Debate on health care includes buyer beware

Judy Roitman (left), Larry Drain, Dixie Damm and Todd Shelton cheer Thursday in Knoxville, Tenn., after the U.S. Supreme Court upheld the federal health care law.

WASHINGTON — President Barack Obama promises nothing will change for people who like their health coverage except it’ll become more affordable, but the facts don’t back him up. Mitt Romney groundlessly calls the health care law a slayer of jobs certain to deepen the national debt. Welcome to the health care debate 2.0. As the claims fly, buyer beware.

A look at some claims and how they compare with facts:

OBAMA: “If you’re one of the more than 250 million Americans who already have health insurance, you will keep your health insurance. This law will only make it more secure and more affordable.”

ROMNEY: “Obamacare also means that for up to 20 million Americans, they will lose the insurance they currently have, the insurance that they like and they want to keep.”

THE FACTS: Nothing in the law ensures that people happy with their policies now can keep them. Employers will continue to have the right to modify coverage or even drop it, and some are expected to do so as more insurance alternatives become available to the population under the law. Nor is there any guarantee that coverage will become cheaper, despite the subsidies many people will get.

Americans might well end up feeling more secure about their ability to obtain and keep coverage once insurance companies can no longer deny, terminate or charge more for coverage for those in poor health. But particular health insurance plans will have no guarantee of ironclad security. Much can change, including the cost.

The nonpartisan Congressional Budget Office has estimated that the number of workers obtaining employer-based coverage could drop by several million, as some workers choose new plans in the marketplace or as employers drop coverage altogether. Companies with more than 50 workers would have to pay a fine for terminating insurance, but in some cases, that would be cost-effective.

Where does Romney come up with 20 million? He does so by going with the worst-case scenario in the budget office’s analysis. Researchers thought it most likely that employer coverage would decline by 3 million to 5 million, but the range of possibilities was broad. It could go up by as much as 3 million or down by as much as 20 million.

OBAMA: “And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses and not enough on your health care.”

THE FACTS: Rebates are coming, but not nearly that many Americans are likely to get those checks, and for many of those who do, the amount will be decidedly modest.

The government acknowledges it does not know how many households will see rebates in August from a provision of the law that makes insurance companies give back excess money spent on overhead instead of health care delivery.

Altogether, the rebates that go out will benefit nearly 13 million people. But most of the benefit will be indirect, going to employers because they cover most of the cost of insurance provided in the workplace.

The government said some 4 million people who are due rebates live in households that purchased coverage directly from an insurance company, not through an employer, and experts say those households are the most likely to get a rebate check directly.

ROMNEY: “Obamacare raises taxes on the American people by approximately $500 billion.”

THE FACTS: The tax increases fall heavily on upper-income people, health insurance companies, drug makers and medical device manufacturers.

People who fail to obtain health insurance as required by the law will face a tax penalty, although that’s expected to hit relatively few because the vast majority of Americans have insurance, and many who don’t will end up getting it. There are no other across-the-board tax increases in the law, although some tax benefits such as flexible savings accounts are scaled back. Individuals making more than $200,000 and couples making more than $250,000 will pay 0.9 percent more in Medicare payroll tax and a 3.8 percent tax on investments. As well, a tax starts in 2018 on high-value insurance plans.

OBAMA: “Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parents’ health care plans, a provision that’s already helped 6 million young Americans.”

the FACTS: Obama is overstating this benefit of his health law, and his administration knows better. The Department of Health and Human Services on June 19 said 3.1 million young adults would be uninsured were it not for the new law. Obama’s number comes from a June 8 survey by the Commonwealth Fund, a health policy foundation. It said 6.6 million young adults joined or stayed on their parents’ health plans who wouldn’t have been able to absent the law. The number includes some who switched to their parents’ plans from other coverage, Commonwealth Fund officials told the Los Angeles Times.