Obama’s Health Care Speech

Summary
President Obama's prime-time address to Congress and the nation on health care prompted a Republican congressman to shout "you lie!" Did he? Here's what we've found:

• Obama was correct when he said his plan wouldn't insure illegal immigrants; the House bill expressly forbids giving subsidies to those who are in the country illegally. Conservative critics complain that the bill lacks an enforcement mechanism, but that hardly makes the president a liar.
• The president said "no federal dollars will be used to fund abortions." But the House bill would permit a "public option" to cover all abortions, and would also permit federal subsidies to be used to purchase private insurance that covers all abortions, a point that raises objections from anti-abortion groups. That's true despite a technical ban on use of taxpayer dollars to pay for abortion coverage.
• The president repeated his promise that his plan won't add "one dime" to the federal deficit. But legislation offered so far would add hundreds of billions of dollars to the deficit over the next decade, according to the Congressional Budget Office.
• The president overstated the degree of concentration in the insurance industry. He said that in 34 states the "insurance market" is controlled by five or fewer companies, but that's true only of insurance bought by small groups, not the entire "insurance market."
• Obama said his plan won't "require you or your employer to change the coverage or the doctor you have." It's true that there's no requirement, but experts say the legislation could induce employers to switch coverage for millions of workers.

Analysis
The president addressed a joint session of Congress Sept. 9, and the event was televised nationally.

Illegal Immigrants
Obama said that his proposal would not cover illegal immigrants, a remark that prompted Republican Rep. Joe Wilson of South Carolina to shout "You lie!"

Obama: There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false – the reforms I'm proposing would not apply to those who are here illegally.

The president is correct: The House bill contains a section (Sec. 246) titled "NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS," which states: "Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States."

However, conservative critics object to a lack of specific enforcement measures in the bill. They argue that the lack of a specific verification mechanism constitutes a loophole that would allow illegal immigrants to get benefits despite the legal prohibition. Republican Rep. Dean Heller of Nevada proposed an amendment to the bill that would have required the use of the Systematic Alien Verification for Entitlements program to check the citizenship of anyone applying for federal coverage or affordability credits. SAVE is the program used by Medicaid and similar entitlement programs. That amendment was voted down along party lines by the House Ways and Means Committee.

Republicans have a point here: More could be done to enforce the ban. But it's worth remembering that, as a spokesperson for the American Immigration Lawyers Association told us, attempting to get a health care credit would have legal repercussions. "Making a fraudulent claim to an entitlement program when you're not actually entitled to it would have serious consequences for any person," the spokesperson told us, "but especially if it's considered a false claim to citizenship, that would have serious immigration consequences that could ultimately lead to deportation." And Rep. Wilson certainly was out of bounds to call the president's statement a "lie." He later issued a statement apologizing for his "inappropriate and regrettable" comments.

Abortion
The president insisted that no federal money would pay for abortions:

Obama: [U]nder our plan, no federal dollars will be used to fund abortions.

The truth of that depends on what is meant by "federal dollars." Actually, as we've written before, under Democratic legislation now before Congress, the "public option" would cover abortions in cases of rape, incest or threat to the life of the mother and could cover all abortions if the administration chooses, and as Obama once promised. Private insurance plans purchased with the help of federal subsidies to low- and moderate-income workers also could cover all abortions, as many, if not most, private plans do today.

Under an amendment adopted by a House committee, abortions would be paid for by the "public option" only with money collected from policyholders in the form of premiums, not with money collected from taxpayers. But is money collected by the government and paid out to abortion providers by the government "federal dollars"? The anti-abortion side says yes. And the same goes for federal subsidies given to low- and moderate-income persons to help them buy insurance. If they use those dollars to buy private policies that cover all abortions, does that mean "federal dollars" go to fund abortions? Again, abortion foes say yes.

The advocates of abortion rights argue otherwise. They say the House bill would be an extension of longstanding policy under the Hyde amendment, which forbids use of federal taxpayer dollars to fund Medicaid abortions except in cases of rape, incest or threat to the mother's life, but also allows states to use their own Medicaid money to fund other abortions (and 17 of them do). In any case, the matter is not so simple or clear as the president would like it to seem.

Deficit-Neutral
The president repeated his promise to fully pay for the plan.

Obama: I will not sign a plan that adds one dime to our deficits – either now or in the future. Period.