The Post And Courier's 2 Year Attack Against The Affordable Care Act

››› ››› SALVATORE COLLELUORI

Over the past two years the Affordable Care Act (ACA) has benefited millions of Americans nationwide. Despite the successes of the law, South Carolina's The Post and Courier has attacked the ACA more than 27 times in its editorials over the past 2 years -- often regurgitating false conservative talking points. Contrary to the misrepresentations of the editorial board, South Carolinians have seen many direct benefits from the law already and will continue to do so. A few of the Post and Courier's myths are highlighted below.

CLAIM: Waivers Were Granted Because Health Care Reform Was Too Expensive And Would Kill Jobs

The Administration Has Granted Waivers Because "Unions And Other Organizations ... Simply Can't Afford To Comply" With The Health Care Law. According to a March 2012 editorial in the Post and Courier:

The administration also has granted more than 1,700 waivers to businesses, unions and other organizations on the practical grounds that they simply can't afford to comply with the so-called Affordable Care Act. [Post And Courier, 3/17/12]

1,800 Waivers Were Granted Because Of Groups "Urgent Warnings That [ACA] Would Kill Jobs." According to a November 2011 editorial in the Post and Courier:

Plus, more than 1,800 companies, unions and other organizations have already been granted waivers from the law, based in large part on their urgent warnings that it would kill jobs. [Post and Courier, 11/17/11]

Post and Courier: "Now Ponder Why Some Companies (And Unions) Are Getting Waivers And Others Are Not - And Why So Many Want Them." According to a November 2011 editorial in the Post and Courier:

Yet House Minority Leader Nancy Pelosi, D-Calif., recently told CNBC that while that number sounds large, the enterprises that got passes from the law are generally not.

She explained: "I couldn't speak to all 1,800 of them, but some of the lists that I have seen have been very, very small companies. They will not have a big impact on the economy of our country."

Huh?

Ponder this merely partial list of the many not-so-small outfits that have gotten Obamcare waivers: McDonalds, the United Federation of Teachers, Aetna, the AFL-CIO Health and Welfare Trust, Manor Care Inc., Universal Forest Products Inc., Waffle House, Universal Orlando, Ruby Tuesday, Olive Garden, Red Lobster ...

Now ponder why some companies (and unions) are getting waivers and others are not -- and why so many want them. [Post and Courier, 11/10/11]

"Growing Confusion -- And Fear" About ACA "Has Prompted The Administration To Grant Nearly 1,500 Waivers From It." According to an August 2011 editorial in the Post and Courier:

And since Obamacare was passed by Congress and signed by the president 17 months ago, growing confusion -- and fear -- about its impact has prompted the administration to grant nearly 1,500 waivers from it. [Post and Courier, 8/31/11, via Nexis]

Post and Courier: "Recognizing Those Job-Killing Implications, The Obama Administration Has Been Granting A Rapidly Rising Number Of Exemptions From The Law's 'Minimum' Standards Of Employee Coverage." According to a December 2010 editorial in the Post and Courier:

Recognizing those job-killing implications, the Obama administration has been granting a rapidly rising number of exemptions from the law's "minimum" standards of employee coverage. Among the waiver recipients (so far) are McDonald's, Waffle House and Universal Orlando.

In a telling twist, 34 unions also have obtained coverage waivers. As The Associated Press reported last week: "Many unions had fought hard for health reform and were dismissive about fears that companies would simply dump their coverage if health reform passed. But unions are now demanding to be exempt from the new law." [Post and Courier, 12/14/10, via Nexis]

FACT: Many Of The Temporary Waivers Were Issued As A "Stop-Gap Measure" To Maintain Existing Coverage Until 2014

Mother Jones: Waivers Are "Essentially A Stop-Gap Measure Designed To Keep Employers From Dropping Health Care Benefits All Together." Mother Jones explained the purpose of waivers for the health care reform law:

Altogether, the Obama administration has granted 1372 waivers and has denied about 100 requests. The mini-med waivers are essentially a stop-gap measure designed to keep employers from dropping health care benefits all together. The White House explains that waivers are granted if conforming to the rules "would disrupt access to existing insurance arrangements or adversely affect premiums, causing people to lose coverage," acknowledging that the low-benefits plans are sometimes the only option that some employers can offer. The Democrats' rationale is that the other changes under federal health reform will eventually allow employers to receive better, more affordable coverage under the health insurance exchange, when it begins operating in 2014. [Mother Jones, 5/17/11]

National Retail Federation VP: Waivers Are Temporary And "Safeguard Existing Coverage" Until 2014. According to Kaiser Health News, Neil Trautwein, vice president of the National Retail Federation, stated:

What we're dealing with is an imperfect world between 2010 and 2014, and how you best safeguard existing coverage in this transition. For this limited-benefits coverage, also known as "mini-meds," nobody is going to pretend that this is the best coverage around, but having that coverage beats not having any coverage. And for a lot of people, if that coverage disappears, they'll have no other affordable alternative to turn to. So our point, which I think the administration shares, is that for the 1.4 million covered by these policies today, you want to make sure that you don't disrupt that before 2014, when there will be more and more affordable alternatives available.

The administration has been very careful to, on the waivers from the restrictions on annual benefit limits, make them year-by-year waivers. So these are not blanket waivers, these are not eternal waivers. [Kaiser Health News, 10/8/10]

White House: "Employers Who Hire Lower Wage, Part Time Or Seasonal Workers" Are Eligible For Waivers. According to the White House's Stephanie Cutter:

Employers who hire lower wage, part time or seasonal workers are more likely to offer limited benefit plans. Retail or chain restaurant employers frequently offer limited benefit plans that contain less comprehensive coverage and annual dollar limits on how much workers can receive in health coverage. The premiums for these limited benefit policies (known as mini-meds) are significantly lower than for policies with comprehensive coverage and are more affordable for lower wage workers and their families. In exchange for the low premiums, these policies generally come with high deductibles and annual dollar caps as low as $2,000. In addition, in many cases, employees are paying the full cost of the insurance policy, with no help from their employer. [...]

The bad news is that today mini-meds are often the only affordable option for many low-wage workers because retail and chain restaurants rarely offer their workers options beyond these plans. And because mini-meds are built around annual limits, estimates from employers and insurers indicate that beginning the phase out of annual limits this year would cause mini-med premiums to rise by more than 200 percent, forcing employers to drop coverage and sending many low-wage workers to purchase insurance on the more expensive individual insurance market, where they would get an even worse deal than what they have today. The result would be a whole new population of uninsured Americans. [WhiteHouse.gov, 12/10/2010]

FactCheck: Waivers "Merely Give Companies A Temporary Delay Before Being Required To Improve The Coverage Of Cheap, Bare-Bones Plans They Currently Offer." From FactCheck.org:

We've received several questions about whether businesses have been able to opt out of the new health care law. The companies haven't been granted permission to ignore the entire law, as the Facebook post quoted by our reader might suggest -- but many have been given one-year waivers to delay compliance with a key insurance mandate that was put into place this fall. The White House says it instituted the waiver process to enable those companies to continue to provide limited-benefits plans -- cheap, bare-bones policies called mini-med plans -- until the law is fully implemented in 2014.

[...]

The new health care law aims to eliminate low annual coverage caps like those over time, and this is where the waiver issue has come in. The law says that annual coverage limits can't be set lower than $750,000 for new policy years starting between Sept. 23, 2010 and Sept. 23, 2011. That cap will be raised each year until 2014, when the law will require companies to have no annual spending limits on most benefits in health care plans.

[...]

The companies that have been approved for the waivers must reapply for them next year. Waivers are available until 2014. [FactCheck.org, 12/7/10]

Mini-Med Policies Enforce An Annual Limit On Care And Are Banned Under ACA Due To Their Inability To Provide Comprehensive Health Coverage. According to a December 9, 2010, Health and Human Services fact sheet:

"The Affordable Care Act will end 'mini-med' plans in 2014 and provide Americans with affordable, high-quality coverage options. Unfortunately, today, mini-med plans are often the only type of private insurance offered to some workers. In order to protect coverage for these workers, HHS has issued temporary waivers from rules restricting the size of annual limits to some group health plans and health insurance issuers. Waivers only last for one year and are only available if the plan certifies that a waiver is necessary to prevent either a large increase in premiums or a significant decrease in access to coverage." [Healthcare.gov, Fact Sheet, 12/09/10, emphasis added]

FactCheck: Companies From Industries That Opposed Health Care Reform Have Been Granted Waivers. From FactCheck.org:

[A]s of Dec. 3, the federal government had approved a total of 222 one-year waivers that allow the insurance plans at companies like McDonald's, Jack in the Box and Ruby Tuesday, and unions, to ignore the requirement on annual limits. Far from being "Obama's buddies," as the Internet post claimed, the restaurant industry, through the National Restaurant Association, opposed the legislation. [FactCheck.org, 12/7/10]

The Obama Administration Has Ended The Waiver Program. According to MSNBC:

The Obama administration says it will end a controversial health care waiver program in September.

Officials announced Friday that all applications for new waivers and renewals of existing ones have to be in by Sept. 22.

That would remove a potential political distraction in the 2012 elections.

The waivers deal with a part of the new health care law that restricts annual dollar limits on coverage. They won't be needed when the law goes into full effect in 2014, because taxpayer-subsidized insurance will be broadly available. [MSNBC, 6/17/11]

CLAIM: ACA Cost Estimates Have Continued To Increase

Post and Courier: "President Barack Obama Offered Dubious Pitches" For The Affordable Care Act "Including A Projected Cost Of Only $940 Billion In Its First Decade." According to a March 2012 editorial in the Post and Courier:

President Barack Obama offered dubious pitches for his landmark health care reform initiative, including a projected cost of only $940 billion in its first decade. This week, the Congressional Budget Office revised its forecast of the cost for that period to $1.76 trillion. Some number crunchers outside the Beltway warn even that new estimate doesn't adequately account for likely increases in medical expenses. [Post and Courier, 3/17/12]

FACT: Despite The Changing Cost Estimates, The ACA Will Still Reduce The Deficit Over 10 Years

The ACA Will Have A Gross Cost Of $1,762 But A Net Cost Of $1,252. According to the Congressional Budget Office:

This report also presents estimates through fiscal year 2022, because the baseline projection period now extends through that additional year. The ACA's provisions related to insurance coverage are now projected to have a net cost of $1,252 billion over the 2012-2022 period; that amount represents a gross cost to the federal government of $1,762 billion, offset in part by $510 billion in receipts and other budgetary effects (primarily revenues from penalties and other sources). [CBO.gov, 3/13/12]

Even Though Revised Cost Estimates Continue To Increase, The Offsetting Budgetary Effects Cause Net Decrease In Cost Over 10 Years. According to the Congressional Budget Office:

Gross Costs Are Higher, but Offsetting Budgetary Effects Are Also Higher

The current estimate of the gross costs of the coverage provisions -- $1,496 billion through 2021-- is about $50 billion higher than last year's projection; however, the other budgetary effects of those provisions, which partially offset those gross costs, also have increased in CBO's and JCT's estimates -- to $413 billion -- leading to the small decrease in the net 10-year tally.

Over the 10-year period from 2012 through 2021, enactment of the coverage provisions of the ACA was projected last March to increase federal deficits by $1,131 billion, whereas the March 2012 estimate indicates that those provisions will increase deficits by $1,083 billion. [CBO.gov, 3/13/12, emphasis original]

CBO: "The Net Effect Of Changes In Direct Spending And Revenues Is A Reduction In Budget Deficits Of $210 Billion" Over The Next 10 Years. According to the Congressional Budget Office:

According to our latest comprehensive estimate of the legislation, the net effect of changes in direct spending and revenues is a reduction in budget deficits of $210 billion over the 2012-2021period. [CBO.gov, 3/30/11]

CLAIM: The Affordable Care Act "Includes $500 Billion In Medicare Funding Cuts"

The Health Care Reform Law "Includes $500 Billion In Medicare Funding Cuts." According to an August 2010 editorial in the Post and Courier:

Andy Griffith, still widely seen in "Andy Griffith Show" and "Matlock" reruns, is the star of the 30-second spots. Now 84, he reassures viewers with a sincerity worthy of Sheriff Andy Taylor: "With the new health care law, more good things are coming - free checkups, lower prescription costs and better ways to protect us and Medicare from fraud."

Mr. Griffith adds: "Like always, we'll have our guaranteed benefits."

He doesn't mention that the reform law includes $500 billion in Medicare funding cuts. He doesn't explain how creating a huge new health care entitlement program could possibly guarantee the financial security of the health care entitlement giant that's already going broke. [Post and Courier, 8/8/10, via Nexis]

FACT: Savings, In Part, Will Come From Reducing Inefficiency; Experts Predict Quality Of Care Under Medicare Will Not Decline

FactCheck: Cost-Saving Provisions Are "Not A Slashing Of The Current Medicare Budget Or Benefits." According to FactCheck.org:

Whatever you want to call them, it's a $500 billion reduction in the growth of future spending over 10 years, not a slashing of the current Medicare budget or benefits. It's true that those who get their coverage through Medicare Advantage's private plans (about 22 percent of Medicare enrollees) would see fewer add-on benefits; the bill aims to reduce the heftier payments made by the government to Medicare Advantage plans, compared with regular fee-for-service Medicare. The Democrats' bill also boosts certain benefits: It makes preventive care free and closes the "doughnut hole," a current gap in prescription drug coverage for seniors. [FactCheck.org, 3/19/10]

PolitiFact: Reductions "Aimed At Eliminating Parts Of The Medicare Program Seen As Ineffective Or Wasteful." From PolitiFact.com:

Under the act, Congress voted to reduce $500 billion in projected Medicare spending over the next 10 years, not in one substantial chunk. The reductions are aimed at eliminating parts of the Medicare program seen as ineffective or wasteful. For example, the plan phases out payments to the Medicare Advantage program, an optional program set up under the George W. Bush administration, where seniors could opt to enroll in a private insurance program and the federal government would subsidize a portion of their premium. [PolitiFact.com, 5/10/11]

PolitiFact: "Experts Say The Quality Of Care Should Not Be Shortchanged." From PolitiFact:

[E]ven though $500 billion in spending is being reduced, health care experts say the quality of care should not be shortchanged.

"Some (reforms) increase Medicare spending to improve benefits and coverage," said Tricia Neuman, vice president and director of the Medicare Policy Project at the nonpartisan Kaiser Family Foundation, in a video on the foundation's website.

"Other provisions reduce the growth in Medicare spending to help the program operate more efficiently and help fund coverage expansions to the uninsured in the underlying health reform legislation," Neuman said. "Other provisions are designed to improve the delivery of care and quality of care." [PolitiFact.com, 5/10/11]

New England Journal Of Medicine: Affordable Care Act Eliminates "Substantial Overpayments" To Medicare Advantage Plans. From an article by Robert A. Berenson in The New England Journal of Medicine:

[T]he currently projected savings come from two main sources: reduced payments to private Medicare Advantage plans and reduced payment updates for hospitals and most other providers. A phased elimination of the substantial overpayments to Medicare Advantage plans, which now enroll nearly 25% of Medicare beneficiaries, will produce an estimated $132 billion in savings over 10 years.

[...]

The Medicare Payment Advisory Commission (MedPAC) has been calling for such fee reductions for years, to keep Medicare Advantage from undermining traditional Medicare.

The ACA also produces nearly $200 billion in savings by assuming that providers can improve their productivity as firms in other industries have done. On the basis of this presumed improvement, the law reduces Medicare's annual "market basket" updates for most types of providers -- a provision that has generated controversy. [The New England Journal of Medicine, 7/8/10]

FactCheck: Changes To Medicare Advantage Come With Extra Benefits For All Medicare Enrollees. According to FactCheck.org:

The CBO has estimated that the move would change the value of the extra benefits Medicare Advantage participants get, but they would not receive fewer benefits than the rest of seniors who aren't on the Advantage plans. The bill does add some extras for Medicare beneficiaries, eliminating copays and deductibles for preventive services, for example. [FactCheck.org, 12/2/09]

CLAIM: IPAB Has The Power To Ration Care For Americans

The IPAB Has "The Sort Of Power Enjoyed By The World War II Rationing Authority, The Office Of Price Administration." According to a May 2011 editorial in the Post and Courier:

Earlier presidents have appointed super-bureaucrats and resisted congressional efforts to curb this abuse. But little in American history has prepared the nation for Mr. Obama's extra-constitutional schemes for controlling health care.

For example, the insurance mandate in ObamaCare is clearly novel in requiring citizens to buy insurance or pay a fine, and it faces multiple court challenges as an overstretch of the Commerce Clause.

But that overstretch pales in comparison to the president's advocacy of another feature of ObamaCare, the Independent Payment Advisory Board (IPAB).

The IPAB, consisting of 15 unelected members nominated by the president and approved by the Senate has, for the health care sector, the sort of power enjoyed by the World War II rationing authority, the Office of Price Administration. It has the extra-constitutional power of a Soviet commissar.

The IPAB takes over from the Medicare Payment Advisory Commission, whose recommendations Congress has routinely overridden, and has the power to force Congress to cut Medicare payments if the growth in costs exceeds a target. Congress can override its recommendations only by a supermajority. [Post and Courier, 5/16/11, via Nexis]

FACT: IPAB Is Specifically Prohibited From Making "Any Recommendations To Ration Health Care"

Law Specifically Prohibits Advisory Board From Making "Any Recommendations To Ration Health Care ... Or Otherwise Restrict Benefits." As Media Matters has noted, the health care law specifically prohibits the Independent Payment Advisory Board from making "any recommendations to ration health care ... or otherwise restrict benefits." [Media Matters, 10/12/10; Patient Protection and Affordable Care Act, accessed, 4/21/11]

White House: "IPAB Is Specifically Prohibited By Law From Recommending Any Policies That Ration Care." In an April 20 blog post on the White House website, White House Deputy Chief of Staff Nancy-Ann DeParle wrote that the "IPAB is specifically prohibited by law from recommending any policies that ration care, raise taxes, increase premiums or cost-sharing, restrict benefits or modify who is eligible for Medicare." [WhiteHouse.gov, 4/20/11]

Kaiser Family Foundation: Board Cannot "Ration Care, Increase Taxes, Change Medicare Benefits Or Eligibility, Increase Beneficiary Premiums And Cost-Sharing Requirement, Or Reduce Low Income Subsidies Under Part D." From the Kaiser Family Foundation's "Explaining Health Reform: Medicare and the New Independent Payment Advisory Board":

The Board is prohibited from submitting proposals that would ration care, increase taxes, change Medicare benefits or eligibility, increase beneficiary premiums and cost-sharing requirements, or reduce low-income subsidies under Part D. Prior to 2019, the Board is also prohibited from recommending changes in payments to providers and suppliers that are scheduled to receive a reduction in their payment updates in excess of a reduction due to productivity adjustments, as specified in the health reform law. The law establishes specific rules and deadlines for Congressional consideration of the Board's recommendations, and specific timelines and procedures for Congressional action on alternative proposals to achieve equivalent savings.[Kaiser Family Foundation, Explaining Health Reform: Medicare and the New Independent Payment Advisory Board, 5/10/10]

CLAIM: It Is Understandable That Many Americans Think The Affordable Care Act Is A "Government Takeover"

Post and Courier: "Many Americans Understandably Regard Obamacare's Unprecedented Intrusions Into The Nation's Health Care System ... As Evidence Of 'A Government Takeover." According to a January 2012editorial in the Post and Courier:

Rep. Steve Cohen, D-Tenn., likened Republicans to Nazi Germany propaganda minister Joseph Goebbels in their push to repeal the health care reform law. From Rep. Cohen's stunning Tuesday night rant on the House floor:

"They say it's a government takeover of health care, a big lie just like Goebbels. You say it enough, you repeat the lie, you repeat the lie, and eventually, people believe it. Like blood libel. That's the same kind of thing."

Rep. Cohen added: "The Germans said enough about the Jews and people believed it - believed it and you have the Holocaust. We heard on this floor, government takeover of health care. Politifact said the biggest lie of 2010 was a government takeover of health care because there is no government takeover."

The congressman defended - in essence, repeated - his horrendous analogy Wednesday night on CNN. Yet if Politifact's "biggest lie" verdict were valid, and it is not, that wouldn't justify his genocidal parallel. Politifact is a St. Petersburg Times operation that has drawn warranted criticism for generally leaning to the left in predictable pronouncements of what are and aren't "facts."

Many Americans understandably regard ObamaCare's unprecedented intrusions into the nation's health care system - including mandates requiring individuals to buy insurance - as evidence of "a government takeover." [Post and Courier, 1/23/12, via Nexis]

FACT: "Government-Run Health Care" Is "Among The Biggest Falsehoods" Of The Health Care Debate

FactCheck: Claim Of "Government-Run Health Care" Among The "Biggest Falsehoods" Of Health Care Debate. On March 19, 2010, FactCheck.org included "It's government-run health care" among the "biggest falsehoods" of the health care debate, writing:

Despite the fact that the federal health insurance plan (a.k.a. the "public option") is now gone from the bill, Republicans and conservative groups have continued to claim that the bill institutes a system like the one in the United Kingdom, or Canada, or otherwise amounts to a government takeover. It doesn't. A pure government-run system was never among the leading Democratic proposals, much to the chagrin of single-payer advocates. Instead, the bill builds on our current system of private insurance, and in fact, drums up more business for private companies by mandating that individuals buy coverage and giving many subsidies to do so. There would be increased government regulation of the insurance industry, however, to require companies to cover preexisting conditions, for example. [FactCheck.org, 3/19/10]

Over The Past 2 Years The Affordable Care Act Has Helped Thousands Of South Carolinians

HHS: "As Of June 2011, 30,376 Young Adults In South Carolina Gained Insurance Coverage As A Result Of The New Health Care Law." According to a Health and Human Services fact sheet:

Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their family's coverage, and, thanks to this provision, 2.5 million young people have gained coverage nationwide. As of June 2011, 30,376 young adults in South Carolina gained insurance coverage as a result of the new health care law. [Healthcare.gov, 3/15/12]

The Discount Received By Seniors Who Hit The "Donut Hole" Resulted In "A Total Savings Of $32,646,527" In South Carolina Alone Or "An Average Savings Of $615 Per Person." According to a Health and Human Services fact sheet:

Thanks to the new health care law, 54,683 people with Medicare in South Carolina received a $250 rebate to help cover the cost of their prescription drugs when they hit the donut hole in 2010. In 2011, 53,081 people with Medicare received a 50 percent discount on their covered brand-name prescription drugs when they hit the donut hole. This discount resulted in an average savings of $615 per person, and a total savings of $32,646,527 in South Carolina. By 2020, the law will close the donut hole. [Healthcare.gov, 3/15/12]

755,000 South Carolinians "With Private Health Insurance Gained Preventive Service Coverage With No Cost-Sharing." According to a Health and Human Services fact sheet:

In 2011, 602,760 people with Medicare in South Carolina received free preventive services - such as mammograms and colonoscopies - or a free annual wellness visit with their doctor. And 54 million Americans with private health insurance gained preventive service coverage with no cost-sharing, including 755,000 in South Carolina. [Healthcare.gov, 3/15/12]

Families USA: "On Average, Each Household In South Carolina Will Be $1,475 Better Off In 2019 Due To The Provisions Of The Affordable Care Act." According to a study of the effects of the Affordable Care Act by Families USA:

  • On average, each household in South Carolina will be $1,475 better off in 2019 due to the provisions of the Affordable Care Act.
  • Households with income of less than $100,000 will receive the greatest financial Benefit.
    • Households with income under $30,000 will be $2,800 better off.
    • Households with income between $30,000 and $50,000 will be $1,596 better off.

Households with income between $50,000 and $100,000 will be $878 better off. [FamiliesUSA.org, Oct. 2011]

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