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During a recent interview with Fox News, Rep. Michele Bachmann, R-Minn., raised the specter of the Internal Revenue Service -- an agency currently under fire for appearing to target conservative groups seeking tax-exempt status -- collecting a database full of "intimate" details about Americans.
Referring to an inspector general’s report on IRS scrutiny of conservative groups, Bachmann said, "So now we find out these people are making decisions based on our politics and beliefs, and they're going to be in charge of our health care. There's a huge national database that's being created right now. Your health care, my health care, all the Fox viewers health care, their personal, intimate, most close to the vest secrets will be in that database, and the IRS is in charge of that database? So the IRS will have the ability potentially -- will they? -- to deny health care, to deny access, to delay health care? This is serious! Based upon our political beliefs? That's why we have to repeal Obamacare. And I still think it's possible."
We’ve already rated two of her claims from this exchange, which came during a May 15, 2013, interview on the Fox News show On the Record with Greta Van Susteren. We gave Bachmann a False for saying that the IRS is "going to be in charge of our health care," and we gave her a Mostly False for her claim that "The IRS will have the ability potentially" to deny or delay health care.
In this item, we’ll focus on whether it’s correct to say that the IRS is going to be in charge of "a huge national database" on health care that will include Americans’ "personal, intimate, most close-to-the-vest-secrets."
After the interview with Van Susteren aired, Dan Kotman, a spokesman for Bachmann, told PolitiFact that she stands by her charge. As evidence, he cited a passage from a Wall Street Journal editorial published one day before her television appearance.
The editorial described a Federal Data Services hub that is taking "the IRS's own records (for income and employment status) and centralizing them with information from Social Security (identity), Homeland Security (citizenship), Justice (criminal history), HHS (enrollment in entitlement programs and certain medical claims data) and state governments (residency). The data hub will be used as the verification system for ObamaCare's complex subsidy formula. ...
"Good luck in advance to anyone who gets caught in this system's gears, assuming it even works. Centralizing so much personal information in one place is another invitation for the IRS wigglers in some regional office—or maybe higher up—to make political decisions about enforcement."
We see four key questions for fact-checking Bachmann’s claim. First, is the government constructing a database? Second, will the IRS be "in charge" of it? Third, would it include "personal" or "intimate" details? And fourth, would it affect all, or most, Americans?
We’ll take these issues in order.
Is the government constructing a database?
Not by the traditional definition of "database." The "hub" the government is creating is a mechanism for extracting data from a variety of databases that exist at other agencies. The hub doesn’t collect, centralize and store data; it is designed to allow real-time access to data that resides on the servers of other agencies in order to verify transactions related to the health insurance exchanges created under Obama’s law.
In an April 22, 2013, release, the Center for Medicare and Medicaid Services, a part of HHS, said that it has completed the hub’s technical design and is in the midst of testing it. "The hub will not store consumer information, but will securely transmit data between state and federal systems to verify consumer application information," the center said in the statement. HHS pledges "strict privacy controls to safeguard personal information," added Brian Cook, a spokesman for the department.
"This is not a huge national database of health records," said Deven McGraw, director of the health privacy project at the Center for Democracy and Technology, which advocates for Internet freedom.
Will the IRS be "in charge" of the hub?
No. It’s being built by HHS, specifically by the Center for Medicare and Medicaid Services. To ensure compatibility, the IRS needs to cooperate with HHS on the effort, but the IRS has only a supporting role in building the system, and the IRS will not be able to use the hub to view information in the other agencies’ databases.
Will the hub include "personal" or "intimate" details?
The hub is not designed to access, much less store, information like body mass index, or whether you have a serious illness or ingrown toenails. The hub will be able to tell if someone has insurance or not, but it will not access records about their health. It could access other "personal" details beyond health status, including adjusted gross income and Social Security numbers, but those already exist in federal databases, so the hub wouldn’t represent an expansion of federal data collection.
Would the hub affect all, or most Americans?
No. The data won’t be accessed by the hub unless an individual logs on to the new insurance exchanges in order to purchase insurance. An estimated 28.6 million Americans might be eligible for health insurance subsidies on the exchange in 2014, though the Congressional Budget Office has suggested that many fewer Americans will actually sign up, at least at first -- 6 million in 2014 and 22 million in 2017.
So the numbers of Americans who might eventually interact with the hub aren’t trivial -- but it’s important to note that even if everyone who’s eligible takes the opportunity to use the exchanges, they would represent a small fraction of all Americans. People who have employer-provided insurance or are on Medicare, Medicaid, veterans health care or most other forms of government-provided insurance should have no need to interact with the hub at all.
Bachmann said the IRS is going to be "in charge" of "a huge national database" on health care that will include Americans’ "personal, intimate, most close-to-the-vest-secrets."
The congresswoman chooses to believe that the IRS and the rest of the government intend to delve ever-further into Americans’ personal lives. We can’t predict what will happen in the future, but as best we can tell now, she has mischaracterized the intent and limitations of the hub. It’s not a "database." The IRS isn’t running it. It won’t include "intimate" health data. And most Americans won’t need to interact with it at all. We rate her comment Pants on Fire.
Centers for Medicare and Medicaid Services, Federal Marketplace Progress fact sheet, April 22, 2013
Wall Street Journal, "Your Next IRS Political Audit," May 14, 2013
Grace-Marie Turner, "Applying for ObamaCare—Still Not Simple" (op-ed in the Wall Street Journal), May 10, 2013
Elaine Kamarck, "The Affordable Care Act: From Hiccups to Repeal" (Brookings Institution paper), May 15, 2013
Government Health IT, "Federal hub tool to check data for insurance exchanges, Medicaid," July 2, 2012
PolitiFact, "Michele Bachmann says IRS 'will have the ability' to delay or deny health care," May 20, 2013
PolitiFact, "Michele Bachmann says the IRS is ‘going to be in charge of our health care,’" May 20, 2013
Email interview with Deven McGraw, director of the health privacy project at the Center for Democracy and Technology, May 20, 2013
Email interview with Brian Cook, spokesman for the Department of Health and Human Services, May 20, 2013
Email interview with Dan Kotman, spokesman for Rep. Michele Bachmann, May 17, 2013
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