THE HEAD OF HHS TELLS FALSEHOODS, JUST LIKE HIS BOSS

The man that lies about the AHCA, HSS Secretary, Tom Price

 

 

 

HSS Secretary offers double-talk in health care for the poor.

 

 

OK, the Health and Human Services Secretary (HHS) Tom Price, has defended the American Health Care Act (AHCA), which is the House GOP plan to overhaul America’s health-care system.  He did this in an interview with CNN.  “The fact of the matter is that Medicaid spending under the proposal and under the budget goes up every single year.”

 

And that’s a bunch of Bull!

When challenged by CNN’s Jake Tapper over reductions in Medicaid spending ($839 billion over 10 years), according to a Congressional Budget Office (CBO) estimate in late March.  But Price responded with Washington double-talk about funding for the health-care program for the poor.

 

Per Price: “Well, remember what the $839 billion is off of. It’s off what is called a baseline, which is what the federal government, what the CBO says we would spend if we just continued current law.”

 

Debates over a government baseline is a very old, on-going, Washington DC story. Over a 10-year period, CBO calculates what would be necessary to maintain current services.  This is accounting based on the on-going inflation, the population growth, etc.  As usual, a dollar in 2026 will not go as far as a dollar in 2016.

 

Here is a perfect example of this, using the nation’s Defense spending that technically remained constant from 1987 to 1994 at $282 billion a year.

But when you look at what happened to the military during those seven years, here’s what actually happened to our military: The number of troops fell from 2.2 million to 1.6 million, the number of Army divisions was reduced from 28 to 20, Air Force fighter wings dropped from 36 to 22 and Navy fighting ships declined from 568 to 387.  That’s because inflation over that time ate away at the value of those dollars. By most measures, defense spending was trimmed in that period, although due to inflation, theoretically, not a penny was cut.

 

The point is that Tom Price, having been chairman of the House Budget Committee, he certainly should understand that this is the case. Yet he went ahead and declared “There are no cuts to the Medicaid program. There are increases in spending.”

                                                                                                                            

Here are the Facts:

 

The proposed changes to the Medicaid budget would reduce spending by nearly 25% over 10 years and it would cover “14 million fewer people than anticipated by 2026”.  Price is also wrong to claim that “Medicaid spending under the proposal and under the budget goes up every single year.”

 

The CBO did not publish these figures, but when you adjust the CBO’s March 2016 baseline for the reductions in outlays in its most recent CBO estimate of the legislation, here’s what happens to annual Medicaid spending:

 

2017: $390 billion
2018: $395 billion
2019: $409 billion
2020: $395 billion
2021: $396 billion
2022: $405 billion
2023: $419 billion
2024: $436 billion
2025: $455 billion
2026: $475 billion

 

Notice that when the major part of the Medicaid changes take effect in fiscal 2020, actual spending decreases year over year. In fact, not until 2023 does spending even get back above the level of 2019. So never mind “the baseline”, spending year over year declines in 2020.  The HHS department did not dispute these calculations by The Post Fact Checkers.

 

So, what is it that happens in 2020?

 

Well, under Obamacare, currently, the federal government would pay for a portion of the cost of Medicaid, at least $1 in matching money for every $1 a state spends on Medicaid, with 90% of the costs if a state expanded Medicaid under President Barack Obama’s Affordable Care Act (ACA).

 

But, under the GOP’s AHCA plan, financing would be set per enrollee in a state, using 2016 as a base year.  Increases in spending in each subsequent year would be limited to the medical care component of the consumer price index for all urban consumers (CPI-U Medical), with a higher rate set for the elderly, the blind and the otherwise disabled starting in 2020.

 

In other words, the base rate is locked in for four years even for the elderly, the blind and the disabled, so that lower baseline would be permanently baked into future calculations even for a group requiring extra resources.

 

Price has said that spending would increase “equal to the cost of medical care,” but the CBO projected that Medicaid spending per enrollee will grow faster than the medical inflation rate. Therefore, it’s clear that less money every year would be available to serve this same population.

 

In any case, it’s all but impossible to predict how much pressure the aging of the baby boom generation will place on Medicaid.  Please note that today, 25% of Medicaid spending goes to nursing home and long-term care, not to elder health care.

 

At one point, Price assured that it was “absolutely not true” that people would lose Medicaid as a result of the spending reductions. This is a misleading GOP talking point, but using simple math explains why this is totally false. Note that people cycle on and off Medicaid on a regular basis. If they try to return to the program once the AHCA takes effect, they will have lost their grandfathered-in status.

 

Price has flatly said that “20 million folks chose to pay a penalty because they wanted nothing to do with Obamacare”.  But if you listened carefully you will noticed a small caveat at the end of Price’s statement..

 

 

“We have got 20 million folks out there across this land who have told the federal government, ‘Phooey, nonsense, I’m not going to participate in your program because it doesn’t do what I need done.’ So, they are paying a penalty. They’re paying the IRS a fine or a penalty because the federal government is dictating to them what they don’t want to do, or they are saying, give me a waiver.”

 

But Price is wildly inflating the facts. According to a letter from IRS Commissioner to Congress, only 6.5 million taxpayers paid the “shared responsibility” fine payments in 2015. And that is actually a decrease from 2014, when 8 million taxpayers made that payment. The payments in 2015 totaled about $3 billion.

 

Please also note that many Americans paid their penalty for only a few months, not an entire year. The CBO estimates that, on average, about 3 million people paid the penalty for being uninsured in any given month in 2016.

 

Did you notice how Price slipped in the word “waiver” at the end of his statement?  He gets to his 20 million by adding in people who received an exemption; that totaled 12.7 million taxpayers. But Price frames this as some sort of mass protest against the law.  When you dig into the data, that’s not the reason.

 

Exemptions are granted for a number of reasons, but the most common one is that a person has income below a certain amount and they live in a state that did not expand the eligibility for Medicaid. The law offered Medicaid to nearly all low-income people with incomes at or below 138% of poverty, or $27,821 for a family of three in 2016. In other words, this is the result of the Republican governors or legislatures that refused to accept the expansion.

 

The second most common exemption is if a citizen lives outside the United States. People do not need to pay a penalty if they would have had to pay more than 8.13% of their income in 2016 to obtain health insurance.

 

President Trump has engaged in similar gamesmanship with these figures and administration officials really need to start citing the data accurately.

 

The HHS national spokesperson, provided the following response for this fact check:

 

“The Washington habit of measuring the success of a program by how much money is spent is one of the reasons the Medicaid program is in dire need of reform. The plain text of the AHCA is clear — spending on Medicaid goes up every year by at least the same rate as average medical expenses. The AHCA is focused on outcomes, who’s actually getting access to quality care, and how can states have the flexibility to tailor their programs to meet the unique needs of the vulnerable populations that Medicaid was created to help. Also, no matter how you slice it, the fact that 20 million Americans paid a penalty or got a waiver from Obamacare is a clear indictment of the law. That’s 20 million Americans our current system has basically written off.”

 

But here’s the Pinocchio Test:

 

Price had flatly stated that Medicaid spending will go up year after year in the budget, but that’s totally false. It actually declines in raw dollars after the switch in funding is implemented. Although HHS suggests he was saying that spending would go up by the rate set in the law, that is very misleading.  If the money falls short, which many are expected to, states will either have to make up the difference or cut expenses by limiting enrollment or reimbursements.  The smaller or less funded states will of course limit one or the other or both.

 

Price is similarly flase when he declares that 20 million people have rejected the Affordable Care Act (ACA) by paying a penalty. He slipped in that word “waiver” at the end, but that’s still misleading because most of the exemptions granted have little to do with “a clear indictment of the law.” It’s disturbing that Price’s spokeswoman would double down on the claim even after it was pointed out with the facts. People who live in non-Medicaid expansion states or overseas are not writing off the law.  In fact, the number of people paying a penalty actually declined by nearly 20% from 2014 to 2015.  That would indicate greater acceptance of Obamacare.

 

The Fact Checkers have wavered between 3 and 4 Pinocchios for Mr. Price and the AHCA plan.  Ultimatel they had to go to 4  when you are reducing spending by more than $800 billion over 10 years, you just can’t pretend you are boosting spending “every single year.”

 

So, 4 Pinocchio’s it is.

 

Copyright G.Ater  2107