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Rep. Michele Bachmann, R-Minn. is one of a number of Republican lawmakers who have recently sought to link the two longtime targets of conservatives -- the Internal Revenue Service and President Barack Obama’s health care law.
In a May 15, 2013, interview with Fox News’ Greta Van Susteren, Bachmann invoked an inspector general’s report critical of the IRS’ scrutiny of conservative groups seeking tax-exempt status.
She 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’ll be looking at a few claims from this exchange. In this item, we’ll look at whether there’s support for her claim that the IRS is "going to be in charge of our health care."
The IRS has a number of roles in implementing the health care law -- the agency has posted a list that includes everything from levying additional payroll taxes on certain high-income Americans to taxation of medical devices and brand-name drugs. Its best known role, beginning in 2014, is to confirm that a taxpayer has health insurance and to assess a financial penalty if they do not. (The penalties start at $95 per adult in 2013 and rise to $695 per adult in 2016.)
In another fact-check, we discussed another key role for the IRS -- approving subsidies for Americans seeking insurance on the newly created health exchanges. To do this, the IRS will need to check its databases to make sure an applicant is eligible to receive subsidies.
But while we noted that any technical failures in carrying out this task could be problematic, it would be a huge stretch to say that this power puts the IRS "in charge of our health care."
For one thing, most Americans will not see any dramatic change in how they obtain insurance, since the law leaves in place the existing system of health coverage provided by employers. In fact, in 2010, we chose the claim that the law amounts to a "government takeover of health care" as our Lie of the Year. To claim that one portion of the government -- the IRS -- is going to run health care is even more far-fetched. The IRS will have nothing to do with the nuts-and-bolts provision of health care to Americans.
Even among federal agencies, the law puts far more responsibility in the hands of the Department of Health and Human Services.
The department’s Web page on the health care law says that "HHS is responsible for implementing many of the health reform changes included in the Affordable Care Act," including "significant roles" for an alphabet soup of HHS offices, including the Administration on Aging, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Food and Drug Administration, the Indian Health Service, and the National Institutes of Health (NIH).
The duties of the Secretary of Health and Human Services in the health care law is expansive enough to fill a 5-foot by 10-foot chart, according to an op-ed by Mike Leavitt, who held the office under President George W. Bush. "It puts more power than is prudent in the hands of one person," Leavitt wrote.
Dan Kotman, a spokesman for Bachmann, explained her comment by saying that "the Supreme Court ruled that Obamacare only meets the constitutionality standard as a tax, and the entity in the United States that enforces tax policy is the IRS. If you don’t comply with Obamacare’s individual mandate, you will be answering to the IRS. That is clearly the context she’s talking within because she had just said, ‘The IRS, Greta, is the chief enforcer of Obamacare.’"
But several health policy experts agreed that’s not the same as the IRS being "in charge of our health care."
William McBride, an economist with the business-backed Tax Foundation, said the IRS has been tasked with "a tremendous amount" and that the agency is in "uncharted territory," but he added that he doubts the IRS "will effectively control much of anything related to health care."
Other health policy specialists were even more blunt. "Not accurate," said Gail Wilensky, who headed Medicare and Medicaid under President George H.W. Bush and who is now a health policy consultant. It’s a "ludicrous statement," said Jonathan Oberlander, professor of social medicine and health policy and management at the University of North Carolina, Chapel Hill.
Bachmann said the IRS is "going to be in charge of our health care." The IRS does play a number of key roles under the health care law, but it’s wrong to say it would "be in charge" of any American’s health care. The IRS won’t oversee interactions between doctors and patients, nor will it play any more of a role than confirming that exchange purchasers qualify for subsidies. Even within the government, HHS plays a much bigger role. We rate Bachmann’s claim False.
Internal Revenue Service, "Affordable Care Act Tax Provisions," accessed May 17, 2013
Department of Health and Human Services, Web page on the Affordable Care Act, accessed May 17, 2013
Kaiser Family Foundation, "The Requirement to Buy Coverage Under the Affordable Care Act," accessed May 17, 2013
Congressional Budget Office, "Payments of Penalties for Being Uninsured Under the Affordable Care Act," September 2012
Washington Post, "IRS scandal probably won’t hurt Obamacare," May 15, 2013
Michael O. Leavitt, "Health reform's central flaw: Too much power in one office" (op-ed in the Washington Post), Feb. 18, 2011
PolitiFact, "PolitiFact's Lie of the Year: 'A government takeover of health care,'" Dec. 16, 2010
Email interview with William McBride, economist with the Tax Foundation, May 17, 2013
Email interview with Jonathan Oberlander, professor of social medicine and health policy and management at the University of North Carolina, Chapel Hill, May 17, 2013
Email interview with Gail Wilensky, former head of Medicare and Medicaid under President George H.W. Bush, May 17, 2013
Email interview with Dan Kotman, spokesman for Rep. Michele Bachmann, May 17, 2013
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