Debate over merits of health care reform has distinct campaign flavor

By Michael Mishak

Sunday, Nov. 1, 2009 | 2 a.m.

Nevadans may have thought the big campaign ended last November, but their TVs are telling them otherwise.

The state has become a key battleground for one of the most expensive — and consequential — public policy debates in history: health care reform. Seven advocacy groups on both sides of the issue have spent more than $1.1 million in Nevada over the past month on ads, hoping to influence voters and pressure lawmakers. The spots have run more than 2,400 times during that period, mostly in Las Vegas, according to the Campaign Media Analysis Group, a nonpartisan research organization.

For the year, spending on ads to influence the debate has totaled $3.8 million. The pro-reform Americans for Stable Quality Care — a coalition of the American Medical Association and the pharmaceutical industry lobby, among others — has led the spending at $1.2 million.

The reason for the attention: Senate Majority Leader Harry Reid is a pivotal player in the health care debate in Washington, and he faces a potentially tough reelection campaign next year.

Most of the ads airing here push for reform.

“Most of these groups are trying to help (Reid) and prop him up,” said Evan Tracey, president of the Campaign Media Analysis Group. “On the other side of the coin, they are sending a message: We could be back in the fall, for you or against you, whatever you need.”

After months of legislative wrangling, both houses of Congress are poised for a floor debate. Democrats say reform is needed to make health care more affordable and accessible to those who have insurance, and provide coverage for millions of Americans who don’t. Republicans warn that the legislation will slash Medicare along the way and saddle taxpayers with huge new financial obligations.

Below, a vetting of the most prominent ads on the issue.

On potential for cuts in Medicare Advantage

What the ad says: Congress is asking the 10 million seniors enrolled in Medicare Advantage to pay “more than their fair share,” as it seeks to cut $100 billion from the popular program. Citing the nonpartisan Congressional Budget Office, the spot says the cuts will hit many seniors hard.

Who’s behind it: The Coalition for Medicare Choices, a project of America’s Health Insurance Plans, the national association representing nearly 1,300 insurers.

Is it accurate? Congress is proposing nearly $500 billion in Medicare cuts, with the single largest cut coming from Medicare Advantage, which allows seniors to use their Medicare benefits to buy coverage from a private insurance company.

If costs aren’t reduced, Medicare is projected to become insolvent in 2017. Lawmakers want to trim as much as $150 billion from Medicare Advantage, because, although many plans in the program provide extra coverage for vision, dental and other services, the program pays insurance companies higher reimbursements and costs the government 14 percent more per person than standard Medicare.

Congress points to studies that show seniors enrolled in traditional Medicare pay higher premiums to cover the additional costs of Medicare Advantage.

The Congressional Budget Office has found that the Senate Finance Committee bill would reduce payments to private Medicare Advantage plans by $117 billion over 10 years. The budget office’s director has said the cuts would, in fact, result in some benefit cuts to seniors in that program — but only to the extra benefits insurers provide under Medicare Advantage. Core benefits would remain untouched.

On making insurance more affordable

What the ad says: Reform legislation would give tax credits to more than 457,000 middle-class Nevadans and more than 32,000 small businesses to make health insurance more affordable. Families would not be denied coverage for preexisting conditions. Health care decisions will be made by you and your doctor.

Who’s behind it: Americans for Stable Quality Care, a coalition of the American Medical Association, PhRMA (the pharmaceutical industry lobby), the Federation of American Hospitals and Families USA (a health care advocacy group), among others.

Is it accurate? The sole source of the information in the ad is healthreform.gov, the Obama administration’s official government Web site for health legislation. Citing the U.S. Census Bureau’s Current Population Survey, the government says that between 377,100 and 457,000 middle-class Nevadans will be eligible for tax credits to “ease the burden” of health care premiums, which it says have risen 61 percent since 2000. The site also says the state’s 32,066 small business operators will benefit from tax credits to make insurance more affordable.

Preventing insurance companies from denying coverage for preexisting conditions, such as diabetes or high blood pressure, has been a signature feature of the reform legislation.

The statement about health care decisions being between you and your doctor, seems to addresses the widely dispelled claim by some Republicans that “death panels” and government bureaucrats would lord over health care decisions.

On donations to Ensign, his public option stance

What the ad says: Sen. John Ensign has taken $874,000 in campaign contributions from the health insurance industry — and then voted against “lowering health care costs” and a public option to compete with private insurers.

Who’s behind it: Health Care for America Now, a coalition of more than 1,000 member-based organizations, including the AFL-CIO, NAACP, MoveOn.org, the Center for American Progress and the Service Employees International Union.

Is it accurate? As for the campaign contributions, the group cites the nonpartisan Center for Responsive Politics, which tallies elected officials’ donations by industry. Where the $874,000 figure comes from is unclear, but the center notes that over the course of his career, Ensign has received $984,936 from “health professionals,” $629,466 from “insurance,” $313,980 from “pharmaceuticals/health products,” $244,804 from “health services/HMOs” and $234,379 from “hospitals/nursing homes.”

The second claim references Ensign’s Sept. 29 vote in the Senate Finance Committee against amendments to add the public option to health legislation. Democrats have argued that a Medicare-like public option would force private insurers to compete for all the new business that health care reform would create, thus leading to lower costs. Ensign has joined his fellow Republicans in fighting the proposal, saying it’s a “slippery slope toward … a complete government-run takeover of our health care system” and that it would force private insurers out of business.

On Ensign’s actions to ‘protect Medicare’

What the ad says: Sen. Ensign is “fighting to protect Medicare,” voting against a plan that would raise premiums for Medicare drug coverage by as much as 20 percent, and working to make health care more affordable for seniors and their families, making sure they have access to prescriptions “without red tape or government restrictions.”

Who’s behind it: Medicare Today, a project of the Healthcare Leadership Council, a coalition of CEOs from all sectors of the health industry, including insurers, hospitals and pharmaceutical companies.

Is it accurate? The ad cites an Aug. 28 Congressional Budget Office letter, which states that under health reform legislation, average premiums for Medicare Part D beneficiaries would rise by about 5 percent in 2011 and 20 percent in 2019.

The ad ignores, however, that one reason for those increases is to close the so-called doughnut hole, or gap in prescription drug coverage under Medicare. “In return for those higher premiums, enrollees would receive greater protection against incurring high drug costs,” the CBO wrote.

On Reid and whether public option passes

What the ad says: Lee Slaughter, a Las Vegas nurse, says she’s taken care of patients for nearly 20 years and watched private insurance companies “cut off care” for many of them. Now, she says she broke her hips and her insurer won’t cover all her care. The costs, she says, could soon bankrupt her family. A “typical swing voter,” Slaughter says she’s watching to see whether Sen. Harry Reid is “strong and effective enough” to include a public option in health legislation.

Who’s behind it: The Progressive Change Campaign Committee, a liberal advocacy group working to elect “bold progressive candidates.”

Is it accurate? Nothing much to vet here. The ad is intended to pressure the Senate majority leader. The spot is linked to a Research 2000 poll the group funded showing 54 percent of Nevadans favor a “government-administered health insurance plan — something like Medicare … that would compete with private health insurance plans.”

On potential for tax on juice drinks and soda

What the ad says: A woman coming home from the grocery store expresses outrage at a potential federal tax on juice drinks and soda. “They say it’s only pennies,” she says, “well those pennies add up when you’re trying to feed a family.”

Who’s behind it: Americans Against Food Taxes, a coalition of beverage industry groups, including major soft drink manufacturers and retailers.

Is it accurate? A group of prominent doctors, scientists and policymakers is pushing the idea of taxing soft drinks, energy drinks and many juices, both to help offset the costs of implementing health care reform and curb the nation’s obesity problem. The group published a study in the New England Journal of Medicine that said a tax of a penny an ounce on sugary beverages would raise $14.9 billion in its first year.

For all the ad’s urgency, the idea faces formidable opposition in Congress. Many members have voiced strong opposition and potential supporters have said little more than they would be willing to consider it.

On Reid and his actions on health care reform

What the ad says: Sen. Harry Reid is working with Democrats and Republicans “toward consensus (on) bipartisan health care reform, fighting to make health care coverage more affordable, close the doughnut hole without raising premiums on seniors and make sure no one can be denied coverage for a preexisting condition.”

Who’s behind it: PhRMA, the pharmaceutical industry lobby, and Families USA, a health care consumer advocacy group.

Is it accurate? The ad doesn’t say much, coming off more like a campaign spot for Sen. Reid’s reelection. Most of the claims mimic the goals of Democrats: making health care more affordable and accessible.

The drafting process for health care legislation, however, has hardly been bipartisan. Republicans are entrenched in their opposition to the sweeping reform Democrats are proposing. A bill emerged from the Senate Finance Committee with one Republican vote, that of Maine Sen. Olympia Snowe. She announced last week that she would oppose the bill Reid is promising to bring to the floor, one with a public option.