Please see below for a fact check on Senators Coburn’s and Kyl’s false claims on the Senate floor today on the Patient Protection and Affordable Care Act:

RHETORIC: Sen. Coburn Claimed That Senate Bill Does Nothing To Incentivize Care Coordination, Reduce Avoidable Care And Complications. “And yet, we don’t address it not one iota in the bill that we have on the floor. Available care — avoidable care. Those are complications. Those are things that we cause. They are induced complications. We’re not going to be able to do much of that. We could fix this — lack of care coordination with accountable care organizations — by incentivizing outcomes, by grouping in payment for how we pay.” [Senate Floor, 12/5/09]
Senate Bill Includes “Value-Based Purchasing Programs,” Programs To Measure And Improve Care Quality, Payment Bundling Reforms, A “Host Of Payment Extensions And Improvements.” Health Affairs blog wrote: “The Medicare title of the bill begins with a number of pay-for-performance and quality initiatives that have no exact equivalent in the House bill.  These include value-based purchasing programs for hospitals and physicians and payment penalties for hospital-acquired conditions.  The bill also requires HHS to establish and update annually a national strategy for health care quality measurement and improvement.  The Senate bill establishes accountable care organization and hospital readmission reduction programs, a national pilot program for payment bundling, and a demonstration program for chronically-ill beneficiaries to receive home-based primary care.  The bill also includes a host of payment extensions and improvements, including several for rural areas.” [Health Affairs Blog, 11/21/09]
RHETORIC: Sen. Coburn Bragged That CBO Estimated Patient’s Choice Act Would Reduce Deficit By $70 Billion, Reduce Spending On Care. “First, let me tell you what the CBO says about it. It said that it will reduce future deficits, the first 10 years, $70 billion. But what it will do for the states is $1 trillion in savings the first 10 years. It will lead to lower budget deficits. That’s what the CBO said. It said it also would reduce spending on health care  because it will be more efficient spending.” [Senate Floor, 12/5/09]
WSJ: CBO’s Estimate Of Senate Bill Is $848 Billion, Cuts Deficit By $130 Billion. The Wall Street Journal reported that, “Senate Majority Leader Harry Reid set the stage for a climactic debate in the Senate over health care by unveiling a 10-year, $848 billion bill that would extend insurance to 31 million Americans without coverage…In a boost for the bill’s prospects, the CBO estimated the Senate measure would reduce the federal budget deficit by $130 billion over the next decade, and additional amounts over the second 10 years of the program. It achieves that in part through a new Medicare payroll tax and a tax on high-value insurance plans, which has aroused strong opposition…To help ease the financial burden on workers, Mr. Reid lowered the maximum amount the bill would require them to spend on premiums, capping premiums at 9.8% of income, down from 12%.” [Wall Street Journal, 11/19/09]
· Roll Call On CBO Score: Senate Bill “Slash[es] The Deficit By A Whopping $777 Billion Over The Next 20 Years,” Sen. Kent Conrad Said Sen. Reid Did “An Exceptionally Good Job.” Roll Call reported that, “[a]t first blush, Reid scored a coup with his $849 billion bill, because Democrats said the Congressional Budget Office estimated that it would slash the deficit by a whopping $777 billion over the next 20 years while providing insurance for an additional 31 million Americans. The price tag is also less than the $900 billion President Barack Obama had called for and the $1.2 trillion cost of the House-passed version… ‘He was applauded. His staff was applauded,’ said Senate Budget Chairman Kent Conrad (D-N.D.), a deficit hawk who said Reid did ‘an exceptionally good job.’” [Roll Call, 11/18/09]
RHETORIC: Sens. Coburn And Burr Praised Their Patient’s Choice Act
Sen. Coburn Said PCA Is “The iPhone” Of Reform Bills. “A comparison of the Patients’ Choice Act to the act that we have here [in the current Senate bill] is like comparing old Ma Bell to an iPhone. In the patient — and the Patient’s Choice Act is the iPhone.” [Senate Floor, 12/5/09]
Sen. Burr Complained Their Sterling Alternative Was “The First,” But Was “Ignored.” “I’ve sat on this floor, as Tom Coburn has, and we’ve had a sharp exchanges about what’s in this bill and what hurts. I’ve listened to folks on the other side of the aisle say when are Republicans going to offer something instructive? When are they going to offer a pathway. We have. We were the first. We were ignored.” [Senate Floor, 12/5/09]
Brookings Expert: PCA Idea “Of Turning Medicaid Patients Over To The Private Market Is Wacky.” Henry Aaron, the Brookings Institution’s “famed health care expert,” responded to various elements of the Patient’s Choice Act. He wrote, “[t]he idea of turning Medicaid patients over to the private market is wacky. Medicaid managed care can be a good idea. Medicaid recipients include lots of people who are poorly educated, mentally handicapped, and have other problems. That is not where one wants the private market to control.” [Washington Post – Ezra Klein, 5/21/09]
CBPP: Patients’ Choice Act Would Dismantle Employer-Sponsored Insurance But Does Not Address “Significant Shortcomings” Of The Individual Insurance Market, Leaving Patients In The Lurch. The Center for Budget and Policy Priorities evaluated the Patients’ Choice Act, and wrote: “[e]ven employers who wished to continue offering coverage might be unable to do so. As explained below, the new tax credit would encourage younger, healthier employees to opt out of employer-based plans, leaving older and sicker workers in the employer insurance pools and thereby driving up the cost per beneficiary of employer coverage. Many employers might ultimately conclude they could not afford to continue offering subsidized coverage. Of particular concern, many of the people who would lose employer-based coverage would likely be unable to find affordable, comprehensive coverage on their own. The bill fails to address the significant shortcomings of the existing individual health insurance market that make it difficult for individuals who are older or have various medical conditions to obtain coverage.” [CBPP, 7/30/09]
CBPP: Patients’ Choice Act “Is Not Likely To Do Much To Reduce The Ranks Of The Uninsured And Would Make Matters Worse For Many People Who Currently Have Coverage.” The Center for Budget and Policy Priorities evaluated the Patients’ Choice Act, and wrote: “Overall, the proposal is not likely to do much to reduce the ranks of the uninsured and would make matters worse for many people who currently have coverage.” [CBPP, 7/30/09]
MIT Health Economist: “I’m Sort Of A Known Skeptic On This Stuff… [But The Senate Bill] Really Make[s] The Best Effort Anyone Has Ever Made [To Bend The Cost Curve]…I Can’t Think Of Anything I’d Do That They Are Not Doing In The Bill. You Couldn’t Have Done Better.” In an interview with The Atlantic, Jonathan Gruber, noted health economist and professor of economics at MIT, said: “‘I’m sort of a known skeptic on this stuff,’ Gruber told me. ‘My summary is it’s really hard to figure out how to bend the cost curve, but I can’t think of a thing to try that they didn’t try. They really make the best effort anyone has ever made. Everything is in here….I can’t think of anything I’d do that they are not doing in the bill. You couldn’t have done better than they are doing.’” [The Atlantic, 11/21/09]
Sen. Snowe: President Obama Is Not A “Big Government Liberal,” “In Fact, I Almost Sense The Opposite. He’s Been Very Realistic In His Views On Health Care…More Moderate Than Liberal On This Question.” On CNBC, John Harwood played a taped interview he had done with Sen. Olympia Snowe, where he had the following exchange: “MR. HARWOOD: Larry, Senator Olympia Snowe, the senior Republican from Maine, may be the most important member of the U.S. Senate on health care. She’s not yet saying how she’s going to vote, but everybody’s looking for signals and body language as to whether she wants to work with Barack Obama and the Democrats to get this done. If you want to see a reason for the White House to be optimistic, consider this signal she sent when I asked her whether she considers President Obama a big government liberal. SEN. SNOWE: No. You know, it’s interesting, I don’t. In fact, I almost sense the opposite. He’s been very realistic in his views on health care, understanding the implications. MR. HARWOOD: Do you see him as a moderate? SEN. SNOWE: More moderate than liberal on this question.” [CNBC, 9/17/09]
Health Reform Historian: “There Was A Time When Many Of The Changes Included In The House And Senate Health Bills Would Have Been Considered Republican Or At Least Bipartisan Ideas…The Current Approach Is Closer To What President Nixon Proposed.” The Philadelphia Inquirer reported that, “[i]n the past, most opposition to changing health care came from health-care interest groups: doctors, insurance companies, drug companies. This time, it’s different. There has been considerable grumbling from the medical establishment, but the approach Democrats are taking ‘doesn’t really threaten any of those groups,’ said Paul Starr, a PrincetonUniversity professor who won a Pulitzer Prize for his book on the history of health care: The Social Transformation of American Medicine. He later was involved in the creation of the Clinton health plan… There was a time when many of the changes included in the House and Senate health bills would have been considered Republican or at least bipartisan ideas, Starr said. In the days of Harry S. Truman, he said, Democrats favored a single-payer system. The current approach is closer to what President Nixon proposed before Watergate sidelined his plans. He called for universal coverage through a combination of government and employer-based insurance.” [Philadelphia Inquirer, 11/19/09]
“Not Much Attention Has Been Paid To The Fact That Three Comprehensive Health Care Bills Introduced By Republicans…Have A Few Key Elements In Common Will All The Democratic Bills.” Kaiser Health News reported on how Republicans continued to denounce Democratic health reform plans, despite the fact that a bipartisan mix of ideas were included in Sen. Baucus’ proposed bill: “[n]ot much attention has been paid to the fact that three comprehensive health care bills introduced by Republicans in the Senate and House have a few key elements in common with all the Democratic bills: they create health insurance exchanges to help the uninsured and small businesses find affordable coverage, provide subsidies to people who need them to buy policies and impose new regulations on insurers.” [Kaiser Health News, 9/16/09]
The Patients’ Choice Act Called For $158 Billion In Cuts To Medicare Advantage. “This Act implements a fair reimbursement mechanism for private plans providing health benefits to seniors. Rather than the current bureaucratic formula, which many contend wastes taxpayer dollars and lines the pockets of insurance executives, the Act would force plans to compete against each other. Competitive bidding would allow the market to set reimbursement rates to plans. The Congressional Budget Office has estimated this may save taxpayers as much at $158 billion, if implemented correctly.” [Patients Choice Act, Sen. Coburn’s wesbite]
Kaiser Health News: Republicans Criticize Democrats For Panels Overseeing Health Care, But Patient’s Choice Act Does The Same Thing. Kaiser Health News reported that, “Republicans have criticized Democrats for proposing numerous panels to oversee health care, but one leading Republican health care bill would create its own commission and office to help set medical quality guidelines. And that has raised eyebrows among some conservatives….But it also would create a five-member Health Care Services Commission and an Office of the Forum for Quality and Effectiveness in Health Care, which would include 15 people nominated by health care organizations and appointed by the commission. The commissioners would be appointed by the president and confirmed by the Senate. The commission’s goals would include conducting and supporting research into the effectiveness, quality, outcomes and costs of medical services, as well as recommending guidelines and standards and making public its findings.” [Kaiser Health News, 9/16/09]