Statement:  I'm satisfied with my current health coverage.  I'm outraged that I won't be able to keep it if H.R. 3200 passes. Read Page 16 of the bill!

Reality:  What Page 16 actually says is that, once the new health insurance Exchange is up and running, insurers will only be able to write new policies for employer coverage that meets a minimum standard. Specifically, employee coverage would need to be at least as good as the basic benefit plan available through the Exchange.  No one will end up with worse coverage as a result of the new standard.

As for policies already in place when the Exchange comes on-line, employees could remain covered by them  for as long as 5 years,  if and only if the insurer does not change the “terms or conditions”. After the 5-year “grace period” ends, even these policies would be subject to that minimum standard.

Even if the insurer stopped offering coverage, employees would NOT be thrown into the “public option” plan.  They would, however, be able to choose coverage in the Exchange (either a private or public option) that meets the minimum standard that the old coverage didn't. Those who are low- or moderate-income would be able to get assistance to help make that coverage affordable.

Reality:  If insurers could sell policies in any state, companies would flock to the state with the least rules and base themselves there, quickly creating a “race to the bottom”. That state's rules would become the national “standard” everywhere.

These largely unregulated insurers would then sell cheap policies in many states with more rules, but mainly scooping up the healthy and leaving older or sicker with fewer options as they undercut the existing in-state market. Even for those who do get less expensive coverage, the cost savings would come from reduced benefits, not increased value.

Reality: Access to the emergency room or safety net providers can never replace real health coverage that provides comprehensive and timely health care.  Emergency rooms treat the problem of the moment, but can't prevent anything, provide follow-up care or address the real causes.  Safety net providers can help, but they are very overburdened and have few of the resources that the general health care system has.

Uninsured people receive significantly less care than those with insurance coverage. They delay getting care and are diagnosed later. They are less likely to get follow-up care and less likely to be admitted to a hospital.

Reality: First, the source of that estimate was a report by the Lewin Group, a consulting group owned by UnitedHealth, one of the nation's largest insurers and an opponent of the public option. 

Second, the estimate of 88 million is based on an unrealistic scenario considered in the Lewin report in which the public option would be operated like Medicare and be open to all employers by 2011. That is not what is proposed in the House bill. The independent Congressional Budget Office (CBO) by contrast estimates that about 30 million people would obtain coverage through the Exchange, and only about a third of those (11 million) would end up selecting the public option over other private coverage.

Finally, when interviewed by the Washington Post, even Lewin's VP conceded that some “would indeed lose what they have, but they might very well be better off.”

Reality: The private insurance market has been unable to address the primary care shortage because there is no incentive in the current system for doctors to choose to practice primary care rather than specialty care. By contrast, a major section of the bill is dedicated entirely to boosting the nation’s primary care provider workforce. This includes, for example:

• Expanding scholarships and loans for individuals in shortage areas.
• Expanding the National Health Service Corps and create a new primary care loan program.
• Increasing the supply of advanced nurse practitioners to further expand the capacity of the system.
• Increasing the number of primary care physicians trained outside of hospitals, where most primary care is delivered.
• Reassigning unfilled graduate medical education residency slots to maximize this critical resource.

Critics often point to Canada as a system with long waits for care. Although those criticisms are significantly overstated, wait times for some services are longer in Canada than in the U.S.  However, that gap is largely attributed to Canada's earlier restrictions on medical school enrollment, which is the opposite of the approach America is taking.