The following article by Calvin Woodward and Jim Drinkard of the Associated Press was posted on the Boston Globe website March 18, 2017:
White House Press Secretary Sean Spicer got the facts wrong on deductibles under the Affordable Care Act.
President Donald Trump’s first spending plan for the government and a report by the Congressional Budget Office on Republican health care kicked up quite a fuss in Washington over the past week. Bold claims flew on those developments and more. Many don’t hold up to scrutiny:
Budget and Economy
TRUMP: ‘‘Already, because of this new business climate, we are creating jobs that are starting to pour back into our country like we haven’t seen in many, many decades. In the first two job reports since I took the oath of office, we’ve already added nearly half a million new jobs. And believe me, it’s just beginning.’’ — Tennessee rally, Wednesday.
THE FACTS: The president has yet to implement policies that would influence hiring on a national scale, despite his aggressive rhetoric on job creation. Nor has his presidency hurt job growth, judging by declines in unemployment in Barack Obama’s last month in office and Trump’s first. Trump takes undue credit for hiring that has yet to occur and for the return of jobs from overseas that have yet to come back. He’s boasted about hiring plans by General Motors, Ford and other companies that were in the works before he took office.
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MICK MULVANEY, Trump’s budget director: ‘‘Let’s talk about after-school programs generally. They’re supposed to be educational programs, right? And that’s what they’re supposed to do, they’re supposed to help kids who can’t — who don’t get fed at home, get fed so that they do better at school. Guess what? There’s no demonstrable evidence they’re actually doing that. There’s no demonstrable evidence they’re actually helping results, helping kids do better at school.’’ — Thursday.
THE FACTS: There is such evidence and it comes from the government as well as multiple scientific studies.
Says the Centers for Disease Control and Prevention , for example: ‘‘Student participation in the United States Department of Agriculture (USDA) School Breakfast Program (SBP) is associated with increased academic grades and standardized test scores, reduced absenteeism, and improved cognitive performance (e.g., memory).’’
Another example: A Harvard study found that after-school programs in general lead to better grades, social development, health and wellness.
Mulvaney appeared to be referring to 21st Century Community Learning Centers, a $1.2 billion program that the Trump administration tabbed in its budget proposal for elimination. The program provides after-school meals along with sports, clubs and enrichment activities. Its primary goal is to provide child care for the parents of 1.6 million kids, allowing them to maintain their jobs and incomes.
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TRUMP: Speaking of the request in his new budget for a $54 billion increase for the Pentagon, ‘‘Our budget calls for one of the single largest increases in defense spending history in this country.’’
THE FACTS: Trump’s proposed increase, 10 percent higher than the Defense Department’s current budget, is large, but a long way from the highest boost ever. In just the past 40 years, there have been eight years with larger increases in percentage terms than the one he’s now proposing.
In the early 1980s, for example, defense spending was increased dramatically as the Cold War with the Soviet Union intensified. The 1981 Pentagon budget saw a nearly 25 percent increase.
And the proposed expansion pales in comparison with earlier times. Military spending consumed 43 percent of the economy in 1944, during World War II, and 15 percent in 1952, during the Korean War. It was 3.3 percent in 2015, says the World Bank.
NATO
TRUMP: ‘‘Many (NATO) nations owe vast sums of money from past years and it is very unfair to the United States. These nations must pay what they owe.’’ — Friday.
THE FACTS: Other NATO countries do not have a past debt owing to the alliance or to the U.S.
The issue is that most of the 28 NATO member countries have not been living up to a commitment to spend 2 percent of their gross domestic product on defense. The Trump administration is leaning on them to start meeting that commitment. But the U.S. is not trying to wring money from past years out of them.
Health care
TRUMP: Claiming blanket conversion of Republican House members Friday for the GOP health care bill, ‘‘We just had a meeting with probably 12 congressmen, and it was an amazing meeting because they were all noes … all noes or pretty much no … but after 15 minutes, they went from no to all yeses.’’ Going into the meeting, there were ‘‘no yesses.’’
THE FACTS: Trump is overstating his powers of persuasion. There were actually 13 lawmakers present, according to a White House attendance sheet, and at least five of them were already on board before they went into the meeting.
Two of those present, Reps. Steve Scalise and Patrick McHenry, are members of the House GOP leadership who are in charge of rounding up votes for the GOP replacement for Obamacare. Two others, Reps. Marsha Blackburn of Tennessee and Bruce Westerman of Arkansas, had voted for the bill in their committees. And another, Rep. Andy Barr of Kentucky, spoke favorably about the bill in a March 9 speech, calling it a ‘‘crucial and necessary first step.’’
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TRUMP, on Obama’s health care law: ‘‘It’s a disaster. Obamacare is dead.’’ ‘’It’s just about on its last legs.’’ Insurers are leaving the program and ‘‘many states are down to one.’’ — Friday.
THE FACTS: Obamacare has problems, but they’re not as dire as Trump describes.
The problems include premium increases and decisions by some insurers to leave the marketplace created by the law for people who buy their own policies. Five states — Alaska, Alabama, Oklahoma, South Carolina and Wyoming — have just one participating insurer across their entire jurisdictions. At the county level, more than 1,000 counties in 26 states are down to one insurer — about one-third of U.S. counties.
Premium increases are offset by subsidies for about 8 in 10 customers who buy individual health insurance policies through government-sponsored markets like HealthCare.gov. But millions who purchase their policies outside the marketplaces get no financial assistance.
A report from the Congressional Budget Office, though, says the market for individual policies in most places is ‘‘stable.’’ The report said the market also would probably remain stable under the proposed GOP replacement legislation.
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SEAN SPICER, White House press secretary: ‘‘Having a card and having coverage that when you walk into a doctor’s office has a deductible of $15,000, $20,000 a year isn’t coverage. That’s a car. That doesn’t get you the care you need.’’ — Tuesday.
THE FACTS: He’s wrong about deductibles under Obama’s law.
Out-of-pocket expenses for consumers are limited. Deductibles, copayments and coinsurance together can’t exceed $7,150 this year for an individual plan sold through HealthCare.gov or similar state markets. For a family plan, it’s $14,300. After that, the insurance plan pays the full cost of covered benefits.
In addition, more than half of customers in these plans get subsidies to help with their out-of-pocket costs.
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SEN. CHUCK SCHUMER, Senate Democratic leader, on the CBO report that estimates 24 million more people will be without health insurance in a decade under the Republican legislation to replace Obamacare: ‘‘CBO is virtually unassailable. Everyone, Democrats and Republicans … has gone along with CBO. … They’ve been speaking the truth for decades and to try to attack CBO is simply attacking the messenger.’’ — Monday.
REP. NANCY PELOSI, House Democratic leader, on Republican reaction to the CBO: ‘‘Some of them are trying to pin a rose on this report and make it sound like it’s a good thing and the others of them are trying to discredit the CBO, but it’s completely wrong, completely wrong. … Numbers are quite elegant things, you know.’’ — Monday.
THE FACTS: Democrats have not hesitated to attack this messenger when its conclusions have not suited them.
‘‘The Congressional Budget Office never gives us any credit,’’ President Obama said in 2009 when the CBO pointed to the expense of Democratic health overhaul proposals. Complained Pelosi at the time: ‘‘The CBO will always give you the worst-case scenario.’’
Again in 2014, Pelosi did not consider CBO’s numbers ‘‘elegant,’’ or correct, when they forecast job losses from a Democratic effort to raise the minimum wage. She accused the CBO of making arguments that ‘‘contradict the consensus among hundreds of America’s top economists.’’
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MULVANEY: ‘‘If you have coverage that doesn’t allow you to go to the doctor, what good is it in the first place? … Democrats took all of this credit for giving people coverage, but ignored the fact that they had created this large group of people that still could not go to the doctor.’’ — Monday.
THE FACTS: Republicans gloss over reality when they make this argument. While deductibles are high for the Affordable Care Act’s private insurance plans (averaging $3,000 last year for a standard silver plan), the law requires preventive care to be covered at no charge. And more than half of the people enrolled in the health law’s insurance markets get an extra subsidy when they go to seek care. It can reduce a deductible from several thousand dollars to a few hundred. The GOP bill would repeal those subsidies.
Other evidence points to tangible benefits from Obama’s coverage expansion. For example, government researchers have found fewer Americans struggling to pay medical bills. A 2015 report found that problems with medical bills had declined for the fourth year in a row. Most of the improvement was among low-income people and those with government coverage, and it coincided with the ACA’s big coverage expansion.
Immigration
TRUMP: ‘‘And by the way, aren’t our borders getting extremely strong? … We’ve already experienced an unprecedented 40 percent reduction in illegal immigration on our southern border, 61 percent — 61 percent since Inauguration Day. Sixty-one percent; think about it. And now people are saying we’re not going to go there anymore ‘cause we can’t get in, so it’s going to get better and better.’’ — Rally Wednesday.
THE FACTS: There’s not much evidence yet that Trump is driving down illegal immigration. It’s true that the number of border arrests dropped about 44 percent from January to February. But it’s too early to know if that will hold or what prompted it. Monthly and seasonal fluctuations are common.
Trump hasn’t expanded the ranks of the Border Patrol or any other immigration or border-security agency. His orders haven’t yet changed the way the Border Patrol operates and so far there is no evidence that more people are being deported. The wall he’s promised to build isn’t up.
The number of border arrests is the primary measure of the flow of illegal immigration at the border, though an imperfect one. If fewer people are arrested, that’s taken to mean fewer people are trying. Over recent decades, presidents have tried to have it both ways. They cite low arrest numbers to illustrate how their policies are dissuading people from crossing illegally. When arrest numbers are high, they say that’s because they’re being aggressive in enforcing the border.
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