Fact Checker: What you need to know about Medicaid spending and preexisting conditions in the Senate health plan

What you need to know about Medicaid spending and preexisting conditions in the Senate health plan This week, Senate Majority Leader Mitch McConnell (R-Ky.) delayed the vote on the Senate health-care plan until after the Fourth of July holiday to give lawmakers a chance to study the bill and work out a new compromise to …   Democracy Dies in Darkness     The truth behind the rhetoric   What you need to know about Medicaid spending and preexisting conditions in the Senate health plan This week, Senate Majority Leader Mitch McConnell (R-Ky.) delayed the vote on the Senate health-care plan until after the Fourth of July holiday to give lawmakers a chance to study the bill and work out a new compromise to overhaul the 2010 Affordable Care Act. We looked into two points of contention in the debate over the Senate bill: Medicaid spending and preexisting conditions. Let’s start with Medicaid. President Trump promised throughout the campaign that he would not cut Medicaid, yet the Senate plan — which he supports — makes drastic changes to its financing. Trump tweeted that under the Senate plan, Medicaid spending “actually goes up.” That’s really misleading. In raw dollars, yes, the federal government’s spending on Medicaid increases from $393 billion in 2017 and $464 billion in 2026. But that’s not how the Congressional Budget Office, and the federal government writ large, measures the impact of proposed legislation. The CBO analyzes the financial impacts of a bill by comparing how much proposed legislation would cost or save the federal government compared to current law. Using that measure gives us a fuller sense of the impact of the Senate health bill: It significantly reduces how much the federal government would spend on Medicaid in future years compared to projections without a change in the current law. This means a reduction of $772 billion over 10 years, from 2017 to 2026. It would lead to 15 million fewer Medicaid enrollees by 2026 than there would be if current law stayed in place. Trump paints a rosy, misleading picture — and earned Three Pinocchios. Are they hiring? (giphy.com) Enjoy this newsletter? Forward it to someone else who'd like it! If this e-mail was forwarded to you, sign up here for the weekly newsletter. Hear something fact-checkable? Send it here, we’ll check it out.  Now, onto preexisting conditions. As with the House version that passed in May, Democrats have criticized the impact that the Senate bill, the Better Care Reconciliation Act, would have on people with preexisting medical conditions. It gets pretty complicated, so we compiled a guide to help readers parse through the rhetoric. (Previously, we published a similar guide to rhetoric about preexisting conditions in the House bill.) ADVERTISEMENT   Under the Affordable Care Act, or Obamacare, insurers can’t raise your premiums or deny you coverage because of a preexisting condition. As you can imagine, this is a popular provision in the new health law; prior to the ACA, insurers could use your health status to raise your premium or deny you coverage. Like the House bill, the Senate bill allows states to apply for waivers from certain Obamacare provisions. But unlike the House bill, the Senate bill explicitly prohibits waivers for preexisting conditions. However, both the House and Senate bills allow states to use the waivers for something called the “essential health benefits” package, which is a minimum standard of 10 types of services that insurers are required to cover under Obamacare. So states that waive coverage of essential health benefits could start taking away coverage for certain types of services that may affect people with preexisting conditions. For example, if you are a cancer survivor, an insurance company can't deny you coverage or increase your premiums because of that preexisting medical condition. But if the state waived the essential health benefits package and insurers redesigned their plans, and the plans didn't cover certain cancer treatments or prescription drugs, then the cost could fall on you. But ultimately, it will depend on the specific policy decisions by states that seek waivers. Bottom line: Be wary when you hear Democrats say the bill “hurts” people with preexisting conditions, or when Republicans say it “protects” people with preexisting conditions. Happy 4th of July weekend! (giphy.com) We’re always looking for fact-check suggestions! You can also reach us via email, Twitter (@myhlee, @GlennKesslerWP or use #FactCheckThis), or Facebook (Fact Checker or myhlee). Read about our rating scale here, and sign up here for our weekly Fact Checker newsletter.  Scroll down for this week’s Pinocchio roundup. — Michelle Ye Hee Lee President Trump’s claim Medicaid spending in Senate health bill ‘actually goes up’ Trump misleads on the impact of the Senate bill on Medicaid spending, only presenting one part of the overall picture. By Michelle Ye Hee Lee  •  Read more »   Do Russia probe attorneys’ donations to Democrats threaten their independence? Half of the publicly-known attorneys so far hired by the Special Counsel's Office donated to Democrats is not an indication that Robert Mueller, the special counsel, has failed to be independent. By Michelle Ye Hee Lee  •  Read more »   President Trump’s claim that MS-13 gang members are being deported ‘by the thousands’ Trump is indeed ramping up enforcement actions against MS-13, but deportations so far this year are in the hundreds, not the thousands. By Michelle Ye Hee Lee  •  Read more »   Video: Two wrongs don’t make a right. The Republican spin on Obamacare premiums For years, Republicans have run inaccurate attack ads based on President Obama's misleading claim that health-insurance premiums would decline by $2,500. By Meg Kelly and Glenn Kessler  •  Read more »   What you need to know about preexisting conditions in the Senate GOP health plan Another debate about preexisting conditions is brewing over the Senate bill to overhaul the health-care system. We dig into what the bill says about preexisting conditions. By Michelle Ye Hee Lee  •  Read more »   ADVERTISEMENT   Recommended for you   The Energy 202 Your daily guide to the energy and environment debate. 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