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The Truth About Health Care Reform; Details of Hurricane Bill
Aired August 22, 2009 - 16:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JOSH LEVS, CNN CORRESPONDENT: It's a great way to start this hour. Because it shows you the things we're hearing. You hear 46 million and then you hear it's really only eight million. Now I'd love to give you a really solid answer. Unfortunately, the reality here is that there is no one who knows. So anytime you hear a number like that used, you got to pour a bunch of salt on it in your mind.
What I do want to do is help you all understand where these numbers are coming from because this is at the crux of this debate in this country. Let's go straight to the screen. I want everyone to see this. Take a look here.
This is what we get from the census. I spoke with the census directly. There is a report that says 45.7 million people inside this country were uninsured for all of 2007. That's where that comes from, but that same report, most people don't realize, Drew, on this next screen, the same report specifically says it's probably not that high. They say that health insurance is actually likely to be underreported.
I called them, they said you know what, yes, it's probably not as high as 46 million. Then you have a conservative group that opposes President Obama's stance and his plan he's putting out there. And you can see right there where they get this. They said wait a second, what about the people in this country who can afford it if they wanted to, who could get on Medicare maybe or Medicaid or one of those other program, various other factors.
Let's show what they came up with, they get all the way down to eight million there. Can we show that from the Pacific Research Institute? There you go. They looked at that Drew. They are winding down to 2003 study that said it goes way down to eight million who are actually chronically uninsured. But there are other groups out there who say no, you know what? We're actually thinking it's a lot higher.
So we had to land on this verdict for the single most complex, I believe, truth squad of all, the verdict being in dispute. If you take away one thing right here is this - people talk about lots of millions, we honest do not have a definitive answer about how many millions are truly insured, unless Drew, you and I want to knock on doors all over the country.
DREW GRIFFIN, CNN ANCHOR: And yet these politicians will definitively state one or the another, they have a hard number.
LEVS: Exactly. GRIFFIN: And all the numbers pre-recession, so all the people that have been losing their jobs aren't counted or in and out of any of these?
LEVS: Exactly. When you think about that you have all these people losing jobs, losing health care, it's probably gone up from whatever it was.
GRIFFIN: Illegal immigrants, Josh. Nobody, you know, it's a big argument, there's 20 million. There's 30 million. There's 11 million illegal immigrants. Is this part of the 46 million?
LEVS: Yes, there are some among the 46 million who are immigrants, the census doesn't know exactly how many of them are illegal immigrants, but I will tell you this, one of the other question we investigated in the truth squad is whether this health care plan will actually cover illegal immigrants or if it's designed do that.
And here's our verdict on that. We can just give it you really simply. False. When you take look a look at what is actually in this plan, it does specifically say that it will not cover illegal immigrants. However, Drew it also won't solve the current problem with illegal immigrants going to hospital emergency rooms to get health care.
GRIFFIN: Yes, you know, that's something we forget. Health care is not denied really to anybody in an emergency room situation. That's part of the problem.
LEVS: Right.
GRIFFIN: We've got huge bills at emergency rooms that we have to pay for.
LEVS: That's right. Yes. You have this huge bills and that is part of the reason that's happening.
GRIFFIN: All right. Let's move on to this controversy.
Will the health care plan lead to rationing?
LEVS: You know, this is another place where we're hearing both sides. Let's take a look.
(BEGIN VIDEO CLIP)
MIKE DIRTH: My concern is being able to be denied the proper coverage. I'm concerned about the rationing of health care. I'm concerned about not being able to get the health care for my elderly parents.
(END VIDEO CLIP)
LEVS: Now let's take a look at the flip side from Vice President Biden.
(BEGIN VIDEO CLIP)
JOE BIDEN, VICE PRESIDENT, UNITED STATES OF AMERICA: When you tell me I can't get insurance because I have a precondition, that's rationing to me.
(END VIDEO CLIP)
LEVS: To him that is rationing. I will tell you, you know, our own Sanjay Gupta has said there is rationing going on right now. When you look at the system inside the insurance system. So what we did at the truth squad is we looked at this question - Will the current health care reform lead to rationing?
And here's our verdict, unfortunately, we had to kind of land on in dispute on this, because we cannot tell you. This is what you and I were talking about earlier, Drew. We can't know for sure what will lead to anything. So it is possible that it will lead to some level of rationing, some groups think well the government says it won't. We just have to keep an eye and see what happens.
GRIFFIN: OK. Well, we're dealing with the facts as we know it and the questions as we get them. And here's a question from viewers about whether the government will determine how much doctors charge.
LEVS: Right. This is a question about mandates. A lot of people have been asking us in the NEWSROOM, will there be a mandate that you can only charge this amount of money for any fee out there, for any service that you provide? This is what the White House said President Obama wants?
(BEGIN VIDEO CLIP)
ROBERT GIBBS, WHITE HOUSE PRESS SECRETARY: We cannot envision a scenario in which we live with anything that doesn't provide choice and competition in a private insurance market that allows people to get the best deal possible on both the price and quality if they enter a private health insurance market.
(END VIDEO CLIP)
LEVS: So their stance is what he wants to see is competition. Therefore, it would not be a specific charge. But let me just show you some points that some private groups out there are making. I have this on the screen for you, too. This is what the other side of that argument is. One group out there, for example, America's Health Insurance Plans. This is group that represents health insurance companies. They're trying to say that if the new government-run plan were to offer artificially low premiums over time, it could be a step toward a single payer system.
Their argument basically boils down to this. If the government ends up taking over, then ultimately there might really be one system in the country. And you can see on the next screen where we go with this. That might potentially in some people's view, lead to their being a way that they could set a price because ultimately if the government has that much control, then ultimately there could be a way to say - you know what, there's only one way of charging.
But the American Medical Association on the opposite side may say that only - the Health and Human Services secretary would be required to establish payment rates only under the public health insurance option. So they're saying no. you know what, if you're in public health insurance option, the government's could set a rate, everybody else, you still got competition so you can see the two sides there. I can tell you that the bill does not at all call for setting rates. It does not say anything about mandating any charges. So under the bill the way it's written, that's not supposed to happen, Drew.
GRIFFIN: There's so many sub texts to this though.
LEVS: Yes.
GRIFFIN: Because if you have the government paying one rate and then the private insurers paying another rate, that's not going to square in the market either. I thinks that's part of the problem as well.
LEVS: Well, the theory is that competition benefits everyone. That's the argument on that side.
GRIFFIN: Great. Well, this might be the most far fetched plan we've heard this week. And it's whether people will be denied care for their eyes until their partially blind.
LEVS: Yes, you heard that one?
GRIFFIN: I heard it, I didn't believe it.
LEVS: It's kind of amazing. Let me show you actually. We got this on a Facebook message to me that someone sent us after seeing us here in the NEWSROOM. Florence Mackie wrote us, you can see - I got a disturbing e-mail that says the new health bill will not help a person with macular degeneration until they lost the vision in one eye first.
We looked into this, Drew, we saw that there's actually other people who are getting this as well. I'm just going to get you straight to the verdict here. Let's show everyone. It's actually really simple. It is not going to do that. The bill does not say it is going to do that at all, but Drew, and we can end this here. But Drew, the point there is that there are a lot of these e-mails going around out there, people are hearing claims and it needs to be very suspicious when they're in there.
GRIFFIN: That's why we're here. That's why cnn.com has got that health care page to answer some of these questions. We're going to answer a lot more including a huge one which is kind of at the center of this debate - pre-existing conditions, whether or not you can move from one insurance to the other insurance company if you have a pre- existing condition. We'll talk about that. Josh?
LEVS: Oh, sorry. Yes. That's one of the questions. Sorry.
(COMMERCIAL BREAK) GRIFFIN: Question about pre-existing conditions has come up in a lot of town hall meetings, so whether or not you can be denied insurance because of a pre-existing health condition it came up Monday in this town hall meeting in Dallas.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Will the proposed health reforms offer better ways to help individuals manage chronic conditions?
As you mentioned that the market is moving to address it, but I think it would be fair to say slowly. So would the market provide coverage for pre-existing conditions?
(END VIDEO CLIP)
GRIFFIN: Angie Holan is at politifact.com. Politifact does not have a political affiliation. Get that out of the way. Right, Angie?
ANGIE HOLAN, POLITIFACT.COM: Thank you.
GRIFFIN: So what is a pre-existing condition?
HOLAN: Well, pre-existing conditions are pretty much any illness that someone may have when they have to switch insurance. We looked into this on the issue of pregnancy. Sometimes pregnancy is a pre-existing condition. Now, I should say if you have insurance through a large employer and you're moving to another employer, usually there's no problem.
The problem is when you go into what's called the individual market. And you have to buy insurance on your own. Then these pre-existing conditions can exclude you from coverage. The new legislation proposes to say that they can't do this, that they must accept everyone regardless of preconditions.
GRIFFIN: And pregnancy included?
HOLAN: Pregnancy included, that's right.
GRIFFIN: Very good. OK. Well, we're hearing a lot of talk about the health co-ops as an option. But what exactly is a co-op? We've asked senior medical correspondent Elizabeth Cohen to take a look at this, she broke it down on "Your Bottom Line" with Poppy Harlow. Let's listen to that.
(BEGIN VIDEO CLIP)
ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Let's take look at what the characteristics of a co-op. First of all, what it is it is not a private insurance company, it a nonprofit organization. The patients elect a governing board and there tens of thousands of members. So they don't have the need to turn a profit in the same way that big companies do.
But you know, I called the two biggest co-ops in the country. There's one in Seattle and one in Minnesota, and I said there's 46 million uninsured people, co-ops are getting a lot of attention, will co-ops help the uninsured? I got to tell you they both - both of them, said, no, not necessarily. We still charge premiums. We charge premiums that are about the average of what other insurance policies charge and so and we also will sometimes deny people from pre-existing conditions.
So co-ops, some people would say, are really not the answer. Because they provide competition, they might lower the price of insurance in their geographical area but they're certainly not charity. That's for sure.
(END VIDEO CLIP)
GRIFFIN: Angie, what have you guys learned about co-ops? Will they work?
HOLAN: Well, what is interesting is we haven't fact checked anything on co-ops yet because we just don't know enough what a national co-op would look like. Would it have a lot of bargaining power? Or would it not have that much? Would it be national or would it be regional? So we just don't know.
We're waiting for more details. The salient point seems to be that it's not government run. It is member run, but other than that, we're waiting for details like everybody else.
GRIFFIN: OK. Thanks a lot. Well, we're just a couple of minutes away now, including the latest on Hurricane Bill from our top stories. And we're going to debunk some of the biggest misconceptions in this health care debate and we'll answer more of your questions with Josh Levs.
Josh.
LEVS: I was just looking for one here we just got from our viewers asking about abortion, whether it will ultimately cover it, under whatever plan could make it through Congress. We'll break that down.
(COMMERCIAL BREAK)
GRIFFIN: We're going to have much more on the health care debate, just ahead.
But first, a look at some of our top stories. Hurricane Bill at the top is heading north, after hitting Bermuda with floods and power outages. It's expected to skirt the coast of Massachusetts this evening, bringing high winds and one or two inches of rain. After that it's due in Canada where the forecast calls for up to seven inches of rain there.
Taliban forces already taking revenge against Afghans who voted in Thursday's presidential election. Observers say two women in the Taliban stronghold of Kandahar had their index fingers cut off. Preliminary election results are expected early next month. Senator Charles Schumer wants the U.N. to condemn Libya for the heroes welcome it gave to a convicted terrorist, Abdel Al Megrahi was serving life in prison for the 1988 bombing of Pan Am flight 103 over Lockerbie. He was released from a Scottish prison because he's dying of cancer and he was greeted like a conquering hero when he returned to Libya.
Schumer says it's clear that the Libyan government still has a love affair with terrorism. We're going to check the stories again in 20 minutes, but our special continues, answering all of your questions, whether they come to us on the phone, on the internet, wherever, on health care and health care reform. Josh Levs is kind of the funnel for all of those questions. Josh.
LEVS: Yes, I feel like a funnel sometimes. Because we got this one from Gene, answer coming up. Gene asks will the current health care infrastructure be overwhelmed?
(COMMERCIAL BREAK)
GRIFFIN: There's a lot of conflicting claims about the what president wants to bring to health care. Lori Robertson from FactCheck.org joins us to sort some of those out. Lori, let's start with one frequent one we get. Will the government decide what care I can get?
LORI ROBERTSON, FACTCHECK.ORG: Well, there's nothing in the bill that says government will decide what care you get, but the sticking point here would be the public insurance plan which would be a government- run plan, you know, would it be deciding what it covers and what it doesn't cover? Certainly it would. The other thing is that the government will set minimum benefit standards and that's just a minimum. Health plans can then offer as much as coverage as they want beyond that.
GRIFFIN: And what about private insurance, how they fit into this? One question is will they eventually be illegal?
ROBERTSON: Well, no, this was actually a misinterpretation of something in the bill about individual health plans that would be grandfathered in. The provision said if you buy your own insurance on your own, your plan is grandfathered in no matter what type of benefit level it is, and that was just completely misconstrued.
GRIFFIN: Yes. You know, we are talking about the government being involved in kind of controlling health care just because of the size. If there was a government-run plan, I wonder if you have any thoughts on that because we're talking about the predictive nature of this, but if that government plan eventually grew to be so huge, would it basically direct all the care in all these plans?
ROBERTSON: Well, that's certainly the concern. You know, we looked at a couple of different studies and it depends on how the public plan is structured. There's concern that if it's rates that are similar to Medicare rates that private plans won't be able to compete with that. But the House plan, as amended by the energy and commerce committee says that rates would be negotiated, putting their premiums more in line with private plans. So it remains to be seen how this public plan is structured.
GRIFFIN: And on Medicare, if there's a government plan, there already is one called Medicare, would Medicare go away? Would that be slashed?
ROBERTSON: There's no plan for that at all, the claim that we've seen people make is that Medicare benefits would be slashed and we've said that that's false. There's actually proposed savings to get out of Medicare, out of projected increases in payments.
GRIFFIN: OK. Thanks, Lori, for all that
We're going to be talk about the dental care provisions. We talked about eye care, now dental care, and we're going to look at the top stories. They're coming up in about 10 minutes.
(COMMERCIAL BREAK)
GRIFFIN: OK. This is where our town hall opens up. We've got Josh Levs in the truth squad, Lori Robertson from FactCheck.org, Angie Holan from PolitiFact.com, we're answering questions all about this health care stuff. Let's talk now about dental care.
A woman who visited a free dental clinic here in Atlanta, she's afraid, Josh, that reform only provides dental coverage to people under 21. True, false?
(BEGIN VIDEO CLIP)
THELMA GRAVES, UNINSURED: I think it's criminal because the average person I said earlier, dental care is not a priority when you're trying to pay your mortgage. I think that they can take into consideration those persons who are not in that age group still have to work.
Those people who's not in that age group will have health problems as a result of not having access to adequate dental care.
(END VIDEO CLIP)
GRIFFIN: This isn't going to cover her.
LEVS: Yes. You know, Thelma has a point there. Let me just show you the basic idea here. I have the screen for you. Because the CNN truth squad has looked into this. Now, the proposed basic public plan does indeed include dental for only people under age 21. So it is true if you're over 21, then you would not have dental care under that plan.
But you could pay extra and get dental care, it's really pretty much like anyone who has private insurance that works for a company, you have your health care and you can choose to pay extra for dental care. So yes, under the public plan, it would not automatically be there but they are saying that there would be something available. Yes, it would cost extra. So you can see where she's coming from that.
GRIFFIN: Something available, details to be filled in later.
LEVS: Yes. So there's our verdict, true but incomplete. Because, you know, it is true, that health care reform is leaving out dental care under 21 is true but the fact is you can still get it if you want to pay some extra money.
GRIFFIN: Right. So, let's open it up. What else are we getting?
LEVS: Yes. We're getting a lot of questions. And Angie and Lori, I'm going to show you web pages, we'll get to some questions for you. Let's zoom right in here. I want to tell everyone cnn.com/healthcare. Has all these fact checks, lots of stuff for to you check out. FactCheck.org - this is where our guest if from today. FactCheck.org is where you can get a lot of great fact checking on health care and also PolitiFact.com, both agencies doing a great job. Kind of our brethren in the world of fact checking.
And we're glad as many people are doing it as possible. Let's get straight to some of these questions. And Lori, we're going to start off with what I want to ask you. This is a question we got from Jessica, who wants to know about abortion and whether or not it will be covered by this plan?
ROBERSON: Well, it certainly could be covered, both the House and Senate bills allow the so-called public plan and other private plans offered through the insurance exchange to cover abortion. There is some language that was added to the House bill saying that public funds couldn't be used to pay for them. And this a bit of a controversial point.
People who are low and moderate income would get subsidies to buy coverage either through the public plan or one of the private plans in the exchange and if that plan covers abortion, well, how do you separate out this money, the federal subsidies from whatever the individual is paying on their own? And that has become a very controversial point. Anti-abortion groups definitely want some more explicit language in the bill saying that any plan that is purchased with federal subsidies can't cover abortions.
GRIFFIN: That's very interesting because I believe I've heard some congressmen saying this would not cover abortion. Josh, have you heard that?
LEVS: Some are saying that they feel ultimately it won't, right?
ROBERTSON: Yes, we don't know for sure. There's nothing in either bill that says abortions will be covered, but they could be. There's certainly that allowance.
GRIFFIN: There's nothing that says it exempts it.
ROBERTSON: Yes.
GRIFFIN: Got you.
LEVS: Yes and that is art of what is complex. You know, let's remind everyone, and we've said it before there is no final bill in either chamber but there is a House bill that is on line and the Senate bill that is on line. You can see both CNN.com/healthcare and a lot of what is happening now is this kind of thing at town halls and here, where people with their specific concerns are weighing in so that hopefully in their view, things will be tweaked before there is a final bill.
GRIFFIN: I mean, this is really an important hotbed issue. Angie, are you finding the same thing? Is that answer correct?
HOLAN: Well, we looked into the abortion issue and we found that a committee in Congress took up the issue to try and craft a compromise that they called abortion neutral. And the idea here is that if you would like abortion services covered, you would select that plan, but you would also, if you didn't like abortion, you would have plans without that option and you could select that one. Now, does that satisfy everybody? I don't think so. But their goal is abortion neutral.
LEVS: I want to get to at lot of you, your viewer question. Let me tell everyone we'll post links to everything that we're talking about here after the show, 5:00. So you'll be able to see the various fact checks on these issues.
Angie, a question for you from Gene, and we actually gut a similar question from a lot of people. Will the current health care infrastructure be overwhelmed? You know, a lot of people are hearing that millions of uninsured will suddenly be insured, right? As it is, you wait in the doctor's office sometimes for an hour. Angie, when you guys looked at this at PolitiFact, is there even the infrastructure to handle all these people suddenly being insured?
HOLAN: Well, that's an interesting question. Certainly the Obama administration is concerned about that. They are directing a lot more resources to encourage general practitioners, people who see families and general doctors, so they're putting resources into that. Now the other point is this bill will roll out in - I don't want to say phases, but it's going to take a while to get it going. So there may be, it may be stretched over time. But the question is a good question and it is a genuine concern.
LEVS: Yes, it would mean a lot more doctors, potentially, right? A lot more doctors, as it is, need for nurses and other medical workers out there. So I guess it could actually trigger some jobs in that sense. And a lot more paying for doctors then, right?
GRIFFIN: Part of this is to cut costs. You know, increasing amounts of people getting health care, that's going to be increasing amount of dollars going to health care.
HOLAN: Well, and the part of reform that's popular with doctors and insurance companies is this individual mandate that would require people to purchase insurance. So the health care sector is supportive of more customers in a way.
LEVS: Let me bring Lori back in here because I want to ask you a question here, that we've gotten from Oliver. And this interesting, it's about this idea of competition. He wants to know why can't health insurance be purchased across state lines.
Now I tell you, lawmakers talk about that. Lori, when you guys at FactCheck look at this issue, is that something that could happen? There might be this national level of competition? Is that something we can expect?
ROBERTSON: I don't know if we'll expect it or not. It was something that was proposed during the presidential campaign, actually by John McCain. One of the problems now is there's so many different rules state by state, whether it's about pre-existing conditions or you know, what you can turn people down for or how you can change what they have to pay based on age or health status. There's so many different rules, state by state, that that makes it pretty difficult to do right now.
In the Senate bill, they're going to structure these insurance are exchanges state by state. The House bill seems to suggest it will be federal but it remains to be seen exactly that would be implemented.
JOSH LEVS, CNN NEWS CORRESPONDENT: Do we have time for one more? Yeah?
We've been talking in recent days -- and Drew, you and I have talked about this -- about this suggestion that potentially the White House, if it wanted to, might be able to push its health care plan through without a lot of support for Republicans.
So the question we're getting right here is -- it's interesting. "Why does president Obama insist on a bipartisan approval of his health care plan "public option" if the Democrats have enough votes to get it done?"
Let's start off with you, Angie. Talk to us about that. If the White House can just shove it through, why are they still pushing so hard? Do you think that will happen?
ANGIE HOLAN, POLITIFACT.COM: This isn't strictly a fact checking question, it's more of a political question. But I have been reading a lot of the coverage on this. And general thinking, even among Democratic supporters, is that it's not clear that all 60 senators are firmly committed to the public option. In fact, it seems like a few of them are not. So I think time is going to have to tell on this issue.
LEVS: OK. We do have something that is up the fact checker's alley coming up. That is coming up, and that is how much it will ultimately cost the country to do this?
We've got a question from Aleck asking how many billions it could cost the country.
I know both of your agencies have looked into that, as have we.
And we will have that coming up, Drew. DREW GRIFFIN, CNN NEWS ANCHOR: And we'll have our top stories, including the latest on where, oh where is Hurricane bill.
(COMMERCIAL BREAK)
GRIFFIN: We are going to keep answering more of your questions about health care after this look at our top stories.
They are closing beaches in Massachusetts's as Hurricane Bill is heading towards the U.S. mainland. Bill expected to skirt New England this evening, bringing one to two inches or rain to the coast. After that, Bill heads to Canada where a hurricane watch is in effect in parts of Nova Scotia.
Meanwhile, Iraq's foreign minister thinks Wednesday's Baghdad bombers may have had inside help. At least 100 people died in these attacks, including 32 foreign ministry employees. The foreign minister is saying an investigation has begun to determine if any Iraqi security officers actually helped those bombers.
And in Kentucky, they are busing prisoners to other prisons following a riot at a medium-security prison near Lexington. Inmates at the North Point Training Center threw rocks at guards and set fires, leaving several buildings in ruins. There were no serious injuries.
OK. Back to health care. We're answering all your questions, including these that Josh has for us next -- Josh?
LEVS: Drew, there's a lot of buzzwords we're hearing flying around. Some of them might make a real impact in the country and how health care plays out here. We're going to hear about health exchanges. We'll post that, coming up.
And this is how you can send your questions right now. We'll show you right now, CNN.com/josh, and I'm also on Facebook and Twitter at joshlevsCNN. In each case, send your questions, your comments, your thoughts. We're going to get in all we can by the end of the hour.
(COMMERCIAL BREAK)
GRIFFIN: Let's go ahead and continue with our checking the facts on this health care reform.
We've got Lori Robertson from Factcheck.org, Angie Holan from PolitiFact and Josh Levs.
Josh, the next question, please?
LEVS: They're flying in. let's zoom in to the screen right here. This one comes from Aleck who asks, "How many more billions will it cost the have government administer the public option?"
Angie, let me toss this at you first. Obviously, a lot of big questions about how much it will cost. What have you found so far?
HOLAN: What we are finding is the details of the public option are being negotiated right now, or even if it will exist, and that's a question, too. So the answer right now is it depends. It depends on how it's structured. It depends on the kind of bargaining power it's going to have, so right now, we just can't say.
LEVS: Lori, are you on par with that?
LORI ROBERTSON, FACTCHECK.ORG: Definitely. We can't too much, up in the air about how thing will be structured.
LEVS: One thing we know is the CBO, the Congressional Budget Office, has said it's going to keep scoring these bills as it studies them, until ultimately they can say we found one. Yes, finally, this version is revenue neutral. And that's apparently that is the version of the health care bill that will ultimately be passed.
GRIFFIN: And, of course, the big problem with this, Josh, is anything they come up with in Washington, you have to put in the multiplying factor, I call it. If they say it's going to cost $80 billion a year, it's probably $200, because everything costs that much.
LEVS: It could hike up. We're definitely seeing that.
GRIFFIN: Could hike up?
LEVS: Let's talk about some of these terms flying around, too. This one is interesting. James wrote us. Can we zoom in on the screen?
This is from James Barkley. I'll scroll down a little bit. He says, "I don't think people understand how health exchanges work. Can you explain how health exchanges work"?
This might southbound mundane.
Angie, to you first.
The reason it's so important is this is a central buzzword in this whole debate about health care. The idea of how a health exchange would work and how would it benefit anyone out there?
HOLAN: The structure of the plan is that employer-provided insurance stays in place. So people who get their insurance through work would continue as usual. But everyone else who has to buy insurance on their own would buy insurance on the exchange. Like Lori said, the House version is a national exchange. So they could go into this exchange. It will probably be on their computer. and they'll be able to look at what kind of option they would want. They can compare prices.
And one of those options will be the public option that we've discussed so much. But they don't have to buy the public option. They can buy private insurance. Experts say the public option maybe the cheapest but there will be other option from private insurers that offer premium coverage or extended coverage.
LEVS: It boils down to competition, right? The idea of the exchange is that part of this competition system? But ideally, if hear the way it's described in Washington, it will benefit people by increasing competition, right?
HOLAN: That's exactly right, increase competition. And also they're going to put the regulations that will rule out excluding people for pre-existing conditions. That's connected to the exchange as well.
LEVS: Lori, you guys look for holes in the argument. Are you hearing from any of the official arguments any holes in this idea of an exchange that maybe it won't be prove to be what we're hearing it would be?
ROBERTSON: No, I don't think so. The other thing about how it would work, that I would just add, small businesses will also be eligible to enter the exchange and possibly more businesses over time. And they would basically pick a level of benefits under the House bill. They would pick your basic plan or enhanced or a premium level and then, among that sort of level of coverage, there would be a public plan option and private plan options as well. So employees would pick among those.
HOLAN: Josh, I just wanted to add, this is where the people who criticize the plan get nervous, because they say that the public option could have unfair advantage and will overwhelm its competitors. So that's where a lot of controversy is coming in. They say there won't be genuine competition. The government will have the advantage.
LEWBS: Drew, that's what you and I have been talking about a lot, this idea that a lot of that is predictive. Will it overwhelm the system? We can't tell you factually.
GRIFFIN: We throw out these terms that keep popping up, co-ops and everything.
But this national exchange idea, would that not, Lori, require changes in state law. Basically the states would have to cede their power to the federal government before a national exchange in insurance sales could take place. True?
ROBERTSON: Yeah. And you know, that kind of relates to these other insurance regulations with pre-existing conditions and saying, you know, you have to take everyone and you can't reject someone based on pre-existing conditions. That kind of overrides state laws on those issues.
GRIFFIN: So the undercurrent sheer states give up power to the federal government potentially to solve this national health care problem.
ROBERTSON: Potentially, yes.
LEVS: I think we have time for one more. At least we can start on it now and we could literally spend the rest of the hour on this.
Let's zoom back in. Another term that keeps coming up, this one, a lot of people very concerned about. This one from Medicare.
This is from Ryan. He says, "Hey, Josh, Medicare is set to reduce reimbursement, but I'm not sure if this is addressed in any of the bills."
Let's start with you, Lori, Medicare. You guys have looked at this.
And then we'll talk to Angie as well.
When you guys look at the impact on Medicare, Lori, what are you finding so far?
ROBERTSON: Well, both bills try to get savings out of Medicare. The House bill is more explicit at this point in getting savings out of projected increases in payments for medical services, except for payments to doctors. Actually there is a scheduled cut in payments to doctors. And the House bill gets rid of that. so they're actually increasing some spending for Medicare in payments for doctors?
LEVS: I know a lot of viewers care about this.
Angie, I want to bring you in because PolitiFact did something very interesting on this. I was really very impressed by this particular fact check.
You guys looked at this question of would benefits ultimately be reduced. We keep hearing lawmakers saying, no, it won't. It will be protected. But you gave that a half true in your truthometer when you looked at what ultimately could happen to Medicare. Tell us about that?
HOLAN: That's right. What we found is that there are measures in the bill to introduce cost savings to Medicare. They're trying to steer Medicare away from deeper service where it's procedure by procedure paid, and to steer more towards paying for good outcome. Now, the Democrats say they can cut about $500 billion by doing this.
We went to experts and said, from the patient's end, will everything still look at exactly the same after they do this? And the experts said, you know, probably, the basics will be the same, but some of the details will be different and especially in a program called Medicare Advantage that the private insurance companies run. There should be a number of changes there. So that's why we rated it half true.
LEVS: It was interesting. You guys were saying it is possible, particularly because of the cuts to Medicare Advantage. There might ultimately be benefits that are reduced.
Which, Drew, brings us back to the whole idea of what we cannot fact check, which is the future.
GRIFFIN: That's exactly right.
We're going to have more questions right after this.
(COMMERCIAL BREAK)
GRIFFIN: Here's a quick reminder, we continue to answer your questions on this show about health care reform. And we've been answering them all hour long. But we want to turn now to a Texas town hall meeting. If there's one thing that town hall shows us is you have plenty of opinions and you want them to be heard.
We want to share one view with you. This is a man who went to Republican Joe Barton's meeting in Marques, Texas.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: I don't care about if they're Republican, Constitution, Libertarian or Democrats, I want somebody that would do what is right. (APPLAUSE). This country is a democracy and, as John Ruskin said, there ain't no free lunch. But let's don't put down these working people. I'm 75, glad to be alive. But I've paid my way with several jobs, college, whatever, and there's nothing wrong with that old nasty four letter word, work. (APPLAUSE). You'll hear there's no jobs. I agree there's no positions. There's a lot of jobs. And a lot of these people right here, you men and women have jobs. You didn't have a position. OK.
Another thing, you tell the president, and even you, sir, you can't put a steering wheel on the American people.
(END VIDEO CLIP)
GRIFFIN: That's just darn good stuff, isn't it.
Lori Robertson from FactCheck.org, Angie Holan from PolitiFact, and Josh Levs.
Josh, what kind of feedback are we getting on this thing?
LEVS: We're getting a bunch of questions about mental health.
I'm going to toss this at Lori first.
Let's zoom in on the board because I want everyone to see some of the examples of what we're getting here.
This is Kesha, "What about mental health? Is it going to be fully covered?" Britney writes something similar? She's 20 years old. She's concerned about whether mental illness will be covered.
Lori, I know you said you were looking at this issue. Is mental specifically in here and do we know yet how it might play out in terms of that kind of coverage?
ROBERTSON: I'm sorry. I did not have time to take a look at it. and I'm not sure if that's part of what the bill said should be in the essential minimum benefits standard.
LEVS: OK, That's cool.
(CROSSTALK)
LEVS: Go ahead. GRIFFIN: You know, it just comes across to me that we're talking about all these individual concerns that people have. It's almost like one size does not fit all in this health care reform. I'm wondering if there's drafted legislation that could possibly cover mental health, dental health, eye care, this care. It just seems like too big a thing to get their hands around to put in one tiny bill.
HOLAN: Josh, when you look at the bill, where it lays out what will be considered essential benefits, it's very generalized language. It's not very specific at all. So particular procedures or particular prescription drugs, it's not laid out in the legislation. That stuff is going to have to come later.
GRIFFIN: Angie, do you think that will mean that if this does pass or if health care reform does pass, then you're going to have somebody, a bureaucrat or somebody trying to decipher whether or not a particular procedure is or isn't covered based on the reading of the legislation?
HOLAN: Well...
GRIFFIN: Or further legislation?
HOLAN: Well, what the House bill doe does, they say there will be a health choice commissioner who will set minimum standards. So I do think someone from the government will set the minimum standards. But then, above and beyond that is where we're going see a lot of diversity. We'll see a public option that offers the minimum standard, if that passes. And then, of course, the private insurers who can offer minimum plans and enhanced or premium plans.
GRIFFIN: Yeah. And that freaks a lot of people out, Josh.
LEVS: It does.
GRIFFIN: What's the next question?
LEVS: One of the many things freaking a lot of people out about this. But I will tell you also, obviously a lot of people writing us messages about how many they want health care reform and want something it to go through.
I'll tell you the next thing. I'll toss it at both of you.
But first, actually, let's go to that screen again, so everyone can see how to weigh in, the various addresses. You have the Facebook and Twitter, and you have the blog, cnn.com/josh.
What I like about all these places, Drew, is that they're not only sending up questions and comments, but they are really online forums where people are listening to each other, responding to each other, having conversations.
Let's zoom in, because this a big topic, a lot of people are writing in all these things. And the real question boils down to, why should we trust the government on this? Jack Ulam says, "Why should we think our government, as prone to special interests as it is, would be any different from what is there now." It talks about TARP money being misused.
I know that you all hear similar things because, Factcheck and PolitiFact, you both run letters from things that people are writing to you out there. Have you had responses to this?
Angie, let me go to you first on this.
If you had any responses to this whole idea where people say, wait a second, look at the government's track record, is it good, is it bad? Should we trust it going into this -- Angie?
HOLAN: You know, based on our reader e-mail, I think that there are two camps, the people who don't trust government and then there are the people who don't trust big business, especially the health insurance companies. So I think people tend to fall into one of those two camps. And you know, each side has answers to the other. The people who say that government is messy and inefficient or the people who like government will say Medicare runs great. People who are in Medicare, like Medicare a whole lot. But the debate just seems to go on and on and it never stops.
LEVS: Let me toss that at Lori, too, because I know you guys have taken a look at this. What does Factcheck.org take on that whole idea, whether to trust the government, given its track record, on taking on something that is a massive bureaucracy?
ROBERTSON: Like Angie said, it's really a matter of opinion. We can't answer that question for people. Our reader e-mail has definitely been the same type of thing. There are people who don't trust the government and people who don't trust big business, mainly insurance companies in this case. So we're seeing those two main opinions and then lots of opinions in between.
But you know, we can tell you a bunch of facts about what the bill will do. It's going to be up to the reader to decide whether to trust the government or not.
LEVS: We all have more facts to look into too. We're going to get on the mental health one after this show and look into it.
Let me just remind everyone, that CNN.com/healthcare is the key place to go right now for all sorts of Factchecks. Also at the blogs you saw before, cnn.com/josh. I have links to our guest's website, Factcheck.org and PolitiFact.com. Everybody doing a good job, trying to break down what we do and don't know.
GRIFFIN: Yeah.
LEVS: And, Drew, and trying to give answer based on all that.
GRIFFIN: And a lot of the uncertainty based on the fact that there's different versions in the House, in the Senate, a Senate conference group trying to come up with something. And the Obama administration appears to be backing away from its strong support early on of the public option. Even Steny Hoyer has said maybe we don't need that public option.
I want to go back Angie Holan with PolitiFact.com.
Angie, is a public option off the table now? What's going on with public option?
HOLAN: I am really fascinated by the diversity of opinion on the public option. Just this week, we've seen more commentary and editorials from people who support health care reform and like the public option, but say it's not the only way to get done what they want to get done. They say don't get sidetracked on the public option, you can achieve the same goals other ways.
So a lot of people -- some people say it's absolutely necessary. Some people say it's not that important. and then on the other side, I think the people who oppose the public option, some of them are intrigued by the idea of co-op co-ops, but people who don't like the public options, some of them say, no, the co-op is just the same thing under a different name. So there's a huge diversity of opinions.
GRIFFIN: Let's talk about costs now. What kind of new taxes -- because it's going to cost money -- are going to be used to pay for this?
HOLAN: OK. Well, for the co-ops, we don't know what kind of setup they would require. Presumably they would need some sort of up front money but we don't know. Now the overall health care reform, there will need to be some new tax revenues, according to the Democrats. And there are different ideas, again. Obama has said -- President Obama has said he wants to limit the deductions for the healthiest people. Their tax deductions. The House proposes a surcharge on the wealthy. Now that's different from Obama's plan. And then the Senate Finance Committee, again, we're waiting on them. We don't know what sort of tax -- new tax measure that they will settle on.
So, and people -- many people believe that the Senate Finance Committee will be crucial. And there's an unknown there.
GRIFFIN: Yeah. A lot of unknowns across the board.
We want to thank you guys for answering the questions so far.
We'll be answering them all the time at CNN.com and on PolitiFact.org.
And Angie Holan with PolitiFact.org, I should thank you.
We will continue to look at this issue all through this month, this crucial month here at CNN, when we're looking at health care reform.
I'm Drew Griffin. The next hour of "CNN NEWSROOM" is just a few minutes away.
(COMMERCIAL BREAK) DON LEMON, CNN NEWS ANCHOR: Big Bill, a major hurricane scrapes the northeast for the first time in years. And the first family heads into the path of the storm.
Mad as hell. Imagine a guy who blew up your loved ones on an airplane and is released to a heroes welcome. How compassionate would you be?
War zone at home. Gangs and thugs run rampant. Families lose children, it seems, everyday, but they refuse to be victims. Can we save Chicago's deadly streets?
Hello, everyone, I'm Don Lemon.
Tropical storm warnings are posted in New England. And huge battering waves are crashing onto east coast beaches as we speak. Hurricane Bill heads north.
Bermuda felt the storm's punch earlier today with flooding and power outages. Look at this iReport. There are no reports of casualties.
