The Richmond Times-Dispatch penned a misleading editorial to attack the Affordable Care Act (ACA) by incorrectly claiming income-based tax credits would not be verified, that caps on co-payments have been eliminated, and that the ACA will leave future Americans uninsured.
The October 23 editorial used the slow start of the exchange websites as a launching point to discount the entire law and its provisions as a failure. The editorial pushed several claims about the law including that it drops proof-of-eligibility requirements and it will leave millions of people uninsured in the next decade (emphasis added):
[The ACA] has failed so miserably that President Obama took to the airwaves to emphasize what a wonderful success it was, despite the website issues for which he offered "no excuses" -- and took no responsibility.
Besides, he said, "the Affordable Care Act is not just a website. It's much more." Indeed it is -- and there have been many more problems than just online technical roadblocks. The administration has delayed the employer insurance mandate for a year. It has dropped proof-of-eligibility requirements for exchange subsidies. And it has jettisoned caps on out-of-pocket expenses such as copayments and deductibles. Democrats and Republicans agree that the tax on medical devices should be repealed.
The ACA is not just a website -- and the glitches are not just web-related. Even if the law works exactly according to plan, a decade from now 31 million Americans will remain uninsured, according to the Congressional Budget Office. If that is success, be afraid of what failure could look like.
The Times-Dispatch's claim that the administration had "dropped proof-of-eligibility requirements" for individuals applying for tax credits to use towards the price of health care coverage bought on the exchanges is patently untrue. In fact, a strengthened income verification measure was part of the minimal concessions given to the Republicans to reopen the government after they held the entire law hostage leading to the government shutdown.
Furthermore, according to CNN Money the current verification methods will allow the IRS to recoup any over-payments from falsified information, meaning "anyone who might get a bigger subsidy than they are eligible for will have to pay back the difference to the IRS." According to CNN Money:
The final calculation of a subsidy's size will be done after the fact by the IRS.
"Your actual tax credit will be calculated based on your actual income that next April [when you file your federal tax return]," [Kaiser Family Foundation Senior Vice President Larry] Levitt explained.
Bottom line: Anyone who might get a bigger subsidy than they're eligible for will have to pay back the difference to the IRS.
And they may owe a penalty, too, since they must attest when applying for subsidies that they are not filing false information.
"If you report your income incorrectly, it will catch up with you because there's a reconciliation of these tax subsidies on your tax return. Come tax time you could see an enormous bill," said Linda Blumberg, a senior fellow at the Urban Institute's Health Policy Center.
The Times-Dispatch editorial also claimed that the administration had "jettisoned" out-of-pocket caps or limits placed on deductibles and co-payments. The editorial frames this as a permanent provision to the ACA. However, in reality, there has been a one-year delay in the implementation of the caps to better allow insurance companies to coordinate and fine tune logistical details so that caps can be calculated accurately. According to The New York Times:
The health law, signed more than three years ago by Mr. Obama, clearly established a single overall limit on out-of-pocket costs for each individual or family. But federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs.
In many cases, the companies have separate computer systems that cannot communicate with one another.
A senior administration official, speaking on condition of anonymity to discuss internal deliberations, said: "We knew this was an important issue. We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person's out-of-pocket costs. They asked for more time to comply."
Caps on out-of-pocket spending remain an important part of the ACA and will save American families billions of dollars each year. In 2011 alone it was estimated that families spent $24.7 billion more than the ACA's cap threshold.
Finally, the Times-Dispatch made the inaccurate claim that the ACA, by design, will leave 31 million Americans uninsured. The editorial states that these individuals would remain uninsured "even if the law works exactly according to plan," suggesting the health care reform measure never intended this group to gain coverage. This analysis is flawed for two reasons. First, the law assumed states would participate in the Medicaid program given the low cost and high benefit structure of expansion, which, due to Republican obstructionism has not happened, potentially leaving 6 to 7 million people uninsured. However, a second flaw in their argument is that many of the remaining uninsured people are undocumented immigrants who were barred from gaining coverage thanks to strong Republican opposition and the lack of Republican support on current immigration reform measures.
Right-wing media misinformer Watchdog.org is pushing fabricated myths about the Affordable Care Act (ACA) into the media discussion, stoking fears the program will lead to higher premium costs and create incentives for people to avoid marriage. In reality, tax credits have kept premiums affordable for young people and have not created fiscal deterrents to marriage.
The Las Vegas Review-Journal penned an editorial attacking the Affordable Care Act (ACA) over high premium prices, but failed to provide more than a pair of anecdotes that misrepresented Nevada's uninsured population to support its claims.
The October 8 editorial promoted the idea that people will turn against the ACA as they learn the price of coverage under the exchanges, and according to the Review-Journal, the only thing preventing that scenario are technical glitches that have slowed the process:
It wasn't part of the Obama administration's shutdown theatrics, but healthcare.gov had to close for the weekend, and it was closed again early Tuesday. The website was taken offline because of myriad glitches that have plagued the national health insurance exchange (and state exchanges across the country) since the Oct. 1 rollout.
The technical problems are significant because huge numbers of people are being prevented from learning how much their newly mandatory health insurance will cost. Once potential enrollees can review exchange plans, their premiums and deductibles, there will be yet another uproar -- one with the potential to force changes to Obamacare or at least delay enforcement of its individual mandate.
The Review-Journal went on to give two examples of Californians over the age of 50 who claim to have been quoted at higher premium prices than they had paid in the past. Because the editorial did not include any information about the pair's previous insurance situation, tobacco use, or any other indicators, however, it is hard to verify or explain why these individuals were quoted at higher premiums. But this lack of information did not stop the Review-Journal from extrapolating their experience onto a wider population and predicting a delay to individuals' requirement to have insurance, an action that would gut the law and cripple insurers' ability to cover those with pre-existing conditions.
The editorial also highlighted the rates these individuals will pay without mentioning that older populations can only be charged up to three times what young and healthy adults can be charged. According to the Congressional Research Service, 49 percent of Nevada's uninsured are between the ages of 19 to 21, as compared to 26.4 percent for ages 21 to 64, and 1.9 percent for ages 65 and over. Using two older buyers as a sample of Nevada's insurance-buying population gives a misleading picture of prices and experiences.
Furthermore, the piece made no mention of the federal tax credits that will help make coverage affordable for many young Americans. Nationally, tax credits will allow 6.4 million people to purchase insurance for less than $100 each month. Including the subsidized prices for plans bought on the exchanges is critical to understanding the actual cost of insurance because the law "provides sliding-scale subsides to help people with incomes up to four times the federal poverty level." As the Kaiser Family Foundation explained in a primer on the makeup of the uninsured:
Most people without health coverage are in working families and have low incomes. Adults make up a disproportionate share of the uninsured population because they are less likely than children to be eligible for Medicaid. While a plurality of uninsured people are White non-Hispanic, racial/ethnic minorities are at especially high risk of being uninsured.
Health insurance makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy people are. The consequences of reduced access to care over time can be serious, including preventable hospitalizations, poor overall health, disability, and premature death.
Local conservative blogs and opinion sections seized on reports of initial technical glitches with the online health care exchanges to broadly slam the Affordable Care Act (ACA), and failed to recognize similar challenges with implementing Medicare Part D.
The online health care exchanges opened on October 1 to assist people in selecting an insurance provider in compliance with the ACA. Since the launch, several local opinion outlets have framed the story to maximize frustrations over technical glitches and paint the federal government as incompetent in preparing for enrollment. These same outlets have been repeatedly critical of the ACA.
For example, the Las Vegas Review-Journal ran an editorial that called the exchange launch "an information-technology disaster." Other outlets have been openly rooting for the exchanges to fail, such as North Carolina's Civitas Institute which called for readers to submit "Obamacare horror stor[ies]." Watchdog.org published a reporter's first-hand "maddening" experience with trying to log onto the New Mexico Health Insurance Exchange.
The user complaints are not completely unwarranted, as very real technical issues attributed to heavy traffic on the sites and software problems have been reported. High demand to access the health care exchanges drove 8.6 million unique victors to HealthCare.gov in the first 72 hours after the exchanges went live.
However, much of the negative local coverage of the rollout fails to take the exchanges in perspective. Few reports question whether it is reasonable to expect such a large and complex undertaking to run smoothly right out of the gate. The 2005 enrollment of millions of seniors in Medicare Part D - the government program to subsidize the cost of prescription drugs for Medicare patients - is the closest way to put the ACA exchanges in perspective.
Watchdog.org's Florida bureau concluded young Americans would rather pay a penalty than pay insurance premiums based on a backward reading of a poll conducted by Reuters, choosing to instead rely on the experiences of its "small sampling" of young people.
The October 4 post attempted to prove that young Americans would prefer paying a penalty for not having insurance under the Affordable Care Act (ACA) rather than paying insurance premiums for coverage. The post relied on a survey of an undisclosed amount of young people, and chose to report three negative responses as evidence of youth resistance to the ACA (emphasis added):
Obamacare "only works ... if young people show up."
That's from former President Bill Clinton in a recent MSNBC interview.
It's why Obamacare supporters and government agencies are trying everything from sports advertising to video contests to get young people in the game.
But will those millions of Millennials show up and sign up for health insurance under the Affordable Care Act?
A recent Reuters poll found Obamacare may not attract enough young people to keep costs low for others. And according to our small sampling, the answer would be no.
The poll reported by Reuters and cited by Watchdog appeared in an article titled, "Insight: Poll shows healthy young adults may keep Obamacare afloat," and contradicts much of what Watchdog claims (emphasis added):
A new Reuters/Ipsos poll of 1,053 uninsured Americans, and detailed interviews with 51 of the respondents, shows that Kormick is not an outlier: Obamacare may attract enough of the young healthy adults it needs to buy insurance to offset the costs of covering sicker Americans and keep the system afloat financially.
"Contrary to commonly held beliefs, young adults do want affordable health coverage," said Dr David Blumenthal, president of the Commonwealth Fund, a nonprofit that studies healthcare systems.
The young demographic is so pivotal to the success of Obamacare that one of the law's fiercest opponents, the libertarian group FreedomWorks, is running a campaign on social and traditional media aimed at persuading Americans in their 20s not to buy insurance on the exchanges.
Instead of accurately reporting the results of the Reuters survey, Watchdog continued to make its case by citing interviews with three members of the target age group. Despite being an inefficient sample size to draw conclusions, the three selected were poorly chosen to answer the questions of whether they would join the exchanges, as two of the responders reported they already had health insurance through an employer or parent.
Conservative groups have targeted young people as a key demographic in shaping the success or failure of the ACA. As noted by Reuters, FreedomWorks -- a Tea-Party affiliated non-profit that is partially funded by tobacco giant Philip Morris - has been a major contributor to the anti-insurance campaign. Watchdog is affiliated with FreedomWorks through its parent organization, the Franklin Center.
Watchdog, along with other Franklin Center affiliates, continue to target state media and promote conservative ideology. When it comes to reporting on the ACA, Watchdog has a track record of misinformation and manipulation.
The Las Vegas Review-Journal's Sherman Frederick once again lobbed false attacks at the Affordable Care Act (ACA), claiming the ACA will fund abortions. But Frederick's claim is based on a misreading of regulations.
Frederick's October 3 post accused the Office of Personnel Management (OPM) of allowing members of Congress and staffers to use subsidies to purchase plans on the exchanges that cover abortion:
The current law of the land strictly forbids federal money being used to fund abortions.
But this Monday the Office of Personnel Management ruled that members of Congress and their staffs will be able to buy health care plans that pay for abortions, even though the premiums are funded by taxpayer dollars.
Many believe that violates the law. But President Obama and most Democrats don't see it that way and are determined to stick by that ruling.
Congressional staffers were forced off of the Federal Employee Health Benefits Program and onto the exchanges during partisan deliberations over the ACA. This would have resulted in a large pay cut for staffers as they would have been forced to pay the full cost for coverage on the exchanges. To compromise, staffers will receive a premium contribution from the federal government to use towards a plan of their choice on the exchanges.
Frederick argued that the OPM will allow members and staff to choose plans that include abortion services, and since the government will partially pay for that coverage, the administration violated the Hyde Amendment preventing federal dollars from paying for abortions. However, the ruling Frederick referred to said OPM "can and will" take steps to ensure that abortion services "are accounted for and paid for by the individual rather than from the government contribution" (emphasis added):
Current law prohibits the use of Federal funds to pay for abortions, except in the case of rape, incest, or when the life of the woman is endangered, and the Smith Amendment in particular makes no funds available "to pay for abortions or administrative expenses in connections with health plans under the FEHBP which provides any benefits or coverage for abortions." Neither the proposed nor final regulation alters these prohibitions. Under OPM's final rule, no Federal 8 funds, including administrative funds, will be used to cover abortions or administer plans that cover abortions. Unlike the health plans for which OPM contracts pursuant to 5 U.S.C. 8902, 8903 and 8903a, OPM does not administer the terms of the health benefits plans offered on an Exchange. Consequently, while plans with such coverage may be offered on an Exchange, OPM can and will take appropriate administrative steps to ensure that the cost of any such coverage purchased by a Member of Congress or a congressional staffer from a designated SHOP is accounted for and paid by the individual rather than from the Government contribution, consistent with the general prohibition on Federal funds being used for this purpose.
Frederick conceded that the OPM ruling has "significant nuances" and linked to a Washington Times article that clearly debunked his argument. Still Frederick persisted by promising the OPM ruling will bring a "much bigger controversy" and headlined his post, "Yes, taxpayers, you will pay for abortions under Obamacare."
Conservative media have long pushed the myth that the ACA will fund abortions, and Sherman Frederick is no exception. His latest article continued his personal crusade against the ACA and expanding health care to millions of Americans.
The Union Leader published a misleading op-ed written by Greg Moore, state director of the Koch-funded Americans for Prosperity (AFP), which promoted tired conservative myths surrounding Medicaid expansion in New Hampshire.
Moore's op-ed in the September 30 Union Leader attempted to discredit Medicaid expansion currently being debated by a panel of state lawmakers who are expected to make a final recommendation by October 15. The piece pushed previously debunked claims that Medicaid expansion would force people off private health care and onto Medicaid, would create long wait times to see doctors, and that the government will be unable to pay for expansion:
According to a report commissioned for the state Department of Health and Human Services by the Lewin Group, expansion would result in 20,500 people being dropped from their high-quality private health insurance into a substandard Medicaid program.
With expansion, we will also need to be prepared to wait longer to see our doctors. A study of Oregon's expansion published in May's New England Journal of Medicine showed that under Medicaid, with its lack of deductibles and minimalist co-payments, health care utilization of those covered exploded. With a major new demand in doctors' time and no new supply of doctors, it means that under expansion doctors will be stretched thin and we should all be prepared to wait more to get an appointment or a referral.
Then there's the question of money. Obamacare supporters claim that the federal government will pay for the entirety of expansion for three years and the vast majority as far as the eye can see, and that the federal government will "always" keep its promise.
With a nation that's $17 trillion in debt, it's just a matter of time until the federal government steps away from the high cost of expansion, which starts at more than $350 million each year in New Hampshire and then grows. If state taxpayers have to pick that up, it's hello to a state income tax.
Moore's first point concerning the 20,500 people expected to move from private health care to Medicaid, according to the Lewin Group study, fails to explain the whole story. While denying Medicaid expansion would keep the estimated 20,500 on private insurance, it would also deny 58,000 people any sort of coverage. According to the Lewin Group, failing to expand Medicaid would also result in a need to provide higher uncompensated care:
Although health systems would see more of an improvement in their bottom line, they would need to provide a greater volume of uncompensated care without the Medicaid expansion.
Uncompensated care costs hospitals millions of dollars each year, and with recent cuts to state reimbursement, this could cancel out savings that hospital systems see from denying Medicaid expansion. According to New Hampshire Public Radio:
"Uncompensated care cost our members a little over $300 million this past year," Steve Ahnen, president of the New Hampshire Hospital Association, says, "and obviously the state did not pay out anywhere close to that to hospitals."
Furthermore, the Lewin Group study estimated health systems -- which include hospitals, physician groups, skilled nursing facilities, freestanding surgical centers, and home health agencies - would "see an increase in net income of about $113.1 million" under expansion.
Moore's second point dismissed benefits of giving the uninsured access to health care, claiming that when Oregon expanded care to those in need, "health care utilization of those covered exploded." He continued, making the case that the newly covered would create backlogs in the health care system that would mean limited access to doctors. However, according to The Washington Post, a survey in Michigan found that doctors were willing to take on more patients in the event of Medicaid expansion. Furthermore, New Hampshire has more doctors per capita than Michigan, meaning there are more doctors available for each person.
Finally, Moore suggests that the federal government may not be able to pay for its share of the Medicaid expansion, thus shifting costs to the state; however, this myth has been previously debunked. According to The Washington Post, "there just isn't a history of the federal government 'dumping' new spending on the state."
Moore's organization, Americans for Prosperity, is a notorious media manipulator that is funded by the conservative billionaire Koch brothers. The Union Leader's op-ed page continues a pattern of support for AFP by repeatedly publishing its misleading talking points.
Right-wing media have consistently hyped several myths about the Affordable Care Act (ACA) during the lead up to open enrollment for state-based exchanges. As media outlets report on implementation of the health care law, they should be aware of these false claims, including zombie myths that the law includes "death panels" and that Congress is "exempt" from the law.
Las Vegas Review-Journal columnist Sherman Frederick hyped two debunked myths about the Affordable Care Act (ACA), including the false claim that the Cleveland Clinic is cutting costs as a direct result of the ACA and that "skinny networks" will limit access to quality care.
In his September 28 column, Frederick claimed the truth about the ACA was revealed when Eileen Sheil, corporate communications director for the Cleveland Clinic Foundation, said that the clinic would be cutting its budget and making other employment decisions due to the law. The column continued:
Ms. Sheil announced that in order to prepare for Obamacare, the Cleveland Clinic, one of the world's best health care providers, would slash up to 6 percent of its 2014 budget, put some 3,000 employees into early retirement, hold positions vacant longer and, if necessary, lay off employees.
Let that sink in. Just like that, the world-renowned Cleveland Clinic brought to bended knee by Obamacare. If this law can do that to one of our best medical institutions, what's going to happen to the quality of our local hospitals? How will isolated, rural facilities cope?
The problem with Frederick's assertion is that it's not true. The Atlantic reached out to Sheil who "seemed a bit confused by the emphasis on Obamacare in reports" and explained that the clinic had been "working on reducing costs for years" in order to remain viable, and the ACA was just the catalyst to implement those decisions. Fox News' Greta Van Susteren also debunked this myth when she backpedaled on initial Fox reports after speaking with Toby Cosgrove, CEO of the clinic.
Anti-Affordable Care Act (ACA) group Generation Opportunity placed a misinformed op-ed aimed at Millennials in at least a half dozen local papers in an effort to prevent younger Americans from enrolling in the Affordable Care Act 's individual exchanges.
Generation Opportunity's op-ed ran in at least a half-dozen newspapers over the weekend of September 28, including in Nevada's Las Vegas Review-Journal and Florida's Sun-Sentinel. The piece was authored by former unsuccessful Congressional candidate from Pennsylvania and president of Generation Opportunity -- a Koch-brothers backed anti-Affordable Care Act group -- Evan Feinberg. The editorial attempted to frame the ACA as a "bad deal for young people" and urged them to "opt out" by claiming it will cost them a lot of money and that it "relies on a system of generational redistribution":
Apparently they think Millennials are gullible. But no veneer of popularity can mask the exchange system's deep problems. The simple fact is that they are a bad deal for young people. And as a result, it makes more financial sense for Millennials to opt out and purchase a non-Obamacare policy on the private market.
The most obvious problem with the exchange system is how it perversely relies on a system of generational redistribution. Quite simply, the law takes from the young to subsidize the old. That's why the White House is so dead-set on getting young people to sign up -- without our money, the system won't work, and the exchanges will enter what has been called a "death spiral."
Despite conservatives' constant attempt to turn young people away from the ACA, many Millennials are able to understand that having health insurance can save thousands of dollars in cases of serious injury or illness and that gaining coverage through the exchanges, employer benefits, or through private plans also allows them to access affordable prescriptions, and afford preventive care which can help prevent minor issues from becoming major health concerns.
Feinberg clearly recognizes the benefits of health coverage, as he suggests that young people "opt out and purchase a non-Obamacare policy on the private market." However, Feinberg leaves out the important detail that federal tax credits, often referred to as subsidies, are only available through the exchanges and are designed to make coverage affordable. Suggesting young people "opt out" and buy coverage through a private plan adds up to telling Millennials to pay more for private coverage that must meet identical standards as the plans offered on exchanges.
A local North Carolina newspaper published several incorrect statements and left out important details in a piece on the Affordable Care Act, including blaming the health care law for job losses, which were actually caused by Republican obstructionism, and providing misleading information about who is eligible for federal subsidies.
Time Warner's Charlotte News 14 omitted critical information about health care premium prices in a report leading up to state-based insurance exchanges opening on October 1 by only reporting average premium prices while omitting the subsidized prices many North Carolina residents would receive under the Affordable Care Act.
The September 25 report relied on data from the Department of Health and Human Services (HHS) which listed average subsidized prices for North Carolina residents:
New estimates show people in North Carolina who shop for health insurance coverage on the federally run, online marketplace could pay more and have fewer choices than the national average.
The U.S. Department of Health and Human Services said premiums for a mid-range plan sold on the health exchange will be $379/month on average. The average cost for that same plan across 48 states will be $328 when the new health insurance markets start.
The figures provided by News 14 represents unsubsidized averages of all people under age 65 but does not tell the entire story for many North Carolina residents. A report by Families USA found that, if Medicaid had been expanded in North Carolina, 868,520 residents would be eligible for tax credits under the exchanges. Yet, as Kathleen Stoll, director of health policy for Families USA explained, this figure is a low estimate because the report assumed the state would expand Medicaid.
The New Hampshire Union Leader exaggerated reports concerning the narrow insurance networks soon to be available on the state's health care exchange as part of the Affordable Care Act (ACA) by claiming residents of New Hampshire will have their "health care choices constrained by Obamacare." In fact, narrow insurance networks are not a new concept and allow insurance companies to create plans that are more affordable and accessible to low-income citizens.
Watchdog.org Virginia Bureau fabricated a quote attributed to the National Center for Policy Analysis (NCPA) to attack Medicaid expansion in the state while peddling other anti-expansion myths.
The Richmond-Times Dispatch hyped a concern that "nobody will check" to ensure that people who request subsidies under the Affordable Care Act (ACA) are actually qualified to do so, despite several safeguards and penalties in place designed to prevent fraud.