Ad Audit: Pro-Reform Groups Stretch Truth About Health Legislation

AD TITLE: “Not Happy”

SPONSORS: Americans United for Change and the American Federation of State, County and Municipal Employees (AFSCME)

SUMMARY: Ads by a liberal activist group and a prominent labor union defend members of Congress who voted for the House health care overhaul bill. But the ads misleadingly claim the legislation would stop premiums from increasing, and also make a debatable assertion that Medicare would be “strengthened.”

BACKGROUND: AFSCME represents government employees; Americans United for Change is an advocacy group funded in part by labor unions and created in 2005 to combat President George Bush’s conservative initiatives. These ads are running in the districts of 13 members of Congress who voted for the health care overhaul bill in the House last month. The ad sponsors say these are the “first wave” of a $1.7 million advertising campaign to support lawmakers being attacked in their districts for their votes.

The ads are running in defense of the following Democrats in these media markets: Baron Hill in Louisville, Ky. and Evansville, Ind.; Brad Ellsworth in Terre Haute and Evansville, Ind.; Christopher Murphy in Hartford, Conn.; Gerald Connolly in Washington, D.C.; Tom Perriello in Charlottesville and Roanoke, Va.; Earl Pomeroy in Fargo, Minot and Bismarck, N.D.; Marion Berry and Vic Snyder in Little Rock and Jonesboro, Ark. The ads are also defending the one Republican who voted for the bill, Joseph Cao, in New Orleans.

AUDIO AND VISUALS (Arkansas version): The screen shows a corporate boardroom with executives talking as the narrator says, “The insurance lobbyists weren’t happy when Congressmen Berry and Snyder voted for health insurance reform. No wonder they are being attacked with TV ads.” The screen displays a picture of a TV ad urging “Vote No on Health Care.”

The ad shows two people adding up their bills while the words “Stop skyrocketing premiums” appear on the screen. The narrator says, “Insurance companies know the reform bill would stop them from raising premiums. And stop them from denying coverage when you’re sick.” The ad shows a mother holding a child while they sit in a waiting room, with the words “No more denying coverage” appearing on the screen.

Next, the ad shows a doctor and then an elderly man as the narrator says: “And the reform bill will strengthen Medicare. That’s why it’s endorsed by the AARP. Call Congressman Berry and Congressman Snyder. Tell them not to back down. Tell them to keep fighting for us.”

POLITICS: Advocates for health care overhaul have regretted not doing more during the 1993 health care debate to support lawmakers who were being attacked by those who opposed Democratic legislation. These ads seek to bolster potentially vulnerable lawmakers so that they will continue to support overhaul in future votes. The ads also are intended to rebut the major attack lines of the negative advertisements being aired by groups including the U.S. Chamber of Commerce and the 60 Plus Association, which styles itself as the conservative AARP.

ACCURACY: The ad wrongly says health overhaul legislation would stop premiums from increasing. There’s no such provision in either the House or Senate bills. Some people may see initial reductions in their premiums as a result of new insurance rules, but there’s nothing in the measures that stops anyone’s rates from rising over time, and in fact the bills — and cost analyses from the nonpartisan Congressional Budget Office — anticipate that premium increases will continue in future years, probably at rates above inflation.

In its defense, the ad points to a part of the House bill that would require insurers to justify to the government their reasons for raising premiums. But such disclosures don’t stop insurers from raising rates. In fact, insurers routinely win premium increases even in states where they must get the prior approval of the insurance commissioner. The ad sponsors also assert that the inclusion of a government-run insurance alternative, known as a public option, would provide competition for insurers, leading to more restrained premium increases. Economists differ on how much of an influence such competition would have, and most believe premiums are likely to continue to rise regardless.

It’s one-sided for the ad to say the bills would strengthen Medicare. The bills do contain benefits for beneficiaries, including closing the so-called doughnut hole in the prescription drug plan over time and providing additional cost-sharing assistance for lower-income people. But the House bill also calls for $477 billion in Medicare spending reductions over the decade. Richard Foster, the chief actuary of the Centers for Medicare & Medicaid Services, has warned that the reductions in the House’s bill could lead some providers to drop out of the program, “possibly jeopardizing access to care for beneficiaries.” Also, people enrolled in Medicare Advantage private plans, which generally offer better benefits that standard fee-for-service Medicare, can expect changes as the bills would cut spending on those plans to bring them more into line with standard Medicare.

It’s true that the bills would ban insurers from refusing to cover people who have pre-existing health conditions. They bills would also establish a standard list of services that all insurers must cover. However, insurers could continue to deny coverage for some experimental treatments, as they do now.

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