Sunday, November 23rd, 2014

PolitiFact examines candidates claims on Medicare

Piedmont Hospital nurse Kathy Flood (right) listens to patient Clarence Dee Holland's breathing to check for signs of pneumonia.
Piedmont Hospital nurse Kathy Flood (right) listens to patient Clarence Dee Holland's breathing to check for signs of pneumonia.

The future of Medicare, the federal health care program for older and disabled Americans, has been a key issue in the race for the White House. The issue came into sharp focus after Republican presidential nominee Mitt Romney named U.S. Rep. Paul Ryan of Wisconsin as his running mate.

In 2011, Ryan proposed a hotly debated plan to ensure Medicare remains solvent. President Barack Obama and Vice President Joe Biden have consistently claimed the GOP approach would end Medicare guarantees for seniors. The Republicans have countered the Obama administration has cut Medicare spending through the controversial 2010 health care law.

Below are some abbreviated versions of fact checks of statements by the candidates on the issue. Look for the complete fact checks at the PolitiFact online sites.

Readers can comment on our Truth-O-Meter rulings at our Facebook page: http://www.facebook.com/politifact.georgia?fref=ts. And they can follow us on Twitter at: PolitiFactGA.



Romney says Obama "robbed Medicare (of) $716 billion to pay for ... Obamacare."


A frequent talking point among Republicans is that Obama has taken -- or "robbed" in Romney’s words -- $716 billion from Medicare for the 2010 federal health care law, which the GOP and now Obama call "Obamacare."

The health care law is aimed at reducing future health care costs, primarily through significant reductions to Medicare Advantage, a subset of Medicare plans run by private insurers. Hospitals, too, will be paid less if they have too many readmissions, or if they fail to meet other new benchmarks for patient care.

The tally of those cost reductions over the next 10 years is $716 billion, according to the nonpartisan Congressional Budget Office.

Now, to address the word "robbed." Congress passed the law through its normal process, and the proposal was debated out in the open during the many weeks that the final law was being negotiated.

The only element of truth here is that the health care law seeks to reduce future Medicare spending. The money wasn’t "robbed," however, and other presidents have made similar reductions to the Medicare program.

PolitiFact rated this statement Mostly False.



Obama: "Medicare does just as good, if not better, at keeping people healthy" as Medicare Advantage.


Obama defended plans to cut Medicare Advantage in a television interview during the early stages of his administration.

The 2010 federal health care law is aimed at reducing future health care costs, primarily through significant reductions to Medicare Advantage, a subset of Medicare plans run by private insurers that was revamped during President George W. Bush’s administration.

The White House sent PolitiFact a report that was pretty down on Medicare Advantage, primarily because of its expense.

Another report from America's Health Insurance Plans, an industry group, said that Medicare Advantage HMOs in California and Nevada reduced hospital days and readmissions compared with traditional Medicare.

PolitiFact reviewed consumer advice on Medicare plans and didn't see any advice that drew broad conclusions about which was better, Medicare or Medicare Advantage.

PolitiFact found little statistical evidence that would definitively confirm or refute Obama’s statement about Medicare vs. Medicare Advantage. MedPAC, the independent agency that reports to Congress, said it had no reason to think that Medicare Advantage overall was superior to regular Medicare.

PolitiFact rated Obama's statement Half True.



Romney: "In 2008, candidate Barack Obama attacked John McCain for proposing cuts to Medicare."


In one television ad, Romney brought a different perspective to the Medicare debate: Obama, the Romney camp said, is a flip-flopper.

The Romney ad says that in 2008, Obama attacked his opponent, U.S. Sen. John McCain, for wanting to cut Medicare -- and then did so himself to pay for the 2010 federal health care law.

"It turns out, Sen. McCain would pay for part of his plan by making drastic cuts in Medicare, $882 billion worth, $882 billion in Medicare cuts to pay for an ill-conceived, badly thought-through health care plan that won't provide more health care, to people, even though Medicare is already facing a looming shortfall," Obama said during a 2008 rally.

Romney’s new ad says "candidate Barack Obama attacked John McCain for proposing cuts to Medicare." That's an accurate description of what Obama said.

PolitiFact rated Romney's claim True.



Obama: Romney "would turn Medicare into a voucher program."


Obama wasted little time deriding Romney’s Medicare plan as a "voucher program" while talking entitlements in the first presidential debate in Denver.

Under the current system, the federal government pays doctors and hospitals fees for particular services. That would end under the Romney-Ryan Medicare plan. Instead, beneficiaries would have the choice of receiving a fixed subsidy from the federal government that could go toward a private insurance plan or a plan similar to traditional Medicare. We should note the plan would apply only to people who are under 55 today, not current seniors.

Some experts in health policy say there are marked differences between the terms "voucher" and "premium support." While there are technical differences that may matter to health policy professionals, these are not the type of differences that most beneficiaries would see as significant. In recent years, the definitions of "premium support" and "vouchers" have become almost indistinguishable.
   
Generally, we think "voucher program" is a fair way of describing to voters the vision for Medicare under a Romney-Ryan administration.

PolitiFact rated Obama’s claim Mostly True.




Ryan: The Romney-Ryan plan for Medicare "does not affect" benefits for anyone 55 or older.


Once Ryan joined the GOP ticket, the Obama campaign and its supporters said the Republican’s Medicare plan cut benefits for seniors.

Not true, Ryan said.

"Our solution to preserve, protect and save Medicare does not affect your benefits," Ryan said during an Aug. 18 stop at The Villages, a retirement community in Florida.  "Let me repeat that -- our plan does not affect the benefits for people who are in or near retirement."

Under the current system, the federal government pays doctors and hospitals fees for particular services. That would end under the Romney-Ryan Medicare plan. Instead, beneficiaries would have the choice of receiving a fixed subsidy from the federal government that could go toward a private insurance plan or a plan similar to traditional Medicare. The private plans would comply with standards set by the federal government.

Ryan’s assurance does not take into account one very large elephant in the room: the federal health care law, which alters Medicare primarily by extending more benefits and savings. Romney and Ryan want to "repeal and replace Obamacare," but they haven’t said with what. Repealing the law would take away benefits for current enrollees.

PolitiFact rated his claim Half True.



Biden says Romney and Ryan would "eliminate the guarantee of Medicare."


Biden made this claim during the vice presidential debate in Danville, Ky.

While the federal government guarantees that you will be served by Medicare once you turn 65, it doesn’t guarantee that you’ll get every possible service or treatment paid for.

Calling today’s Medicare benefits "guaranteed" is partially, but not entirely, true. Currently, Medicare does guarantee broad health coverage for seniors and, in the short term, guarantees specific benefits. But Medicare doesn’t cover everything, and Congress and the president can change what is covered -- and will be forced to do so when fiscal pressures hit.
   
Meanwhile, it’s plausible that the Romney plan could provide less of a "guarantee" than Medicare currently does, but we found sharp disagreement between supporters and opponents of Romney’s Medicare plan on that point. This disagreement is hard to resolve given the shortage of information Romney has so far provided.
   
On balance, PolitiFact rated the claim Half True.



Romney: "Only one president has ever cut Medicare for seniors in this country . . . Barack Obama."


Romney made this claim during a Republican presidential debate.

PolitiFact went back through the history of Medicare and found several presidents had cut Medicare spending or benefits. Ronald Reagan cut Medicare by reducing payments to hospitals, and he cut benefits by raising deductibles. George H.W. Bush cut benefits by repealing a law that would have expanded coverage for drugs and catastrophic illness. Bill Clinton cut Medicare by changing payments to doctors and other providers, which could be considered to have an indirect effect on beneficiaries. Obama cut future Medicare spending but expanded benefits.

The statement gets it wrong on every front. Further, by specifying that Obama cut Medicare "for seniors," Romney seems to mean that the president slashed benefits, not just the program’s spending.

That’s a lot of inaccuracy in a single sentence.

PolitiFact rated Romney’s statement False.



Obama says under Romney, "Medicare could end as we know it, leaving Julia with nothing but a voucher to buy insurance, which means $6,350 extra per year for a similar plan."


Poor Julia.

The fictional character created by the Obama campaign to illustrate the benefits of the president’s policies for women would have a tough time under Romney’s Medicare proposal, the Obama team claimed.

The Obama campaign based its claim on an April 2011 Congressional Budget Office analysis of the Ryan plan. However, the analysis is of an out-of-date plan, and it ignores that Romney has offered his own.

Romney’s plan simply isn’t specific enough to justify the statement, "which means $6,350 extra per year for a similar plan" — a number based on analysis of the original Ryan plan.
   
The Obama campaign ties Romney to an outdated plan with less generous spending growth and no traditional Medicare option. Romney does support a voucherlike system, but the graphic ignores critical facts that would give a different impression about his plan.

PolitiFact rated the claim Mostly False.