Pants on Fire!
Chain email
The Affordable Care Act says that "at age 76 when you most need it most, you are not eligible for cancer treatment. …  Cancer hospital will ration care according to the patient's age."

Chain email on Tuesday, October 21st, 2014 in a chain email

Five years on, chain email about cancer treatment rationing after age 76 is still Pants on Fire

A reader recently sent us a years-old chain email that has morphed into something more timely. It now has the heading, "IMPORTANT ACTION INFORMATION FOR NOVEMBER, 2014  VOTE."

For years before that, though, the chain email has floated around the Internet, making the scary claim that "at age 76 when you most need it most, you are not eligible for cancer treatment. Cancer hospital will ration care according to the patient's age." PolitiFact Oregon gave this a rating of Pants on Fire when they looked at it in 2013.

The email -- which has changed somewhat as it has zigzagged around social media -- can be identified by its attribution of the information to Judge David Kithil of Marble Falls, Texas. (More on him later.) It opens with a dire warning:

"MEDICARE AT AGE 76, IMPORTANT PLEASE READ - ANYONE WHO DOUBTS THIS IS TRUE CAN DOWNLOAD THE NEW OBAMA CARE AND LOOK UP THE PAGES MENTIONED. THIS IS JUST THE BEGINNING......THIS should be read by everyone, especially important to those over 75..... If you are younger, then it may apply to your parents…."

However, the email is hardly up-to-date -- it’s been circulating since 2009 and apparently stems from a list of tweets by blogger Peter Fleckenstein about H.R. 3200. That was an early version of the legislation that later became the Affordable Care Act, or Obamacare. Many aspects of that original bill never made it into law, and other provisions have been misinterpreted or exaggerated by the email’s author.

In fact, our friends at FactCheck.org found that just four of the email’s 48 claims were accurate.

Here, we'll recap what we know about the cancer claim and a few of the email's other points.

The cancer claim

The email bases its claim about the age-based rationing of cancer care on page 272 of H.R. 3200, section 1145. But the claim is not correct.

The Patient Protection and Affordable Care Act was signed into law in March 2010. It does not include rationing for cancer treatment based on age or any other demographic factor. Nor did the precursor bill, H.R. 3200, include a cut-off age for cancer treatments.

One provision of H.R. 3200 did include a section on "treatment of certain cancer hospitals," but this simply allowed Medicare -- the federally run health plan for those older than 65 -- to allocate more funding to cancer hospitals if they incurred higher costs. The American Nurses Association called this the "opposite of rationing."

Under current legislation, "all medically necessary treatment is covered by Medicare. Including cancer treatments, regardless of age," said Katherine Fitzpatrick of the Medicare Rights Center, an advocacy group, in a June 2013 interview.

The Medicare Rights Center and AARP, the largest national organization of seniors, agree that hospital admittance has to do with billing under parts A or B of Medicare. Under the version of the Affordable Care Act that was adopted, Medicare payments to hospitals can be reduced if patients are readmitted within 30 days for certain conditions, such as pneumonia, but that’s not what the email claims.

Meanwhile, the email raises a legitimate concern -- "rationing" -- but does so in a misleading way.

"Everyone hates the word ‘rationing,’ " Harvard University health-policy specialist Katherine Baicker told PolitiFact in 2009. But rationing is not something that suddenly appeared in the Affordable Care Act, she added. "From an economics perspective, there's no way around rationing. Some care is being rationed now. Everyone isn't getting everything."

It’s theoretically possible to spend an unlimited amount on health care, but as a society, we only have a limited amount of public resources -- so tough decisions have to be made on how to allocate those resources.

Before the Affordable Care Act was passed, "rationing" occurred when private insurers denied coverage for those with pre-existing conditions, or denied reimbursement for certain basic services, or priced their plans too high for certain consumers to pay.

If anything, John F. Holahan, a fellow at the Urban Institute's Health Policy Center, said in an earlier interview that private insurers are historically more likely to deny health services than Medicare is. "That's the argument you hear people making," he said. "But I think they have it backwards."

A final word. Remember Judge Kithil, the supposed author of the email? He’s disowned it.

"I wish it would die. I can’t control it," David Kithil told PolitiFact Oregon in 2013. "I don’t know how something like that goes viral."

The former judge recalled that he wrote a letter to his local newspaper in 2009, protesting the initial version of the health care act. The letter was published in the River Cities Daily Tribune, circulation 5,000. Somehow, he said, it was republished online.

Kithil said he wants readers to disregard his letter, since it is outdated and based on legislation that did not become law.

"I’ve had calls from all over the country -- 300 to 400 calls over three or four years on this," he said at the time. He said he pleads with the callers, "Don’t pass it on. It’s not accurate anymore. Trash it."

Our ruling

The chain email says that the Affordable Care Act requires that, "at age 76 when you most need it most, you are not eligible for cancer treatment. … Cancer hospital will ration care according to the patient's age."

With this email, longevity has not meant accuracy: Seniors do not need to worry about their cancer care being yanked away once they reach age 76. The claims are based on an incorrect understanding of a bill that never passed. The Affordable Care Act does not include any sections on seniors losing their treatment eligibility once they reach age 76.

We rate the claim Pants on Fire.