|(clipped from PolitiFact.com)|
The fact checkers:
Angie Drobnic Holan: writer, researcher
Bill Adair: editor
PolitiFact sets the stage:
The Republican response to attacks on the Ryan plan has been to attack back, saying President Barack Obama has cut "$700 billion" out of Medicare. And the Democratic response to that: Well, Paul Ryan cuts that amount, too!PolitiFact selects the claim to check:
"You know, I heard Mitt Romney deride the $700 billion cuts in Medicare that the president achieved through health care reform," Cutter said. "You know what those cuts are? It’s taking subsidies away from insurance companies, taking rebates away from prescription drug company. Is that what Mitt Romney wants to protect? And interestingly enough Paul Ryan protected those cuts in his budget."PolitiFact avows that it will focus on "whether Cutter is correct that Ryan relies on those same reductions in his budget."
PolitiFact uses the next nine grafs to outline the nature of the $700 billion reduction in Medicare expenditures projected by the CBO.
PolitiFact's source, a CBO report, communicates the nature of the reduction a bit more clearly than does PolitiFact (yellow highlights added):
Changes to Payment Rates in MedicareThe bulk of the reduction, then, occurs as the result of the two reductions the CBO identifies. Therefore, we should expect to see both of those features in the Ryan budget plan at minimum to rate Cutter's statement true.
In February 2011, CBO estimated that the permanent reductions in the annual updates to Medicare’s payment rates for most services in the fee-for-service sector (other than physicians’ services) and the new mechanism for setting payment rates in the Medicare Advantage program will reduce Medicare outlays by $507 billion during the 2012–2021 period. That figure excludes interactions between those provisions and others—namely, the effects of the changes in the fee-for-service portion of Medicare on payments to Medicare Advantage plans and the effects of changes in both the fee-for-service portion of the program and in the Medicare Advantage program on collections of premiums for Part B (Supplementary Medical Insurance).
Having more-or-less identified the nature of the projected Medicare savings, PolitiFact proceeds to the next phase of its fact check:
Now onto [sic] our second question: Does Ryan’s budget keep the reductions in Medicare spending? The short answer is yes.
Here’s what Ryan said in an interview with George Stephanopolous of ABC News in June, before his selection as Romney’s running mate:
Stephanopoulos: "You know, several independent fact-checkers have taken a look at that claim, the $500 billion in Medicare cuts, and said that it's misleading. And in fact, by that accounting, your budget, your own budget, which Gov. Romney has endorsed, would also have $500 billion in Medicare cuts.
Ryan: "Well, our budget keeps that money for Medicare to extend its solvency. What Obamacare does is it takes that money from Medicare to spend on Obamacare. ..." (Read the full exchange.)
Slate's Dave Weigel claimed that Ryan uses the same cap on Medicare spending as Obama. But his explanation does not appear to help PolitiFact's argument.
Weigel (bold emphasis added):
Remember, Obamacare is supposed to save $700 billion by capping the rise in Medicare spending from GDP growth plus 0.5 percent. The Ryan budgets in 2012 and 2013 don’t alter Medicare for anyone entering it before 2022—a buffer that lets current retirees breathe easy. After 2022, it turns all of Medicare into a premium support plan like Medicare Advantage. At that point, “an annual competitive bidding process” is supposed to push providers to provide lower rates. “The per capita cost of this reformed program for seniors reaching eligibility after 2023,” explains Ryan in his budget guide, “could not exceed nominal GDP growth plus 0.5 percent.” So, if it works, it’s got the exact same Medicare cap as the Obama plan.Weigel is talking about two different means of obtaining the same future rate of growth on Medicare spending.
As for PolitiFact, it's sticking with Paul Ryan's supposed confession:
So Ryan has confirmed his budget includes the Medicare savings."The" Medicare savings? The same exact ones from the ACA and not just the future rate of growth pegged at the same percentage? How do we know that? Where is the fact check?
Still, Ryan himself said his plan did include the reductions in future spending that were part of the federal health care law.Sorry, but that's not a fact check and it's very misleading. PolitiFact is seizing on an ambiguity from Ryan and insisting that it perfectly dovetails with Cutter's claim. A real fact check would verify from the text of Ryan's budget that the savings have the same origin as those projected by the CBO for the health care reform law. This fact check doesn't do that at all. Ryan's budget is neither listed among the sources on the sidebar nor linked in the text of the story.
Another of PolitiFact's sources helps confirm that PolitiFact simply blew this fact check. The CBO did attempt to score Ryan's budget proposal. The CBO did a baseline scenario using the assumption that the health care reform bill would remain in effect:
The baseline scenario incorporates policies restraining Medicare spending that are embedded in current law. Such policies include the sustainable growth rate mechanism, which determines the payment rates for physicians; payments to other providers in the fee-for-service portion of Medicare that would grow more slowly over roughly the next two decades than the cost of their inputs; and the Independent Payment Advisory Board (established by the Affordable Care Act), which is required to make changes to the Medicare program to reduce spending if the growth in such spending is projected to exceed certain targets.And the CBO created an alternate scenario where Medicare savings were much less:
The alternative fiscal scenario incorporates less restraint on Medicare spending. Specifically, payments for physicians would not be reduced as they would be under the sustainable growth rate mechanism, and payments to other providers would grow more rapidly than under the baseline scenario after roughly the next decade. The remaining restraints on Medicare spending could also have the potential consequences noted for the baseline scenario, but presumably to a much lesser extent because the restraints would be much less tight.If the cost reductions are "protected" in the Ryan budget, then why does the CBO run an alternative scenario where the supposed protected cost reductions do not occur?
By all appearances, the PolitiFact team mailed it in on this fact check. The evidence strongly suggests that the Ryan budget plan only relies on savings through ObamaCare to the extent that the CBO assumes that existing law will remain in effect--its standard procedure--while projecting the effects of Ryan's budget.
Cutter gets a "True" for that?
Angie Drobnic Holan: F
Bill Adair: F
Seriously: Where's the fact check?
Here's one of those statements from the CBO that seems to have a tough time finding its way into PolitiFact's fact checks (bold emphasis added):
CBO’s cost estimate for the legislation noted that it will put into effect a number of policies that might be difficult to sustain over a long period of time. The combination of those policies, prior law regarding payment rates for physicians’ services in Medicare, and other information has led CBO to project that the growth rate of Medicare spending (per beneficiary, adjusted for overall inflation) will drop from about 4 percent per year, which it has averaged for the past two decades, to about 2 percent per year on average for the next two decades. It is unclear whether such a reduction can be achieved through greater efficiencies in the delivery of health care or will instead reduce access to care or the quality of care (relative to the situation under prior law). Also, the legislation includes a provision that makes it likely that exchange subsidies will grow at a slower rate after 2018, so the shares of income that enrollees have to pay will increase more rapidly at that point, and the shares of the premiums that the subsidies cover will decline.