Contrary to the fact-averse claims made by the right wing radicals, like Cruz, like Bachmann, the ACA is bringing down some costs, slowing down the rate of increase of others, and NOT disadvantaging people in the horrible ways they claim.
They LIE. They lie often, the lie loudly.
I try to fact check both the statements made on the right and the left. There seems to be a clear difference between deliberate misrepresentation of facts, and occasional confusion over numbers as those numbers are emerging or changing. That is a distinction between deliberate lying, and sloppy quoting or legitimate conflicting data.
Ted-the fuse-Cruz is a bomb thrower of the deliberate exploitative liar variety, in that his data was never true, never accurate or even close to accurate, and there is no similar data with which it honestly could be confused. It is in fact the OPPOSITE of the actual data. But Cruz wants to make a big noise, and the more destructive the amount of damage, the happier he is.
from
Factcheck.org:
Cruz Distorts ACA Impact on Seniors, Children
- Posted on
October 21, 2013
Sen. Ted Cruz says his “fight against Obamacare must continue,” and so must our fact-checking of claims about the law.
Cruz distorted the impact of the Affordable Care Act on two vulnerable populations — the elderly and special needs children:
- Cruz said seniors “right now” are being notified that they are
“losing their health insurance” during the enrollment period that began
Oct. 15. In fact, the number of seniors enrolled in the Medicare
Advantage plans to which he’s referring has increased 30 percent since the law took effect in 2010 — and enrollment is expected to increase again next year.
- He also claimed seniors “are facing higher prescription drug costs”
next year. In fact, seniors to date have received $7 billion in rebates
and prescription discounts under the Affordable Care Act, and the
average senior will have the choice of more prescription drug plans for 2014.
- Cruz said “families of special needs children will face a new
penalty for using savings” to pay for medical expenses. He’s referring
to a $2,500 cap on pre-tax contributions to flexible spending accounts.
Actually, advocates for special needs children say that provision hasn’t
had much of an impact, and other provisions of the new law “greatly
benefit people with disabilities.”
Medicare Advantage
On Oct. 16, when Senate leaders announced a bipartisan deal that
would end the partial government shutdown, Cruz held a media
availability and issued a press release to say he opposed — but would
not block — the agreement.
He said he would oppose the Senate compromise because it does nothing
to help “the millions of Americans who are being harmed by Obamacare,”
singling out some of the nation’s most vulnerable populations.
Here’s what he said about the Senate bill in a press availability with reporters on Capitol Hill (
at about the 48 second mark):
Cruz, Oct. 16: And it provides no relief
to all the seniors, to all the people with disabilities who are right
now getting in-the-mail notifications from their health insurance
companies that they’re losing their health insurance because of
Obamacare.
And this is what he said in a
written statement issued that same day:
Cruz, Oct. 16: As a result of Obamacare,
families of special needs children will face a new penalty for using
savings to pay for medical therapies and health-related expenses. That’s
not part of the discussion. Seniors who are facing higher prescription
drug costs as a result of this law won’t be given any consideration,
either.
We asked the senator’s office for information on the statements he
made about the impact of the law on seniors and special needs children.
Let’s start with senior citizens, beginning with the claim that seniors
are “losing their health insurance.”
The senator’s office referred us to a
recent analysis
by the consulting company Avalere of Medicare Advantage plans that will
be available to seniors for 2014. The consulting firm’s report found
that the number of plans available to seniors in 2014 would “dip
modestly” from 2,664 to 2,522, a decline of 5.3 percent. The
open enrollment period
began on Oct. 15 and ends Dec. 7, so Cruz is no doubt right that some
seniors have been told that their insurance plan is no longer part of
the Medicare Advantage program.
However, a drop in the number of plans does not mean a drop in the number of persons covered.
In fact, the nonpartisan
Kaiser Family Foundation reports
that the number of persons enrolled in MA plans rose by nearly 10
percent this year, compared with 2012. A total of 14.4 million persons
now are covered by MA plans, more than ever before.
The Centers for Medicare & Medicaid Services says that trend will continue. In a
Sept. 19 press release,
the CMS said “for the fourth straight year enrollment is projected to
increase” in 2014. CMS spokesman Raymond Thorn told us in an email that
enrollment “is projected to grow to 14.995 million in 2014,” an increase
of 4.7 percent over this year.
This is exactly contrary to the predictions at the time of the law’s
enactment. KFF notes: “Since 2010, enrollment in Medicare Advantage
plans has grown by 30 percent in spite of concerns that the payment
changes enacted in the 2010 Affordable Care Act would lead to
significant reductions in enrollment.”
In fact, as Affordable Care Act critic Alyene Senger of the conservative Heritage Foundation
wrote recently,
“It is not yet known how MA plans will react to Obamacare’s significant
reductions or how beneficiaries will respond to any changes made by MA
plans.” But that hasn’t stopped Cruz from saying seniors are losing
coverage. His office even cites Senger’s article as supporting that
claim, perhaps hoping that we would not actually read it.
Allyson Funk, a spokeswoman for the AARP, did not express concern
about the slight dip in MA plans. She said there “will remain broad
penetration and availability of MA plans” in 2014. Funk also noted that
Medicare Advantage premiums have gone down, “while quality has
improved,” since the passage of the Affordable Care Act. CMS says the
average premiums for Medicare Advantage plans are
down by 9.8 percent since the health care legislation became law.
Disabled Seniors
In his criticism of the law’s impact on seniors, Cruz also made
reference to seniors with disabilities when he expressed concern about
“all the people with disabilities” who “right now” are “losing their
health insurance.”
This time, the senator’s office referred us to a
Sept. 16 opinion piece written by
Scott Gottlieb
of the conservative American Enterprise Institute about 9 million
low-income people who are eligible for both Medicaid and Medicare.
Gottlieb wrote that many of these people “will be forcibly moved into
Medicaid HMOs once another long-delayed element of the bill starts to
get implemented this fall.”
But they are not “losing” coverage “right now” — in fact, most of the
9 million will be unaffected now and for at least three years.
Here’s what’s happening: In April, CMS
announced
that it would provide funding and technical assistance to 15 states to
develop demonstration programs designed to provide better, more
cost-effective services to low-income people (elderly and non-elderly)
who are eligible for both Medicaid and Medicare.
In a recent report,
KFF says the demonstration project is limited to no more than 2 million
dual-eligible beneficiaries, and, so far, CMS has approved specific
plans in eight states covering 1.1 million beneficiaries.
The demonstration programs, which will last for three years, target
both the elderly and non-elderly. In fact, Massachusetts’ program will
include only non-elderly, dual-eligible beneficiaries, according to
KFF’s report. Five of the eight states (and the county of Los Angeles)
will seek volunteers for the demonstration programs before automatically
assigning beneficiaries to managed care plans. In one state, Minnesota,
the demonstration program will be strictly voluntary. Six states will
allow beneficiaries assigned to HMOs to opt-out.
According to CMS:
“[I]n each Demonstration beneficiaries will receive all the current
services and benefits they receive today from Medicare and Medicaid with
added care coordination, protections and access to enhanced services.”
In other words, the coverage they are getting is supposed to be
better than the coverage Cruz says they are “losing.” Whether it works
out that way or not, we can’t say, and at this point neither can he.
‘Higher Prescription Drug Costs’?
Cruz also said that seniors “are facing higher prescription drug
costs,” and his office again referred us to the Avalere analysis.
In addition to its analysis of Medicare Advantage, Avalere also
reviewed the costs of Medicare Part D standalone Prescription Drug Plans
(PDPs) for the 2014 coverage plans that seniors are now signing up to
join. The analysis concluded: “On average, PDP premiums will increase by
5.1 percent overall.”
The Kaiser Family Foundation,
in its own analysis,
says that the average increase for these plans will be a little less
than 5 percent — from $38.14 per month to $39.90 — “unless many new or
current enrollees select lower-priced plans.” That is entirely possible.
KFF notes that Medicare beneficiaries in 2014 “will have a choice of 35
stand-alone PDPs, on average, up by four from 2013.”
KFF also illustrates in Exhibit 3 of its report that average premium
increases are nothing new for Medicare Part D standalone plans. Since
2006, the average premium has gone up about 54 percent — including a
high growth rate of 17 percent in 2009, which was before the Affordable
Care Act took effect. The only year the average premium did not go up
was in 2012, when the law was in effect.
But seniors — and about two out of three seniors are in standalone
prescription drug plans — should be warned that averages are just that.
What any individual will pay will vary — sometimes greatly — as KFF’s
study points out.
KFF says: “Enrollees in two of the most popular PDPs will experience
50-percent premium increases if they stay in the same plans in 2014,
while enrollees in three other popular PDPs will see lower premiums.”
Exhibit 4 provides this breakdown: Forty-four percent will see an
increase of $1 to $10 per month, and 14 percent will see an increase of
more than $10 per month. Thirty-one percent will see a decrease of $1 to
$10 per month, and 4 percent will see a decrease of more than $10.
About 7 percent will see a minimal change.
As is the case with most insurance coverage, the actual change in
premiums will depend upon an individual’s personal situation and the
decisions that he or she makes.
“We encourage our members to carefully evaluate their Part D plan
options each open enrollment period by comparison shopping,” the AARP’s
Funk said.
It’s also true that premiums are just one component of the prescription drug insurance coverage.
KFF notes that a little more than half of the PDPs — about 53 percent
— require a deductible. For those that do, the deductible will fall
next year from $325 to $310 — a $15 savings that would help offset the
average premium increase for some seniors.
Also, the Affordable Care Act has provided
6.6 million seniors with $7 billion in rebates and discounts on prescription drugs
to help them pay for costs that fall into a gap in coverage known as
the “doughnut hole.” In 2014, the plans will pay most drug costs (minus a
deductible and co-pays) up to a certain level (after a beneficiary
incurs $2,850 in total costs). But then beneficiaries will have to pay
all of their prescription costs until they reach a “catastrophic level”
of $4,550 out-of-pocket expenses “(or $6,691 in total drug costs under
the standard benefit),” KFF says in its report. About 82 percent of PDPs
offer no or very limited gap coverage, the report says.
However, the Affordable Care Act provided a
one-time $250 rebate
to seniors who have Medicare Part D drug coverage in 2010 to help cover
some of the costs of the doughnut hole. In addition, the law provides
discounts each year and eventually (by 2020) phases out the doughnut
hole entirely. In 2014, for example, that means that seniors who reach
the coverage gap will receive a
50 percent discount on brand-name drugs and the insurance plan will pay 2.5 percent of the cost, leaving seniors to pay 47.5 percent during that gap period.
Special Needs Children
Cruz also said “families of special needs children will face a new
penalty for using savings to pay for medical therapies and
health-related expenses.” Some may, but advocates for these families say
Cruz overstates the impact and ignores the benefits these families will
receive from the Affordable Care Act.
Cruz’s office told us the senator was referring to the $2,500 cap the
new law places on annual contributions to Flexible Spending
Arrangements (FSAs). These accounts allow
an estimated 33 million Americans to contribute pre-tax dollars from their pay checks for future medical expenses. Until January of this year, the IRS did not
limit how much employees could contribute — although employers could.
The senator’s office referred us to a
Sept. 25 blog post
on the website of Americans for Tax Reform, a conservative group that
is opposed to the law. ATR says the cap “will be particularly cruel and
onerous” on special needs children, because these families use the
accounts not only for medical expenses but also to pay tuition for
special needs education.
This is not the first time that Republicans have cited the cap as
being particularly onerous for special needs families who use FSAs for
education costs. The Republican National Committee has claimed that the
cap will result in a “
$13 billion tax increase on families with special needs.”
The RNC also says special needs families use these accounts “to pay for
fees at special needs schools, transportation costs associated with
their child’s education, Braille books, and guide dogs for the visually
impaired.”
It is simply not true that the special needs families will have to
pay $13 billion in additional taxes. That’s the total amount that the
cap is expected to generate in new revenues over a 10-year period,
according to the Joint Committee on Taxation.
It isn’t known how much of that would be paid by the families of
special needs children, but the ARC — one of the nation’s leading
advocates for children with developmental disabilities — tells us that
it hasn’t seen any evidence of the cap having much of an impact on
families with special needs children.
“We do not know how many people may be using FSAs to pay for private
school tuition or other expenses — we have tried to research it but
found no information,” the ARC said in a statement provided to us by
spokeswoman Kristen McKiernan. “We know it can be expensive to have a
special needs child but we have not seen any evidence that the ACA
change [on FSAs] is very impactful.”
Wendy Fournier, president of the
National Autism Association,
said her organization hasn’t fielded any questions or complaints about
the cap on FSAs for either tuition payments or medical expenses. “We
haven’t had any of our members say it is an issue for them,” she said.
It may be an issue for some, but she’s not heard that it is. “This is
the first I heard of it,” she said.
The ARC statement noted that the IRS still allows special needs
families to deduct medical expenses and health-related expenses,
including for special education.
IRS rules say
such families can deduct certain educational expenses for “children who
have learning disabilities caused by mental or physical impairments,”
including tuition, meals and lodging. The deduction, of course, does not
provide the same benefits as pre-tax contributions to an FSA.
The ARC and the
United Cerebral Palsy websites say the Affordable Care Act “contains numerous provisions that greatly benefit people with disabilities.”
The ARC and the United Cerebral Palsy:
The most important changes that the ACA will bring about are:
Prohibiting pre-existing condition exclusions; Eliminating annual and
lifetime caps; Prohibiting discrimination based on health status and
disability (prevents insurers from dropping individuals when they get
sick); Requiring insurers to issue and renew insurance to employers and
individuals; Expanding Medicaid eligibility to cover individuals with
incomes up to 133 percent of the federal poverty line (approximately
$29,000 per year for a family of four); and making a number of
improvements to the Medicaid program.
The ARC statement summed it up by saying, “We expect that the ACA
will benefit people with disabilities because of the health insurance
reforms.”
– Eugene Kiely, with Brooks Jackson
