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Democrats are capitalizing on Ron DeSantis’ opposition to the Affordable Care Act in an ad that portrays him as having little concern for cancer patients.
"In Congress, Ron DeSantis demanded that any new health law eliminate protections for people with pre-existing conditions," said an ad for Andrew Gillum's campaign produced with the Florida Democratic Party. "He’d let insurance companies deny them coverage. And when he was asked what cancer patients should do without health insurance, DeSantis said 'show up to the emergency room.'"
We will explain the context of the comments by DeSantis about cancer patients and the emergency room. In a related fact-check we will explain the ad’s evidence related to his stance on pre-existing conditions.
DeSantis, a longtime critic of the Affordable Care Act, was first elected to Congress in 2012 and resigned in September to focus on his race for governor against Gillum. A DeSantis campaign spokesman didn’t respond for this fact-check.
The statement about the emergency room stemmed from a March 8, 2017, appearance by DeSantis on Erin Burnett’s OutFront on CNN about a House Republican plan to replace the Affordable Care Act.
The show included a clip of an interview with Republican Tiffany Koehler, who found out she had cancer shortly after she lost a race for the Wisconsin State Assembly. Koehler said she could only afford chemotherapy as a result of her state’s Medicaid expansion.
Burnett asked DeSantis about Koehler’s situation (the bold emphasis is ours):
Burnett: "I want to start with Tiffany's story that you just heard there because of course, the GOP House plan that we've seen does roll back the Medicaid expansion. And I know you think it doesn’t quite do enough on that front. What do you say to Tiffany? I mean, she's a Republican, but, you know, she wouldn't be alive, she wouldn't be here without that Medicaid expansion and Obamacare."
DeSantis: "Well, if you remember when Obamacare was enacted, there were millions of people who had their health care canceled. And so there are stories of people who had certain needs, cancer or whatnot who got pushed into policies that they didn't want, and then they didn't have the same coverage that they had because of the broken promise. So I think this law has really created a lot of different aspects.
"I would say though, and people who supported Obamacare used to make this point a lot before it passed, there really is no lack of health care. If people really need it, if they show up to the emergency room, they do get care, it just gets passed on --"
Burnett: "But not -- I mean, she had $1 million in cancer treatments. You're not going to get that by showing up in an emergency room."
DeSantis pivoted to his opinion that the health care law isn’t sustainable. For the rest of the interview, neither DeSantis nor Burnett brought up anything about patients showing up at an emergency room.
So DeSantis did make the statement that if people need care they can go to the ER, but he was speaking broadly and not only about a cancer patient.
A few days later at a testy town hall over health care at Bethune-Cookman University, DeSantis addressed his emergency room comment. He said "he had conflated two ideas" and that going to the emergency room "was not the way to handle that situation," according to the Daytona Beach News-Journal. (PolitiFact was unable to find a full video of that town hall.)
Because emergency rooms by law cannot turn patients away, they can become a health care provider of last resort. President Barack Obama had expressed hope that the Affordable Care Act would lower emergency room use. In 2017, we found that there was strong evidence that emergency room usage hadn’t declined much, if at all, since the law largely took effect in 2013. There’s also evidence that it has increased.
Gail Wilensky, who headed Medicare and Medicaid under President George H.W. Bush, told PolitiFact the problem with cancer treatment in emergency rooms is the lack of continuity of care.
"Many hospitals, especially public hospitals, will have clinics and similar programs to treat people in a more ongoing way," she said, "but it still tends to be a very expensive way to receive care."
A Gillum ad said, "When he was asked what cancer patients should do without health insurance, DeSantis said 'show up to the emergency room.'"
What he said is not that cut and dried.
DeSantis did bring up the requirement that everyone be treated in the emergency room when a CNN host asked what he would say to a cancer patient who benefited from Medicaid expansion.
In context, however, he appeared to be talking more broadly about "how there really is no lack of health care." He side-stepped the direct question, for sure. But he did not straight-up say that cancer patients should seek care at the ER.
At a town hall a few days later, DeSantis said "he had conflated two ideas" and that going to the emergency room "was not the way to handle that situation."
We rate this statement Half True.
Andrew Gillum campaign, Ad, Sept. 26, 2018
CNN, "Cancer survivor, Republican has change of heart on Obamacare," March 9, 2017
Daytona Beach News-Journal, "GOP Congressman Desantis under fire at town hall meeting in Daytona," March 11, 2017
Daytona Beach News-Journal, "DeSantis has concerns on day before health-care vote," March 22, 2017
Politico, "Democrats launch website attacking 'DeSantisCare,'" Sept. 10, 2018
Tampa Bay Times The Buzz, "Andrew Gillum hits Ron DeSantis' health care record in new TV ad," Sept. 26, 2018
PolitiFact, "HHS chief Tom Price mostly correct that ER use is up since Obamacare," March 10, 2017
Interview, Carlie Waibel, Andrew Gillum campaign spokeswoman, Oct. 15, 2018
Interview, Gail Wilensky, who headed Medicare and Medicaid under President George H.W. Bush, Oct. 15, 2018
Interview, Katherine Baicker, professor of health economics at Harvard University’s T.H. Chan School of Public Health, Oct. 15, 2017
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