An Unhealthy ‘PolitiFact Health Check’

This week PolitiFact, with its franchise partner Kaiser Health News, published what was, in effect, a fact check of a prediction by President Barack Obama.

“PolitiFact Health Check” awarded Mr. Obama a “True” rating for his prediction.

Spoiler: For good reason, fact checkers usually try to avoid doing fact checks on predictions.

A Trump Lawsuit Seeking to Overturn the ACA?

We noted days ago that a number of political and media figures promoted the idea that President Trump had sued to overturn the Affordable Care Act.
In fact, the Trump administration has not sued to overturn the ACA. Instead, a coalition of states sued to end the ACA and the Trump administration formally agreed with their argument.

PolitiFact Health Check ignored those easy pickings, opting to take on a more complex claim from Mr. Obama.

Mr. Obama Predicts

What was Mr. Obama’s version of the claim.? Let PolitiFact tell of it:

“The Republicans occupying the White House and running the Senate … have shown themselves willing to cut [sic] millions off their health insurance and eliminate preexisting condition protections for millions more, even in the middle of this public health crisis,” Obama said.

Obama was referring to a couple of GOP policies, the former president’s senior adviser Eric Schultz told KHN. The first: a pending Supreme Court case, Texas v. Azar, in which the Trump administration has argued the 2010 health law should be struck down. Schultz also highlighted the White House’s refusal to provide a special open enrollment period for the ACA health exchanges in the midst of the coronavirus pandemic.

Why do we call Mr. Obama’s version of the claim a prediction? Because, going by Eric Schultz’s explanation, he was talking about a pending Supreme Court case.

That case won’t get decided until 2021.

Is 2021 “the middle of this public health crisis”? How would Mr. Obama know without seeing the future? And how does he know that Republicans will not come up with a replacement plan between now and a Supreme Court decision overturning the ACA? Is it impossible for such a plan to pass between now and then?

PolitiFact Health Check Seeth No Evil

PolitiFact Health Check did not see Mr. Obama’s claim for the prediction it was. And worse, PolitiFact viewed the claim as perfectly “True.”

Perhaps the claim was helped along by its second part? Schultz said Obama’s claim also referred to the GOP refusal to allow a special ACA open enrollment period.

Does refusing to allow a special ACA enrollment period “kick millions off their health insurance“? Or affect the ACA’s protections for pre-existing conditions?

What did PolitiFact use for evidence to find Mr. Obama’s claim “True”?

The Lawsuit Would Kick Millions Off Their Insurance During the Middle of the Health Crisis Because?

PolitiFact:

Obama is correct: The Republican Party has opposed the ACA for years.

But Obama did not claim the GOP opposed the ACA for years. Obama claims the GOP will kick millions off their insurance (and eliminate protections for pre-existing conditions) during the middle of a health crisis.

The GOP’s longstanding opposition of the ACA does not offer good evidence in support of that claim. It does not follow that “Obama is correct.”

PolitiFact:

A collection of Republican states’ attorneys general now argue that, without the penalty, the rest of the health law doesn’t work and should be struck down.

If by that PolitiFact means the states argue the individual mandate is not severable from the rest of the law, then the statement is correct. When the Supreme Court found the ACA constitutional back in 2012, the key part of Chief Justice Roberts’ opinion found that the individual mandate was constitutional based on Congress’ constitutional ability to levy taxes (even though Democrats had argued the penalty was not a tax). When Congress passed a law effectively removing the penalty in 2017, the move rendered the ACA unconstitutional by Roberts’ reasoning.

A pandemic does not erase the hole the 2017 law created in Roberts’ rationale for finding the ACA constitutional. Should it?

If the White House Does Not Provide an Open Enrollment Period Millions Will Be Kicked Off Their Insurance Because?

PolitiFact never really tries to address this question. It looks like PolitiFact reasons that since it will help some people if they can sign up for insurance plans during open enrollment, therefore Obama was right (about something).

We do not detect any argument stronger than the following in this section of PolitiFact’s fact check:

Uninsured people with underlying chronic conditions don’t have a way to pay for health care, noted Robert Berenson, another Urban Institute fellow. If left untreated, those chronic ailments make COVID-19 far more dangerous than it would be for someone able to get preventive treatment earlier on.

Therefore millions get kicked off their insurance? Or lose protections for pre-existing conditions?

We don’t see it.

Fact Check Quibbles

Digressing from our main point, we have some quibbles about PolitiFact’s fact-checking.

PolitiFact quotes Mr. Obama incorrectly. He said “willing to kick millions off their health insurance,” not “willing to cut millions off their health insurance.”

PolitiFact’s fact check does not identify the American Enterprise Institute as right-leaning. Nor does it identify the Urban Institute as left-leaning.

In addition, PolitiFact fails to inform its readers that the experts it quoted from the Urban Institute, Linda Blumberg and Robert Berenson, give politically to Democrats. That would not surprise readers who know the Urban Institute leans left, which counts as another reason to identify the political leaning of think tanks, including “non-partisan” think tanks.

Perhaps we should also mention that Larry Levitt, another expert PolitiFact cited, also gives to Democrats. We found no record of political giving for Thomas Miller, the expert PolitiFact cited from the American Enterprise Institute. We did not search exhaustively through the many Thomas Millers that came up in the donor search at Open Secrets.

Finally, PolitiFact does not mention the option some people have for buying short term catastrophic plans at lower cost than a full coverage plan. But note that open enrollment periods also apply to plans, including catastrophic ones, bought outside the ACA exchange system.

Diagnosis

PolitiFact Health Check ruled it “True” that Republicans in the White House and the Senate want to kick millions off insurance and remove protections for more millions with pre-existing conditions, even during the height of a health care crisis.

As we pointed out, it counts as a prediction to say a 2021 Supreme Court ruling would occur during the height of a health care crisis, in addition to the assumption Republicans would not address pre-existing conditions during the interim.

As for continuing current limits on open enrollment, we do not see how that would kick millions off their insurance or have any effect at all on protections for pre-existing conditions.

PolitiFact’s “True” rating implies it sees those consequences but the fact checkers fail to back up the claims with evidence.

Update April 17, 2020: Added a link to the PolitiFact article and made minor adjustments to formatting.