Taxpayers Mislead On Health Reform

by Elizabeth MacDonald

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The Government Accountability Office says a Medicare mailer sent out by Kathleen Sebelius, secretary of Health and Human Services, to Medicare recipients on the new health-care law isn’t accurate.

In fact, according to the GAO, the brochure, which cost $18 million in taxpayer dollars to publish and emanated from the Centers for Medicare and Medicaid Services, presented a view of the health reform law that is “not universally shared,” that it “overstated the benefits” of health reform,” and that it failed to note the possibility of less generous Medicare benefits and higher costs.

While the GAO cleared the administration of putting together a purely partisan or propagandizing brochure, it was nonetheless critical of its content.

Is this Sebelius brochure good use of nearly $20 million in taxpayer money?

Prior to press, Fox Business reached out to HHS for its response to the GAO report. After the story appeared on the FBN website, HHS emailed this statement: "The GAO report confirms what we have been saying all along. The Medicare brochure is a critical tool to inform Medicare beneficiaries and their families about how the Affordable Care Act affects them." The statement concludes by saying that the GAO report "confirms that it [the brochure] is not partisan and is not propaganda."

The irony is rich. Almost a year to the day, Humana, one of the biggest private insurers offering richer Medicare plans to the elderly, sent out a letter last September warning senior citizens that a government revamp of health insurance could eliminate their benefits.

An official with a unit of the Centers for Medicare and Medicaid Services then sent the insurer a threatening letter instructing Humana that it was now under investigation, that it must “end immediately all such mailings to beneficiaries” and that it must “remove any related materials” from its website, adding, “please be advised that we take this matter very seriously and, based upon the findings of our investigation, will pursue compliance and enforcement actions.”

That letter set off an explosive fight in Congress, with Democrats Sen. Max Baucus and House Speaker Nancy Pelosi on the one side and Senate Minority leader Mitch McConnell on the other.

Representatives David Camp (R-Mich.) and Wally Herger (R-Calif.) had asked the GAO to determine whether the HHS brochure violated publicity or propaganda prohibitions in federal law.

In the brochure, Kathleen Sebelius, secretary of Health and Human Services, says the handout provides taxpayers with “accurate” information about “new services and benefits” under health reform.

Specifically, in a section entitled "What Stays the Same," Sebelius advises taxpayers that "[t]he guaranteed Medicare benefits you currently receive will remain the same,” that reform “preserves and strengthens Medicare," makes "improvements," and creates "new benefits."

But the GAO says those statements are misleading and are overstatements.

For example, the GAO says the brochure fails to note that reform actually delivers cuts to the Medicare program, increases Medicare prescription premiums, and cuts payment to doctors.

The GAO also says the Sebelius brochure made misleading statements about health reform making “improvements” to Medicare Advantage, and that the brochure does not cite the $123 billion in estimated cuts over a ten-year period to Medicare Advantage, which provides services beyond regular Medicare offerings. Medicare Advantage is the private options that about one in five Medicare beneficiaries enroll in.

And the GAO says the brochure fails to note that “two government analyses have determined that [health reform] reductions in funding for Medicare Advantage may decrease enrollment and result in less generous benefit packages.”

The GAO also says the brochure misleadingly tells Medicare recipients that health reform "increases the number of primary care doctors, nurses, and physician assistants" enrolled in Medicare, when in fact, reform only provides incentives for those doctors to voluntarily join or stay in Medicare.

The GAO also says the brochure misleadingly refers to new programs as being available for Medicare recipients, when they are not eligible for these offerings.

A spokesman for the GAO says the report "confirms what we have been saying all along. The Medicare brochure is a critical tool to inform Medicare beneficiaries and their families about how the Affordable Care Act affects them and remind them to be on the alert for any scams asking for personal information. Today's GAO report confirms that it is not partisan and is not propaganda."

In a section called “Improvements beyond Medicare that you and your family can count on,” Sebelius’s brochure notes that under the new health reform law, children up to age 26 can stay on their parents plan. But the GAO says that section is misleading, as Medicare beneficiaries “are likely to be ineligible” for that offering, meaning, their children can’t get Medicare benefits.

And in that same section, the Sebelius brochure also cites a new long-term care insurance program that requires enrollees to work while paying premiums. But the GAO says that, again, Medicare beneficiaries “are likely to be ineligible” for that offering.

The GAO also says the brochure fails to acknowledge what the 2010 Medicare Trustees Report says, “that while the financial outlook for the Medicare program is substantially improved as a result of” reform, “the feasibility of long-range improvements is still uncertain, and significant increases in premiums for some beneficiaries may be necessary.”

The Sebelius brochure also states that reform will "ensure accountability throughout the health care system,” but the GAO report says it “does not guarantee it.”

Similarly, the brochure notes that health reform "reduces payment errors, waste, fraud, and abuse,” but again the GAO says those reductions are not guaranteed.

And the GAO says the brochure makes other “overstatements of information” on health reform, including that "[i]nsurance companies will be prohibited from denying coverage due to a pre-existing condition for children starting in September, and for adults in 2014," when in fact the new law “does not apply to all health plans,” and that “a subset of health plans-grandfathered individual health insurance plans-are exempt” from restrictions on denying coverage for pre-existing conditions.

Elizabeth MacDonald is the stocks editor for Fox Business Network. She is recognized as one of the top prize-winning business journalists in the country, and has received 14 awards, including the top prize in business journalism, the Gerald Loeb Award for Distinguished Business Journalism, and the Newswomen's Club of New York Front Page Award for Excellence in Investigative Journalism.

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