Concerned Women For America: “Care”

In an ad from the conservative Concerned Women for America, Dr. Ami Siems delivers a monologue riddled with misleading statements about the Affordable Care Act. No matter how many times conservatives say it, the law does not increase the deficit – it reduces it. And those “Washington bureaucrats” cannot deny or ration care. Perhaps the biggest problem with the ad is that it uses a seemingly neutral figure to argue that the law “just isn’t fixing things,” but this is not Dr. Siems’ first go-round as a conservative mascot. She appeared in 2009 anti-reform ad paid for by Americans for Prosperity in which she advanced several falsehoods.

Affordable Care Act Reduces The Deficit

CBO: The Affordable Care Act Will Reduce Deficits By Over $200 Billion From 2012-2021. According to Congressional Budget Office Director Douglas Elmendorf’s testimony before the House on March 30, 2011: “CBO and JCT’s most recent comprehensive estimate of the budgetary impact of PPACA and the Reconciliation Act was in relation to an estimate prepared for H.R. 2, the Repealing the Job-Killing Health Care Law Act, as passed by the House of Representatives on January 19, 2011. H.R. 2 would repeal the health care provisions of those laws. CBO and JCT estimated that repealing PPACA and the health-related provisions of the Reconciliation Act would produce a net increase in federal deficits of $210 billion over the 2012–2021 period as a result of changes in direct spending and revenues. Reversing the sign of the estimate released in February provides an approximate estimate of the impact over that period of enacting those provisions. Therefore, CBO and JCT effectively estimated in February that PPACA and the health-related provisions of the Reconciliation Act will produce a net decrease in federal deficits of $210 billion over the 2012–2021 period as a result of changes in direct spending and revenues.” [“CBO’s Analysis of the Major Health Care Legislation Enacted in March 2010,”, 3/30/11]

  • July 2012 Report Affirmed Projection That ACA Will Reduce Deficits. According to a Congressional Budget Office Report titled “Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision”: “CBO and JCT have not updated their estimate of the overall budgetary impact of the ACA; previously, they estimated that the law would, on net, reduce budget deficits.” [, July 2012]

Those “Washington Bureaucrats” Cannot Deny Or Ration Care

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]

Dr. Siems Has History Of Presenting Health Care Misinformation In Conservative TV Ads

In 2009 Americans For Prosperity Ad, Dr. Siems Warned Of ‘Government Takeover,’ Rationing, Medicare Cuts. From “Meanwhile, the conservative advocacy group Americans for Prosperity is running its own ad featuring Dr. Ami Siems, a family practitioner. The group is spending $1.7 million to run the ad through next Wednesday on national cable, Chris Cillizza reports. ‘If the government starts to take over health care, your choices could be reduced health care could be rationed, quality would suffer,’ Siems warns.”  From “ One of the ads is an anti-reform spot; it was produced by the conservative group Americans for Prosperity, and features a doctor named Ami Siems warning viewers about government’s handling of Medicare. In doing so, it goes too far — at one point, Siems says, “Medicare will be bankrupt in eight years.” That’s not strictly true; it’s one of Medicare’s trust funds that would run out of money, not the whole system. And there have been predictions of that fund going bankrupt since the 1980′s. AFP will reportedly be spending $1.7 million to air the spot.” [, 10/6/09, emphasis added;, 10/6/09, emphasis added] Took Issue With Siems’ 2009 Claim That Proposed Health Care Reforms Would Result In System That’s “Already Failed” In Britain, Canada. From

We’ve examined ads from Patients First and its parent group, Americans for Prosperity, before, and they’ve put forth the same straw man argument: that Congress wants a Canadian- or British-style health care system. As we’ve pointed out in several articles, that’s not what the legislation in Congress would set up. As evidence, the back-up for this ad includes a column in the Tucson Citizen that repeats falsehoods we’ve already debunked about the stimulus bill, which was passed in February.

The group’s support also includes several articles about patients in Canada waiting for specialist appointments, MRIs and even surgeries. It’s Dr. Siems’ opinion that this amounts to a “system that has already failed.” Others would disagree, such as a Canadian scientist quoted in a 2007 article that’s among the group’s back-up: “‘Canada is not a medical utopia, as some would have you believe, or a disaster, as others claim,’ said Jack Tu, a senior scientist at the Toronto-based Institute for Clinical Evaluative Sciences and co-author of a recent study on waiting times. ‘Most people get care in a reasonable amount of time. What you hear about are the horror stories.’ “

But a debate on whether or not the system has “failed” north of our border is irrelevant. The health care legislation in Congress doesn’t amount to “forcing Americans” into such a system, anyway. [, 10/7/09]

Here Are Some Things The Affordable Care Act Is Fixing…

Up To 30 Million Are Expected To Gain Coverage Gained As A Result Of The Affordable Care Act. From the Congressional Budget Office: “CBO and JCT now estimate that the ACA, in comparison with prior law before the enactment of the ACA, will reduce the number of nonelderly people without health insurance coverage by 14 million in 2014 and by 29 million or 30 million in the latter part of the coming decade, leaving 30 million nonelderly residents uninsured by the end of the period.” [, July 2012]

Closing The Donut Hole

“Donut Hole” Is Gap In Drug Coverage For Annual Costs From $2,830-6,440. From CNNMoney: “What’s the donut hole? In addition to a $310 deductible, Medicare beneficiaries pay 25% of their drug costs until the total reaches $2,830 for the year. Then, they fall into a coverage gap. At that point, enrollees must pay all costs out of pocket until their annual expenses exceed $6,440. After that, seniors pay 5% of drug costs for the rest of the year. [CNNMoney, 6/7/10]

Affordable Care Act Eliminates Coverage Gap By 2020. The Kaiser Family Foundation explains how the Affordable Care Act closes the “donut hole”:

• In 2010, Part D enrollees with spending in the coverage gap will receive a $250 rebate.

• Beginning in 2011, Part D enrollees who reach the coverage gap will receive a 50 percent discount on the total cost of their brand-name drugs in the gap, as agreed to by pharmaceutical manufacturers.

• Over time, Medicare will gradually phase in additional subsidies in the coverage gap for brand-name drugs (beginning in 2013) and generic drugs (beginning in 2011), reducing the beneficiary coinsurance rate in the gap from 100 percent to 25 percent by 2020. [, March 2010]

The Donut Hole Got “Noticeably Smaller” In 2011, Benefitting Over 2 Million Seniors. As the Associated Press reported: “Medicare’s prescription coverage gap is getting noticeably smaller and easier to manage this year for millions of older and disabled people with high drug costs. […] The average beneficiary who falls into the coverage gap would have spent $1,504 this year on prescriptions. But thanks to discounts and other provisions in President Barack Obama’s health care overhaul law, that cost fell to $901, according to Medicare’s Office of the Actuary, which handles economic estimates. […] More than 2 million beneficiaries already have gotten some help, discounts that have gone largely to middle-class seniors, because the poor are covered in the gap at taxpayer expense.” [Associated Press, 11/27/11]

Expanding Preventive Care

Medicare Beneficiaries Receive Free Preventive Services, Annual Wellness Visits Under Health Care Law. As Kaiser Health Newsreported: “[T]he new health-care law will make it easier and cheaper for seniors to get preventive care. Medicare beneficiaries will be able to receive for free all preventive services and screenings that receive an A or B recommendation for seniors from the U.S. Preventive Services Task Force. That includes mammograms and colorectal cancer screening, bone mass measurement and nutritional counseling for people at risk for diet-related chronic diseases such as diabetes. Medicare beneficiaries will also get a free annual wellness visit under the new law. The visit will cover a number of services, including a health risk assessment and a review of the person’s functional and cognitive abilities. […] Currently, seniors in traditional Medicare pay 20 percent of the cost for most covered preventive services. [, 8/10/10]

  • More Than 25 Million Seniors Have Received Free Preventive Services. The Centers for Medicare and Medicaid Services reports: “According to preliminary numbers, at least 25,720,996 million Americans took advantage of at least one free preventive benefit in Medicare in 2011, including the new Annual Wellness Visit.  This represents 73.3% of Medicare fee-for-service beneficiaries.” [, 2/15/12]

…And Repeal Would Have Negative Consequences For Millions

Up To 6.6 Million Young Adults Would Lose Health Care Coverage Through Their Parents’ Plans. From the Los Angeles Times: “President Obama’s healthcare law helped as many as 6.6 million young adults stay on or get on their parents’ health plans in the first year and a half after the law was signed, a new survey indicates. […] Earlier surveys by the federal government found that the number of people ages 19 to 25 without insurance declined after the law was signed, reversing years of erosion in health coverage for young adults.” [Los Angeles Times6/8/12]

70,000 Americans With Pre-Existing Conditions Would Lose Insurance Coverage. According to the Department of Health and Human Services, as of May 31, 2012, 73,333 people were enrolled in the Pre-Existing Condition Insurance Plan (PCIP) created by the Affordable Care Act. [, 7/13/12]

5.2 Million People Would Have To Pay More For Prescription Drugs. From the Centers for Medicare and Medicaid: “As a result of the Affordable Care Act, over 5.2 million seniors and people with disabilities have saved over $3.9 billion on prescription drugs since the law was enacted.  The Centers for Medicare & Medicaid Services (CMS) also released data today showing that in the first half of 2012, over 1 million people with Medicare saved a total of $687 million on prescription drugs in ‘donut hole’ coverage gap for an average of $629 in savings this year. […] Coverage for both brand name and generic drugs in the gap will continue to increase over time until 2020, when the coverage gap will be closed.” [, 7/25/12]

Over 35 Million Seniors Would Lose Access To Free Preventive Services. The Centers for Medicare and Medicaid Services [CMS] report that 35,106,598 people were enrolled in Medicare Part B in 2011. CMS also reports:

Beginning January 1, 2011, the Affordable Care Act eliminated Part B coinsurance and deductibles for recommended preventive services, including many cancer screenings and key immunizations. The law also added an important new service — an Annual Wellness Visit with a health professional — at no cost to beneficiaries.

According to preliminary numbers, at least 25,720,996 million Americans took advantage of at least one free preventive benefit in Medicare in 2011, including the new Annual Wellness Visit.  This represents 73.3% of Medicare fee-for-service beneficiaries, including 2,404,792 African-American beneficiaries, 537,110 Hispanic beneficiaries, 104,393 American Indian beneficiaries, and 508,398 Asian-American beneficiaries. [, 2/15/12]

[DR. AMI SIEMS:] As a doctor, I do everything I can to make sure my patients get the very best care. But look at our health care system. Everyone agreed we needed reforms, but this new health care law? It just isn’t fixing things. President Obama promised my patients that they could keep me, but what if because of this new health care law, I can’t keep them? I’ve looked at this law. I know the consequences. Delayed care, and worse yet, denied care. Studies show the president’s health care law is projected to add hundreds of billions of dollars to our deficit and increase spending by more than a trillion dollars. And the truth is we still don’t know how much this law will eventually cost. I don’t want anything to come between my patients and me, especially Washington bureaucrats. We need real reform that improves care, and the president’s health care law just isn’t it. It just isn’t worth it. This is where health care decisions should be made, not in Washington. [Concerned Women for America via, 6/19/12]