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There is a once-obscure government report that Obamacare’s critics don’t seem to be able to resist misquoting.
Sean Hannity made this mistake on his Fox News show Monday.
"In July 2010 the government said small businesses -- 60 percent -- will lose their health care, 45 percent of big business and a large percentage of individual health," Hannity said. "That's not 5 percent. That’s half of America. That's 128 million Americans, by their math, not mine."
Fox News told us that Hannity drew upon an article in Forbes that projected about 93 million people would not be able to keep their current plans under Affordable Care Act regulations. That article, plus a report from NBC, relied upon a government analysis from June 2010. It drew very little attention when it was published in the Federal Register. That has since changed.
In this fact-check, we’re going to walk you through the report -- and why it doesn’t say what Hannity says it does.
The 2010 federal report
As part of the health care law, the federal government said people could keep the health insurance they had so long as the plan was in place before the health care law was passed in 2010. That’s the so-called "grandfather" provision.
But if the plan changed -- sometimes even in ways people might consider minor -- people would have to purchase health insurance that meets new minimum standards. For some people, that could mean purchasing additional coverages for maternity and mental health care, which in turn could mean higher premiums.
Back in 2010, three federal departments (Labor, Health and Human Services and the Internal Revenue Service) tried to determine how many plans would change to the point that they would need to meet the new minimum standards.
They looked at the historical patterns of insurance plans pre-Obamacare and tried to project what would happen in an Obamacare world.
What they found is that many plans indeed would make the changes to trigger the new minimum standards.
How many people would be affected?
By the end of 2013, government analysts said half of all group or employer-based plans would change to the point that they would need to meet the new standards -- which is about what Hannity said.
When combined with the number of people in the individual insurance market facing the same fate, government officials concluded that the health care plans of about 93 million to 99 million Americans would need to now meet the minimum standards created by the health care law. (Hannity said 128 million, which we’ll address shortly.)
So why is Hannity wrong?
The problem for Hannity is that the government analysts did not try to determine how many of those millions of Americans are in health insurance plans that already meet the minimum standards.
That’s an important distinction because if plans already meet the minimum standards, the health care law has a modest impact.
Robert Kaestner, a professor at the Institute for Government and Public Affairs at the University of Illinois, told us that most large employers already do what the law demands.
"The requirements are not that binding because many of these plans adhere to the requirements already," Kaestner said.
A 2013 survey by the International Foundation of Employee Benefit Plans backs up Kaestner’s point. It found that about three-quarters of the employer-sponsored health plans it contacted already meet the criteria of the health care law. The survey included both large and small employers and was based on 966 responses from human resource officers and benefits consultants.
While we don’t know exactly how many plans already meet the new minimum standards and how many don’t, there’s nothing in the government report to suggest that the reality is close to the 128 million that Hannity claimed.
The difference between a changed plan and no plan at all
Hannity said a total of 128 million Americans will lose health care. This is quite similar to a mistake Glenn Beck made, and we repeat this key point: A change in a plan is not the same as losing health coverage.
One of the highest estimates of how many people will see their plans change comes from Christopher Conover, a researcher at Duke University and an adjunct scholar with the American Enterprise Institute. (The American Enterprise Institute and its scholars have generally been critical of the health care law.)
Fox News noted that Hannity had interviewed Conover and relied on his work. But even Conover doesn’t back up Hannity’s claim.
Conover estimated that as many 135 million people would see their plans affected, although his mid-range figure was 129 million.
But Conover draws a line between seeing your plan change and losing your health care.
"Let me clear that I am not predicting that 135.8 million Americans have or will have their policies canceled due to Obamacare," Conover wrote.
Scott Harrington, professor of health care management at the University of Pennsylvania’s Wharton School, was equally emphatic.
"Losing grandfathered status does not mean that you lose your health insurance," Harrington said.
Citing a government report, Hannity said "small businesses -- 60 percent -- will lose their health care, 45 percent of big business and a large percentage of individual health."
The government report did not say that.
The report attempted to quantify the number of insurance plans that -- through the normal ebbs and flows of the market -- would change to the point that they would trigger new minimum standards.
Put another way, government analysts tried to quantify how many plans would lose their grandfathered status.
But they didn’t look at the coverage those plans offered. In those terms, many of the plans that will lose their grandfathered status already met the new minimum standards.
We rate Hannity’s claim False.
Fox News, Hannity, Nov. 11, 2013
Federal Register, Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection and Affordable Care Act, June 17, 2010
The Daily Caller, Expert: At least 129 million will ‘not be able to keep’ health care plan if Obamacare fully implemented, Nov. 4, 2013
Forbes, Obama Officials In 2010: 93 Million Americans Will Be Unable To Keep Their Health Plans Under Obamacare, Oct. 31, 2013
NBC News, Obama administration knew millions could not keep their health insurance, Oct. 29, 2013
Email interview, Christopher Conover, policy analyst, Center for Health Policy and Inequalities Research, Duke University, Nov. 4, 2013
Email interview with Robert Kaestner, professor, Institute of Government and Public Affairs, University of Illinois, Nov. 4, 2013
International Foundation of Employee Benefit Plans, 2013 Employer-health care: ACA’s impact, 2013
Email interview with Scott Harrington, professor, Health Care Management Department, Director, Wharton/Penn Risk and Insurance Program, Wharton School, University of Pennsylvania, Nov. 4, 2013
Email interview with Laura McGinnis, spokesperson, U.S. Labor Department, Nov. 5, 2013
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