Now or Never PAC attacks Arizona Senate candidate Richard Carmona for supporting the “Obamacare takeover,” which the group describes as a “$716 billion cut to Medicare,” and for allegedly opposing tax cuts for small businesses. In reality, the Affordable Care Act relies on the private sector to increase insurance coverage and reduces future spending on Medicare without cutting benefits. Moreover, Carmona supports extending tax relief for the middle class while phasing out tax breaks for top income earners, which would affect few actual small businesses.
Obamacare Is Not A “Takeover”
PolitiFact: “Takeover” Charge “Does Not Hold Up Under Examination.” According to PolitiFact: “[T]he law increases regulation. But it greatly relies on the private sector to provide health care. Hospitals will not be taken over by the government, doctors will not become federal employees. The act relies on private insurers to compete and provide health care coverage to an expanded customer base. Employer-based coverage through private companies continues. The ‘government takeover of health care’ is a potent political charge that does not hold up under examination.” [PolitiFact.com, 6/16/12]
Federal Government’s Share Of U.S. Health Spending Is Projected To Grow Very Slowly Under ACA. According to Kaiser Family Foundation president Drew Altman: “Measured by the government’s share of health care spending, there is no sign of a government takeover of the health care system.” The following chart, based on analysis by the Center on Medicare and Medicaid Services, shows the projected share of U.S. health spending by the states, the federal government, and the private sector in 2010 and 2020:
Affordable Care Act Savings Do Not ‘Cut’ Medicare Benefits
PolitiFact: Affordable Care Act Does Not Cut Medicare’s Budget, It Attempts To Reduce Future Costs. According to PolitiFact, “Neither Obama nor his health care law literally cut a dollar amount from the Medicare program’s budget. Rather, the health care law instituted a number of changes to try to bring down future health care costs in the program.” [PolitiFact, 8/15/12]
Medicare Spending Reductions “Aimed At Insurance Companies And Hospitals, Not Beneficiaries.” According to PolitiFact: “What kind of spending reductions are we talking about? They were mainly aimed at insurance companies and hospitals, not beneficiaries. The law makes significant reductions to Medicare Advantage, a subset of Medicare plans run by private insurers. Medicare Advantage was started under President George W. Bush, and the idea was that competition among the private insurers would reduce costs. But in recent years the plans have actually cost more than traditional Medicare. So the health care law scales back the payments to private insurers. Hospitals, too, will be paid less if they have too many re-admissions, or if they fail to meet other new benchmarks for patient care. Obama and fellow Democrats say the intention is to protect beneficiaries’ coverage while forcing health care providers to become more efficient.” [PolitiFact, 8/15/12]
- CBO’s July Estimate Updates Medicare Cost Savings To $716 Billion. According to the Congressional Budget Office’s analysis of a bill to repeal the Affordable Care Act, repeal would have the following effects on Medicare spending: “Spending for Medicare would increase by an estimated $716 billion over that 2013–2022 period. Federal spending for Medicaid and CHIP would increase by about $25 billion from repealing the noncoverage provisions of the ACA, and direct spending for other programs would decrease by about $30 billion, CBO estimates. Within Medicare, net increases in spending for the services covered by Part A (Hospital Insurance) and Part B (Medical Insurance) would total $517 billion and $247 billion, respectively. Those increases would be partially offset by a $48 billion reduction in net spending for Part D.” [CBO.gov, 8/13/12]
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.” [WashingtonPost.com, 6/15/11, emphasis added]
- Carmona’s Opponent, Rep. Jeff Flake, Voted To Keep The ACA’s Medicare Savings. Along with 234 other House Republicans, Rep. Flake voted “yea” on the House Republican budget. [H.Con. Res. 34, Vote #277, 4/15/11]
Carmona Supports Extending Middle-Class Tax Cuts – Not Raising Taxes On Small Businesses
To support the claim that Carmona opposes “the full extension of critical tax relief for small businesses,” the ad cites The Hill on September 24, 2012.
Carmona Supports Extension Of All Tax Cuts Excluding Those For Top Income Earners. According to The Hill: “[Carmona] said, however, that if he were in the Senate right now he’d support the position held by most Democrats to extend the George W. Bush-era tax rates for the lower and middle classes, while possibly letting them expire for the highest wage-earners. ‘I personally would favor extending [the Bush-era tax cuts]. I would extend it certainly for the poor and for the middle class. I would be willing to enter into discussion to say, people making over $250 or $300 or $500 [thousand] could pay, and you know, I’m a high wage-earner, and if I had to do that to help out for the next year, OK, I’ll do that, but we have to stop putting Band-Aids on a broken system,’ he said, adding that long-term tax reform was necessary to fix the system for good.” [The Hill, 9/24/12]
Those In The Top Bracket Still Benefit From Middle-Income Tax Cuts. According to the Center on Budget and Policy Priorities:
Furthermore, as Figure 2 shows, under the proposal to allow tax cuts on income above $250,000 ($200,000 for single filers) to expire, taxpayers in the top two brackets would still keep sizeable tax cuts on the first $250,000 of their income ($200,000 for single filers).
[Center on Budget and Policy Priorities, 7/19/12]
Few Top Income Taxpayers Are Actual “Small Businesses”
CBPP: “Only 2.5 Percent Of Small Business Owners Face The Top Two Rates.” According to the Center on Budget and Policy Priorities: “Allowing the top two marginal tax rates to return to pre-2001 levels as scheduled next year would affect very few small businesses, a recent Treasury Department study found. The study shows that only 2.5 percent of small business owners face the top two rates.” [Center on Budget and Policy Priorities, 7/19/12, internal citations removed]
- Conservatives Rely On Definition Of “Small Business” That Counts President Obama And Mitt Romney. According to the Center on Budget and Policy Priorities: “The claims that allowing the Bush tax cuts for high-income people to expire would seriously harm small businesses rest on an exceedingly broad, and misleading, definition of ‘small business.’ The definition is so broad, in fact, that under it, both President Obama and Governor Romney would count as small business owners — as would 237 of the nation’s 400 wealthiest people.” [Center on Budget and Policy Priorities, 7/19/12, internal citations removed]
- Conservative Definition Of “Small Businesses” Includes Multi-Billion-Dollar Corporations Like Bechtel And PricewaterhouseCoopers. According to the Center for American Progress: “‘That’s 750,000 small businesses in America, the most productive, the ones that are the most successful, getting hit by a tax increase on top of everything else that’s happened to them in the last 18 months of this administration,’ said Senate Minority Leader Mitch McConnell (R-KY). But McConnell’s number is only accurate if you take an incredibly expansive view of what constitutes a small business. Included in that 750,000 is the Bechtel Corporation, the largest engineering firm in the country. It is the fifth-largest privately owned company in the United States, posting gross revenue in 2008 of $31.4 billion. […] The auditing firm PricewaterhouseCoopers, which has operations in more than 150 countries, fits the bill as well.” [Center for American Progress, 10/21/10, emphasis added]
- Former Bush Economist Alan Viard: GOP’s Definition Of Small Businesses Is A “Fallacy.” As reported by the Washington Post: “Which is why Republicans continually define pass-through entities of all sizes as small businesses, a position [former Bush White House economist Alan] Viard called a ‘fallacy.’ ‘How can it be that 3 percent of owners are accounting for 50 percent of small business income? Those firms they’re owning can’t be all that small,’ Viard said. ‘And that’s true. They’re very large.’” [Washington Post, 9/17/10]
Joint Committee On Taxation: “3.5 Percent Of All Taxpayers With Net Positive Business Income” Fall Into Top Tax Bracket. According to the Joint Committee on Taxation: The staff of the Joint Committee on Taxation estimates that in 2013 approximately 940,000 taxpayers with net positive business income (3.5 percent of all taxpayers with net positive business income) will have marginal rates of 36 or 39.6 percent under the president’s proposal, and that 53 percent of the approximately $1.3 trillion of aggregate net positive business income will be reported on returns that have a marginal rate of 36 or 39.6 percent. [Joint Committee On Taxation, 6/18/12]
[NARRATOR:] Richard Carmona wants to be let in to the Senate. The handpicked choice of Obama, Carmona wants to knock down the door for his failed agenda. Supporting the Obamacare takeover, backing a $716 billion cut to Medicare, and opposing the full extension of critical tax relief for small business, he’s a threat to us. Richard Carmona: Don’t let him in. Now or Never PAC is responsible for the content of this advertising. [Now or Never PAC, 10/27/12]