveness research has been done by the government for years and years. The Obama administration wants to greatly expand the amount of research. The economic stimulus package also included more funding for comparative effectiveness research. And the bill included a similar disclaimer that it would not mandate insurers to cover or reimburse one treatment or medication over another.

    Need more?  Politifact had a couple more reliable sources up their sleeve:

    AARP, the leading advocate for seniors, has long been a strong supporter of such research.

    "It boggles the mind" said AARP spokesman Jim Dau, how comparative effectiveness research has been portrayed by opponents of the health care plan as government rationing of care.

    "It's just good common sense," Dau said of the research. "It's giving individuals and doctors better evidence-based research so that they can make better decisions."

    Gail Wilensky, who ran the Medicare program under President George H.W. Bush in the early 1990s, is another big advocate of comparative effectiveness research. She views it as lobby-free information that can be used to empower patients.

    A New York Times editorial out today also touches on one of the recent news hooks opponents of reform are attempting to twist for their own purposes, the bogus links between a recent study on mammograms and health insurance reform (previously debunked here as well). They rightly boil the issue down to this:

    The only part of the reform bills that could affect mammography would only make them more accessible.

    This could be said of preventive care across the board as well.

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  • Reality Check: Claims That Reform Will Encourage Abortions at School "Sex Clinics" are Absurd

    Posted by Macon Phillips on November 19, 2009 at 9:16 PM EDT

    Reality Check

    Ed. Note: Opponents of health reform appear to have run out of fresh smears against health insurance reform and have started recycling old debunked attacks. In response to those that brought up this attack that Politifact proved false months ago, we simply bring back this classic Reality Check first published on October 1, 2009.

    Last night Minnesota Congresswoman Michele Bachmann questioned health insurance reform, raising the spectre of school-based "sex clinics" that would take students to "have their abortion, be back and go home on the school bus that night":

    It means that parents will never know what kind of counsel and treatment that their children are receiving.  And as a matter of fact, the bill goes on to say what's going to go on -- comprehensive primary health services, physicals, treatment of minor acute medical conditions, referrals to follow-up for specialty care -- is that abortion? Does that mean that someone's 13 year-old daughter could walk into a sex clinic, have a pregnancy test done, be taken away to the local Planned Parenthood abortion clinic, have their abortion, be back and go home on the school bus that night? Mom and dad are never the wiser.

    The absurdity of this claim earns high honors from Politifact, a non-partisan research organization: Pants on Fire!

    Critics of the Democratic health care proposal have been increasingly raising concerns that the plan would provide taxpayer-subsidized abortions (a claim we address here). The Liberty Counsel, a conservative group, puts a different twist on that concern, alleging that Page 992 of the bill "will establish school-based 'health' clinics. Your children will be indoctrinated and your grandchildren may be aborted!"

    The claim comes from a long list of items allegedly in the bill that is posted on the group's Web site and has been widely circulated in a chain e-mail. The list looks a lot like one that we checked in July, based partly on blog postings by Peter Fleckenstein on his blog Common Sense from a Common Man . In fact, the Liberty Counsel says it adapted its memo from Fleckenstein's original work.
    …

    We spoke with Sarah Speller at the Liberty Counsel, who told us that the group had been getting a lot of calls about the memo and that everyone there was very busy as a result. However, she assured us that "as far as our office can tell, everything in the overview is accurate. That's about all I can tell you," she said. "I'm just relaying what I've been told to say."

    That's not persuasive. We see no language in the three main versions of the bill that would allow school-based clinics, which have a long history of providing basic health services to underprivileged students, to provide abortions. Nor would the clinics even be new — they have been around for three decades. So we rate the claim Pants on Fire!

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  • Reality Check: Desperately Twisting the CBO Analysis on the Deficit

    Posted by Dan Pfeiffer on November 19, 2009 at 8:55 PM EDT

    Reality Check

    From the very beginning defenders of the status quo have held up the Congressional Budget Office as the gold standard for judging the impact of health reform legislation on the deficit. Indeed, as recently as two weeks ago, when alternative legislation based on insurance industry proposals was introduced, those opponents of real reform boasted of the CBO's declaration that it would cut the deficit by $68 billion over 10 years.

    But that was a long time ago (two weeks ago), and now times have changed. Now that the very same CBO has declared that the Senate’s Patient Protection and Affordable Care Act cuts $130 billion from the deficit, those same defenders of the status quo seem to be saying that the CBO estimate is meaningless.

    Their argument claims that because some aspects of the legislation don’t kick in for the first few years, such as the health insurance exchange, the CBO estimate is skewed. Here are the facts:

    • The suggestion that this bill pays for six years of coverage with ten years of pay-fors is simply false: Even in the six-year period when the exchange is operational (2014-2019) the CBO finds that the bill will reduce the deficit by at least $31 billion.
    • The claim that early surpluses mask later deficits is also untrue: In 2019 alone, the bill reduces the deficit by $8 billion, and in the second decade the CBO finds that the bill will continue to reduce the deficit.  
    • Taking the time necessary to launch the health exchange is responsible policy, not a gimmick. Republicans who supported the Medicare Part D program should remember that it took three years to stand up that program.
    • In the run-up to launching the exchange in 2014, the Senate plan takes several important steps to improve the quality and affordability of care, including investments in: tax credits for small businesses, a high risk pool, reinsurance, and prevention programs and our health care workforce, along with saving seniors thousands on prescription drug costs.

    No matter how you try to twist or distort its analysis, the Congressional Budget Office has confirmed that the Senate Health Bill is a solidly fiscally responsible approach to health reform.

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  • Moving Closer to a Victory for All Americans

    Posted by Valerie Jarrett on November 19, 2009 at 1:53 PM EDT

    In an historic vote a week and half ago, the House of Representatives passed a bill that would finally make affordable health care possible for the citizens of our wonderful country.  Then yesterday the Senate introduced their own legislation, "another critical milestone in the health reform effort" as the President put it.

    When President Obama addressed members of Congress in September, "This is our moment to live up to the trust that the American people have placed in us—even when it’s hard; especially when it’s hard. This is our moment to deliver."  But of course as great a milestone as the vote was, we’ve still got a ways to go so we need everybody to stay involved.

    For our part, we have been working all along to ensure the American people are engaged in the discussion on reform.  That’s why I hosted a web chat recently on how health insurance reform will help to eliminate health disparities and how reform will affect underserved communities.  Citizens and leaders from around the country submitted hundreds of questions beforehand and during the chat via Facebook.  I wanted to post the video of that for anybody who missed it and take this opportunity to address some of the questions we didn’t have time to answer.

    Download Video: mp4 (390MB) | mp3 (28MB)

    Question #1: We got a lot of questions from disabled Americans – I touched on some of the issues during the chat, but this was another one I wanted to address:

    "How will the special needs of some people with disabilities be addressed? Examples include deaf individuals needing interpreters skilled in signing medical information, women who are partially paralyzed or use wheel chairs needing special equipment for medical examinations such as gynecological examinations. The Rehabilitation Institute of Chicago would be a great resource on these issues."

    Health reform will lower costs for people with disabilities by rewarding quality and cutting waste, two guiding principles for this entire effort.

    By expanding health insurance to all Americans and providing premium assistance to make it affordable, health insurance reform will significantly increase access to a choice of health insurance plans for individuals with disabilities. This will enable individuals who are employed to keep their jobs rather than giving up employment in order to receive Medicaid benefits.

    People with disabilities are less likely to receive preventive care and are more likely to be diagnosed with screenable cancers at a later stage. By ensuring that all Americans have access to preventive care and investing in public health, health reform will work to create a system that prevents illness and disease instead of just treating it when it’s too late.

    In addition, health reform will include the CLASS Act - a new voluntary, long-term care services insurance program.  Under the program, individuals will pay a premium, and in exchange, the program will provide a lifetime cash benefit that offers seniors and people with disabilities some protection against the costs of paying for long-term supports and services.  The program also helps individuals obtain services and supports that will enable them to remain in their homes and communities. The CLASS Act is not comprehensive long-term care reform, but it represents a helpful step that provides individuals with a viable mechanism for insuring against the risk of needing long-term services that broadens the resources for financing long-term services to lessen the reliance on Medicaid. 

    Question #2:  This is a question that we didn’t get to, but really we just can’t answer enough because of how much misinformation has been out there about it:

    "How will the health insurance reform affect costs and coverages for seniors who currently already have Medicare? Will they have to pay more taxes in the future? Many solely depend on their social security retirement income, what impact does it have on seniors?"

    Health insurance reform protects Medicare benefits and reduces costs for seniors. Medicare benefits will not be cut.  Period.  In fact, seniors will get benefits they do not have under the current system: a reduction in prescription drug prices if they fall into the gap in coverage known as the “donut hole”; no cost-sharing for preventive care; and more coordinated care that will enable providers to track their health, treatments and prescriptions and avoid duplication and medical errors.
     
    The President’s plan protects Medicare and improves its financial health. Not one penny of the Medicare Trust Fund will be used to help pay for reform.

    By eliminating waste, such as overpayments to private insurance companies and cutting down on unnecessary hospital readmissions--- we will strengthen the Medicare trust fund – by 4 to 5 years - and be sure benefits are protected in the future.

    Question #3: This one gets at a core issue in our health care system:

    "Health Insurance Reform has focused on acute medical care. Why has it ignored long-term care which if unattended creates serious acute medical care problems (particularly for minority communities)? When will the White House address long-term care?"

    As I mentioned above, health insurance reform adds a new, innovative program for long-term supports and services called the CLASS Act. Employed individuals pay premiums, and if they develop a disability, they receive a cash benefit of at least $50 a day that they can use to pay to for services to assist them with daily activities. This program will empower people to remain active in their communities, and take charge of their long-term care needs. It will also help people avoid needing to go into a nursing home or other nursing facility.

    Beyond the CLASS Act, several proposals exist that would improve long-term care. The draft Senate Finance bill would provide additional funding to states to develop home and community based services under Medicaid.  It would also provide funding to ADRCs, or Aging and Disability Resource Centers, which provide needed information for people with disabilities seeking caregiver assistance. Also, nursing homes would have increased transparency, including reporting of staffing and improved complaints processes.

    Valerie Jarrett is Senior Advisor and Assistant to the President for Intergovernmental Affairs and Public Engagement

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