Obama, Romney, 'Obamacare' and the Facts

The Romney and Obama campaigns have gone into spin overdrive since the Supreme Court decision upholding the Affordable Care Act. So what holds up to the facts and what doesn’t?

Three nonpartisan fact-checking outfits—FactCheck.org, Politifact, and The Fact Checker (The Washington Post’s Glenn Kessler)—have done extensive research on various health care claims that have surfaced for the last two years. Here’s a guide to their findings on what you have heard from the presidential candidates about the ruling, and are likely to hear many times again before Election Day:

1. If you like your health insurance plan, you can keep it under the Affordable Care Act.

One of President Obama’s go-to points is that the Affordable Care Act won’t change things for Americans who like their current health insurance plan. On Thursday, in response to the Court’s decision, Obama reiterated, “If you’re one of the more than 250 million Americans who already have health insurance, you will keep your health insurance.”

That will be true for most people. But, as Factcheck.org points out, nothing in the Affordable Care Act prevents employers from switching their coverage plans just as they could do before. Also, some of the 30 million Americans who purchase their own insurance may have to change providers if their plan does not meet minimum benefit standards.

In addition, while the law requires employers to pay a penalty if they do not offer insurance, they might pay it because they prefer that their employees purchase insurance through the federally subsidized exchanges. The nonpartisan Congressional Budget Office estimates the law may result in "a small reduction" in the number of people who receive employer-provided insurance.

(RELATED: Visit our health care decision page for full coverage of the Affordable Care Act and the Supreme Court's ruling. HERE.)

2. The Affordable Care Act will add trillions to the deficit.

Numerous leading Republicans have said this over and over again, presenting the health care law as another budget-busting initiative by the Obama administration in the same vein as the stimulus or the auto-industry bailout. “ 'Obamacare' adds trillions to our deficits and to our national debt, and pushes those obligations on to coming generations,” presumptive GOP nominee Mitt Romney said in a press conference following the Supreme Court ruling.

In fact, when the health care bill was passed in March 2010, CBO found that enacting the legislation would lead to a net reduction in federal deficits of $143 billion over 10 years. Later, when congressional Republicans proposed legislation to repeal the law, CBO estimated that the GOP bill would add $230 billion to the deficit if enacted, also over a period of 10 years.

CBO did recently say, however, that the Supreme Court’s ruling might change the math. “CBO is in the process of reviewing the Supreme Court’s decision related to the Affordable Care Act to assess the effect on CBO’s projections of federal spending and revenue under current law,” the agency said in a statement. “We expect that this assessment will probably take some time.”

3. The health care law puts the federal government between you and your doctor.

One of the most passionate arguments made by conservatives against the health care law, and made again by Romney on Thursday, this too has been debunked on several occasions. The Affordable Care Act does not intervene at all between doctors and patients, although it does set up minimum benefit requirements for insurance companies, according to FactCheck.org.

Many raised the specter of government rationing of care during the health care debate, but what people are referring to—the Independent Payment Advisory Board—is forbidden from changing benefits or eligibility requirements. It was created to recommend savings in other areas to Congress, and Congress can override its suggestions. 

4. The health care law cuts $500 billion from Medicare.

The frequency with which the claim has been made prompted Columbia Journalism Review to dub it the “$500 billion bogeyman.” That didn’t stop Romney from repeating it again in his response to the Supreme Court ruling.

In fact, the law curbs future growth in Medicare over 10 years, but does not cut any benefits for participating seniors or affect the current Medicare budget at all, as Politifact New Jersey reported when Congressman Jon Runyan, R-N.J., said it again in a press release.

5. The provision of the Affordable Care Act that allows people to stay on their parents’ insurance plan until age 26 has helped 6.6 million young adults obtain coverage.

Both FactCheck.org and The Post's Fact Checker have concluded that the White House is fudging the numbers on this one. The Obama team is using findings from a survey by the nonprofit Commonwealth Fund, which estimated that 6.6 million young people were able to join their parents’ health plan as a result of the Affordable Care Act. However, not all those young adults were uninsured prior.

More accurately, the Health and Human Services Department put the figure at 3.3 million young adults who would not have health insurance without the provision. 

6. Obamacare is a job-killer, and three-quarters of U.S. businesses say they are less likely to hire people because of it.

Republicans often make these claims, as Romney did on Thursday. FactCheck.org has called the job-killer tag “health-care hooey … with little basis in fact.” CBO has projected the law could cause a slight dip in employment due to people deciding to work less or retire earlier because they won’t be dependent on health plans from their employer. The agency also said job gains in the health and insurance fields might boost overall employment.

The three-quarters figure comes from an online, opt-in survey of small-business executives by the U.S. Chamber of Commerce. That means, as FactCheck.org notes, that it was a self-selected sample that may not be representative of all small-business executives. The Chamber acknowledged as much in its press release on the survey, saying it was “not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated.”

7. Preventive care saves the government money and, under the health care law, has already helped 54 million people in private insurance plans.

Obama has often touted the fact that under the health law, all insurance plans are required to cover preventive medicine at no cost. In his remarks after the Supreme Court ruling, he went a step further, saying that the provision had already helped 54 million people.

While it’s true that crunching numbers from the Kaiser Family Foundation does yield that figure for the number of people who are receiving expanded preventive care services as a result of the health care law, there’s no saying if their plans before included some of the same or how much they’re being “helped” by the new suite of services.

Moreover, Obama has said that preventive care actually saves money by catching and managing illnesses before they become critical. Politifact, however, found evidence to the contrary. A 2009 CBO study found that preventive services lead to “higher, not lower, medical spending overall,” because while mammograms, checkups, and the like are cheap for the individual, the cost of all of them put together adds up. Because they only catch disease and illness for a small sliver of people who are tested, while they are good for people’s well-being, so far they haven’t brought costs down.