The sweeping federal health care law is a key point of disagreement between Sen. Scott Brown and his challenger, Elizabeth Warren.
Brown, a Republican, vows to repeal the law and let states craft their own health care reform plans. Warren, a Democrat, supports the federal Affordable Care Act and says the country must stay with the gains already made under the law.
In the last two weeks of this campaign, you’ll likely hear many competing claims about how the law will affect you; here are two.
The first claim is about Medicare, the government program of health coverage for most Americans 65 or older. The political action wing of Boston-based Community Catalyst is out with a report that says repealing the Affordable Care Act (ACA for short) would hurt seniors.
Community Catalyst Action Fund Director Rob Restuccia says seniors would see their Medicare costs increase about $500 a year if the law is repealed. Medicare members who take a lot of medications and hit the “donut hole” could see their costs increase up to $1,700 a year, according to projections from the Obama administration.
“We know that the drug costs are lower (under the ACA),” Restuccia says. “We know that there’s preventive services that seniors are getting, but also their premiums are lower. Put it all together and it’s a big deal for seniors.”
And here’s the reason that Restuccia is sending out this analysis.
“We think that Sen. Brown and others are really distorting what the Affordable Care Act does.”
Restuccia’s right: Brown doesn’t talk about Medicare saving seniors money. He talks about Medicare cuts. Brown calls the $716 billion that the Congressional Budget Office says Medicare plans to save through lower reimbursements to doctors, hospitals and health insurers “cuts to Medicare.”
There’s the competing claim about what happens to Medicare under the ACA: savings versus cuts.
The second claim you’ll hear has to do with everyone who has private insurance, usually through their employers. The federal law includes a tax on Americans with what are known as “Cadillac” or top-of-the-line health insurance plans. A report from the Pioneer Institute in Boston concludes that half of Massachusetts residents will be considered as having Cadillac plans and have to pay that tax, starting in 2018.
“We have extremely robust and generous health care plans (in Massachusetts)”, says the report’s author, Josh Archambault. “We have historically and we expect to continue in the future. As a result, most people will probably be spending within the tens of thousands of additional tax dollars because their health insurance is so generous.”
Archambault’s predictions about “tens of thousands of dollars” in additional taxes won’t hold if the slower premium growth we’ve seen in the last few years continues and if employers continue to shift more health care costs to employees (through higher deductibles and co-pays). But even if premiums only increase on average at 4.8% a year, Archambault says, half of Massachusetts residents with private coverage will pay a Cadillac tax of some amount.
Republicans say Warren is conveniently ignoring the Cadillac tax as she heralds the ACA’s benefits.
I’m going to expand the second competing claim to this: Will the ACA increase or lower costs for Massachusetts residents? We don’t have an answer that is specific to Massachusetts. The Congressional Budget Office says the ACA will save private and public insurance plans $84 billion over the next 11 years.
Restuccia says, “the Affordable Care Act will reduce costs overall for everyone. Some will see small rises in premiums, but overall, when you look at the CBO reports, there are significant savings for almost all consumers.”
But Archambault suggests that even if there some savings, “Voters should think through the financial situation of any health care program going forward. As a nation, can we afford the kind of spending that we have in the current programs and any proposed new programs?”
Opponents of the law argue that there’s little proof the law will make health care more efficient and great concern that the ACA is creating a set of new commitments the country can’t afford to keep.
Supporters counter that the ACA’s complex plan of coverage, focused on prevention, with payment based more closely on delivering better care, is the country’s best hope to reduce health care spending over time.
So back to Brown vs. Warren…Is her support for the ACA or his vow to repeal the act an issue you’ll think about as you walk or drive to the polls in two weeks?