i9 Fact Checker: Republican attack ad jumps to conclusions on a public option in healthcare

Published: Oct. 28, 2020 at 8:58 PM CDT
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CEDAR RAPIDS, Iowa (KCRG) - A new ad from a Republican Super PAC is critical of a public option for health care. That would give people the option to buy into a government-run health care plan. It’s a plan Democratic Senate challenger Theresa Greenfield and several other Democrats support.

Source: The ad called “Struggling” is from the Senate Leadership Fund. The group is a Super PAC with the goal of protecting and expanding the Republican majority in the U.S. Senate.

Claim #1: “But the Theresa Greenfield-Nancy Pelosi Health Care Plan could take away our employer-provided health insurance”

Analysis: Greenfield’s campaign website said she supports a “public health option for Iowans to buy into”.

A public option would operate like medicare, where private insurance and employer given insurance would still exist. But, people would have the option to buy into a government-run plan as well.

The plan is supported by a number of different democrats like Nancy Pelosi and Joe Biden.

The ad cites an article from the New York Times examining the possible effects of a public option in health care. The article, which uses an expert from a Washington D.C.-based think tank called the Urban Institute, noted there are several different versions of a public option plan, each with different impacts.

The Kaiser Family Foundation breaks down some of those options, including some versions of the law that would allow employers to offer the public option as part of its group plan. Other versions would allow workers to opt-out of employer coverage to get the public plan with subsidies.

Kaiser notes a potential impact is that employees choose to take the public plan instead of their company’s plan. With fewer employees enrolled, that would drive up the cost per person for employers and make it more cost-efficient for companies to stop offering insurance plans and pay a tax penalty instead.

The article from the Times notes those effects of the public option are tied to the specifics and intricacies of the plan, like if it’s linked to Medicare or not.

Conclusion: The public option the ad refers to would not directly eliminate employer insurance plans. Instead, it could drive market forces that lead companies to choose to stop offering them as employees opt for the public option instead. And that is still a big ‘if’ depending on the intricacies of how a public option would work. That’s why this gets a C.

Claim #2: “The Greenfield-Pelosi Plan could also take away our access to the doctor of our choice”

Analysis: This claim uses an editorial written in the New York Times about the public option in 2009 from a former presidential advisor for George W. Bush.

The article itself doesn’t say it could take away the doctor of our choice, rather it argues a public option would possibly lead to doctors earning less money, which could drive some doctors to a different career.

The group also uses the article cited in the previous claim, which notes that Medicare patients often receive lower prices because of its buying power. Conversely, if a public option is not tied to Medicare, it would face tougher pricing negotiations. The previous article said if that happens “the public option might look a lot like existing insurance: pretty expensive, and covering a limited set of doctors and hospitals.”

Conclusion: The use of the word “could” here makes the statement closer to true. But a public option would make it your choice – not a requirement – to change insurance plans. Market forces might dictate your choice, but it would still be a choice under the public option proposals. As with any time you change insurance coverage, what doctors and hospitals it covers will vary. That’s why this gets a D.

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