American Future Fund: “Come Clean”

American Future Fund calls on North Dakota Senate candidate Heidi Heitkamp to “come clean” about the Affordable Care Act, repeating misleading talking points about “government bureaucrats” and other alleged consequences of the law. Contrary to what the ad suggests, the Affordable Care Act slows the rise in health care costs and reduces future Medicare spending without ‘cutting’ seniors’ benefits. In fact, most of the Medicare savings in the health care law were preserved in the Republican budget plan supported by Heitkamp’s opponent.

“Government Bureaucrats” Tasked With Finding Medicare Savings Cannot Ration Care

The ad’s mention of “government bureaucrats” cites a Wall Street Journal editorial about the health care law’s establishment of the Independent Payment Advisory Board.

ACA Establishes An Independent, Senate-Confirmed Board (IPAB) To Find Additional Savings. As explained by the Kaiser Family Foundation: “The 2010 health reform law (the Patient Protection and Affordable Care Act, also referred to as the ACA) establishes a new Independent Payment Advisory Board (IPAB) with authority to issue recommendations to reduce the growth in Medicare spending, and provides for the Board’s recommendations to be considered by Congress and implemented by the Administration on a fast-track basis. […] As authorized by the health reform law, IPAB is an independent board housed in the executive branch and composed of 15 full-time members appointed by the President and confirmed by the Senate. [Kaiser Family Foundation, April 2011]

IPAB Proposals Will Be Implemented Unless Congress Finds Alternative Savings Or Supermajority Overturns Them. According to the Washington Post: “Beginning with fiscal 2015, if Medicare is projected to grow too quickly, the IPAB will make binding recommendations to reduce spending. Those recommendations will be sent to Capitol Hill at the beginning of each year, and if Congress doesn’t like them, it must pass alternative cuts — of the same size — by August. A supermajority of the Senate can also vote to amend the IPAB [spending] recommendations. If Congress fails to act, the secretary of Health and Human Services is required to implement the cuts by default.” [Washington Post, 5/8/11]

IPAB Cannot “Ration” Care. According to the Kaiser Family Foundation: “The Board is prohibited from recommending changes that would reduce payments to certain providers before 2020, and is also prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing.” [Kaiser Family Foundation, April 2011]

Rising Health Care Costs Are Due To Market Forces, And Are Slowed By ACA

USA Today: The Minimal Proportion Of Premium Increases Resulting From ACA Are Because Of Expanded Benefits. From the USA Today article cited by Crossroads: “[Director of Kaiser’s Health Care Marketplace Project Gary] Claxon estimated, based on Office of Management and Budget figures, that about 1% of the rise came from changes due to last year’s health care law, allowing children up to age 26 to remain on their parents’ insurance, and requiring preventive medical services, such as annual exams and colonoscopies, with no co-pay.” [USA Today9/27/11]

Most Of The Rise In Insurance Premiums Is Due To Increasing Health Care Costs. From “Health insurance premiums for employer-sponsored family plans jumped a startling 9 percent from 2010 to 2011, and Republicans have blamed the federal health care law. But they exaggerate. The law — the bulk of which has yet to be implemented — has caused only about a 1 percent to 3 percent increase in premiums, according to several independent experts. The rest of the 9 percent rise is due to rising health care costs, as usual.” [, 10/24/11]

Rising Health Care Costs Are Part Of A Long-Term Trend. The following chart from CNNMoney illustrates  increasing health care costs between 2002 and 2011:


[, 5/11/11]

Without ACA, Health Care Costs Would Rise Even Faster. From CNNMoney: “The individual mandate would help spread health care costs to a larger pool of individuals, thus potentially lowering costs. Should the Supreme Court strike down the Affordable Care Act, consumers can expect that percentage to increase even more as costs rise ‘very fast,’ [Mathematica Policy Research senior fellow Deborah] Chollet said. Without the law’s measures to promote preventative care and spread costs across a larger population, overall costs will rise, she explained. Those without employer-provided health care coverage … will likely pay more for their plans because there will be fewer restrictions on insurers. Individuals could be denied coverage altogether because of a pre-existing health condition or offered coverage only at a very high premium, both of which are prohibited under the Affordable Care Act, Chollet added. Those with insurance through their employer will also pay more to cover the growing number of uninsured, she said.” [, 3/29/12]

Affordable Care Act Savings Do Not ‘Cut’ Medicare Benefits

Affordable Care Act Reduces Future Medicare Spending, But “Does Not Cut That Money From The Program.” According to PolitiFact: “The legislation aims to slow projected spending on Medicare by more than $500 billion over a 10-year period, but it does not cut that money from the program. Medicare spending will increase over that time frame.”  [, 6/28/12]

GOP Plan Kept Most Of The Savings In The Affordable Care Act. According to the Washington Post’s Glenn Kessler: “First of all, under the health care bill, Medicare spending continues to go up year after year. The health care bill tries to identify ways to save money, and so the $500 billion figure comes from the difference over 10 years between anticipated Medicare spending (what is known as ‘the baseline’) and the changes the law makes to reduce spending. […] The savings actually are wrung from health-care providers, not Medicare beneficiaries. These spending reductions presumably would be a good thing, since virtually everyone agrees that Medicare spending is out of control. In the House Republican budget, lawmakers repealed the Obama health care law but retained all but $10 billion of the nearly  $500 billion in Medicare savings, suggesting the actual policies enacted to achieve these spending reductions were not that objectionable to GOP lawmakers.” [, 6/15/11, emphasis added]

  • North Dakota Republican Rick Berg Voted To Keep The Medicare Savings. Along with 234 other House Republicans, Rep. Rick Berg voted “yea” on the House Republican budget. [H.Con. Res. 34, Vote #277, 4/15/11]

[NARRATOR:] Do you support the president’s health care law? Heidi Heitkamp did. [HEITKAMP CLIP:] “We can only imagine what would happen to our health care if we took the federal government out of health care. [NARRATOR:] She thought that government bureaucrats between you and your doctor, higher premiums, and cutting $500 billion from Medicare to pay for more wasteful spending was a good idea. She’s changing her tune now, but we know the truth. Tell Heidi Heitkamp to come clean about her support for the health care law. [American Future Fund via YouTube, 6/13/12]