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Open Discussion Discuss Fact Check at the General Forum; AP FACT CHECK: Did Trump really favor Macron in France? WASHINGTON — President Donald Trump told France's new president that ...

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Old 05-25-2017, 11:40 PM
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AP FACT CHECK: Did Trump really favor Macron in France?

WASHINGTON — President Donald Trump told France's new president that he was "my guy" in the recent election, a French official said Thursday. The record shows only favorable words from Trump for centrist Emmanuel Macron's opponent, the defeated far-right candidate Marine Le Pen.
A look at Trump's views, before and now, on this month's French vote:

TRUMP to Macron at a lunch meeting in Brussels on Thursday, according to a French official: "You were my guy" in the French campaign. Trump also said he didn't endorse Le Pen, according to the official, who wasn't authorized to speak publicly on the matter and requested anonymity.

THE FACTS: Trump may never have explicitly endorsed any candidate in France's election, but he had only nice things to say about one candidate: Le Pen. Whatever views he may have expressed privately are unknown.

In an April 21 interview with The Associated Press, Trump said he believed an attack that week on police officers in Paris would help the National Front leader because the violence played to her strengths.

"She's the strongest on borders, and she's the strongest on what's been going on in France," Trump said in the Oval Office interview. "Whoever is the toughest on radical Islamic terrorism, and whoever is the toughest at the borders, will do well in the election."

By contrast, Trump never spoke publicly about Macron before the vote. Former President Barack Obama endorsed Macron.

While Le Pen had echoed some of Trump's hardline rhetoric on immigration, the U.S. leader's words of support were surprising.

Le Pen had distanced herself from her father, National Front party founder Jean-Marie Le Pen, who has been convicted of crimes related to anti-Semitism and mocked the Holocaust as a "detail" of history. But she still drew criticism for denying during the campaign that the French state was responsible for the roundup of Jews during World War II, and maintained an inner circle of old friends from her student days that included members of a radical group known for violence and anti-Semitism.

Trump called Macron after his resounding victory. He also tweeted congratulations to the 39-year-old winner, saying he looked forward to working with him.

AP FACT CHECK: Did Trump really favor Macron in France?
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Old 05-25-2017, 11:41 PM
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AP FACT CHECK: No Medicaid cuts in Trump budget? Really?

WASHINGTON — Trump's budget director insists the administration's spending plans won't cut Medicaid money, but by any conventional measure of federal financing the health care program for families and the poor is clearly on the chopping block.

Mick Mulvaney, director of the Office of Management and Budget, while introducing the budget Tuesday: "There are no Medicaid cuts in the terms of what ordinary human beings would refer to as a cut. We are not spending less money one year than we spent before."

THE FACTS: Mulvaney is being artfully evasive.

His argument is that Medicaid funding will still increase in dollar terms each year during the 10-year budget window. What President Donald Trump wants to do is merely slow the growth of Medicaid spending, he said. It's an obvious workaround for a president who pledged as a candidate not to cut the entitlement program.

But the accounting is flawed for several reasons.

First, even before delving into the budget, the Trump-supported rollback of President Barack Obama's health care law would reduce federal money that 31 states and Washington, D.C., have relied on to extend coverage to low-income adults under Medicaid.

Additionally, the Republican health care bill passed by the House would cap the overall federal share of Medicaid spending. The program would no longer be an open-ended entitlement, and one of the ways states are expected to respond is by restricting eligibility.

"Ordinary human beings" who can't get Medicaid under those constraints would feel that.

The Trump budget could compound those restrictions by reducing the rate of growth in federal Medicaid funding even more. Here's why:

One of the best ways to evaluate government spending is as a proportion of the total economy, since that can help to account for changes in population, inflation and the budget priorities that define a presidency.

So, yes, Medicaid spending would increase by $4.7 trillion over a decade. But as a proportion of the economy, it would clearly be cut.

Medicaid spending would fall from 2 percent of the economy to 1.7 percent in 2027 due to the reductions in spending projections by Trump. That slight decrease adds up to more than $600 billion over 10 years.

When it suits the administration's case, Mulvaney relies on this same metric for measuring the budget as a proportion of the economy.

At the same briefing, talking about the plan for helping to curb the debt, he said: "It begins to reduce the size of the debt relative to the size of the economy in Year One, OK?"

While Mulvaney gets the basic measure correct, his claim about the debt relative to growth is also suspect because of the administration's economic assumptions, which include an overly optimistic projection of economic growth.

AP FACT CHECK: No Medicaid cuts in Trump budget? Really?
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Old 05-25-2017, 11:43 PM
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Default Re: Fact Check

Pence Misleads on Premiums

Vice President Mike Pence went too far in claiming that a new report showed that “the average premium across this country has actually doubled under Obamacare.” The report, from the Department of Health and Human Services, focuses only on insurance purchased on the HealthCare.gov exchanges in 39 states and notes that it is “an approximation” with limitations.

Also, the vast majority of people buying plans on those exchanges aren’t actually paying the 2017 premium prices that HHS includes in its report, because 83 percent of them got premium tax credits to help pay for insurance.

Pence made his claim in a speech at Cajun Industries in Louisiana on May 24.

Pence, May 24: Obamacare, in the facts, has caused premiums to skyrocket across America. Here are the numbers, this is fresh out from Health and Human Services yesterday. The average premium across this country has actually doubled under Obamacare. More than a 100 percent increase in only four years. … These are the real numbers that have been released by our administration, and they’re numbers that the past administration just never would have released to the public.

A Department of Health and Human Services report published May 23 says that premiums on the individual market “have increased significantly since the Affordable Care Act’s key provisions have taken effect.” That’s a comparison of 2013 premiums, before the ACA’s major changes to the individual market went into effect, and 2017 HealthCare.gov exchange premiums. That overall finding is no surprise. As the report notes in its introduction, the ACA changed how insurers could price plans on the individual market — limiting price differentials based on age, and banning pricing based on health status or gender. And the law required insurers to accept any customer, regardless of preexisting conditions, and include a set of essential benefits in their plans.

That means cheap, skimpy plans for healthy customers became a thing of the past.

“In most states these regulations increased insurance coverage requirements and would be expected, on average, to increase the price of ACA-compliant plans relative to pre-ACA plans all else equal,” the HHS report said.

But as the report itself makes clear, its specific figures on increases from 2013 to 2017 come with some caveats or limitations.

The “real numbers,” as Pence put it, on the increase in individual market premiums pre- and post-ACA may not be quite as high as a doubling. And more important, Pence, as we’ve seen politicians do repeatedly, doesn’t make clear that he’s only talking about the individual market and not average premiums overall. About 7 percent of the total population gets coverage on the individual, or nongroup, market, where people who don’t have employer-sponsored coverage or insurance through government programs such as Medicaid and Medicare buy their own policies. More specific to this report, 9.2 million people in 2017 enrolled in plans in the 39 HealthCare.gov states, the focus of the HHS analysis, not “across this country,” as Pence said.

The HHS report found that “average exchange premiums were 105% higher in the 39 states using Healthcare.gov in 2017 than average individual market premiums in 2013,” an increase from a $232 average monthly premium to $476. The analysis used two different data sets. HHS used what’s called MLR data (medical loss ratio) for the individual market in 2013 and compared that to data from the Centers for Medicare & Medicaid Services on plans purchased through the HealthCare.gov websites in the 39 states using the federally run exchange in 2017.

HHS acknowledges that this isn’t a “perfect comparison,” but says it “provides an approximation for how average individual market premiums have increased” under the Affordable Care Act.

The medical loss ratio data, which insurers send to the National Association of Insurance Commissioners and to HHS, is only available through 2015. But the data that are available show that the average MLR premiums have been lower than average HealthCare.gov exchange premiums under the CMS data. (See Appendix B in the HHS report.)

For instance, using the MLR-to-CMS comparison shows a 53.4 percent increase in average premiums from 2013 to 2015 in those 39 states, but using an MLR-to-MLR comparison shows a 41.8 percent increase for the same time frame. Either is still a sizable increase, but shows the HHS’ less-than-perfect comparison may be skewed higher than an apples-to-apples comparison would reveal.

There are other limitations, most of which the HHS report also acknowledges:

This comparison excludes off-exchange, individual market premiums in 2017. Those buying their own insurance but not through the exchanges don’t get premium tax credits. They’re paying full price, so they often buy less generous coverage, Cynthia Cox, the Kaiser Family Foundation’s associate director for the Program for the Study of Health Reform and Private Insurance, told us. Including off-exchange premiums could therefore lower the average premium for 2017.
Also, HealthCare.gov states have “slightly higher premiums” on average than the state-based exchanges, Cox said, largely due to demographic reasons and southern states that didn’t expand Medicaid. The HHS report says that looking at national premiums could in fact lead to different results. “To the extent that trends are different in state based exchanges (SBEs), especially large SBEs like California and New York, the national average increase may differ from what is reported in this Data Point.” Three million people signed up for the state-based marketplaces in 2017, HHS says.

There’s no adjustment for the type of people getting these insurance plans in 2013 versus 2017. The risk pool has changed. Now, because of the health care law, insurers have to take everyone regardless of preexisting conditions and can’t charge them more. “Older and less healthy people are a larger share of the individual market risk pool now than in 2013,” the HHS report says. “The changing mix of enrollees and adverse selection pressure has likely been a significant cause of the large average premium increases in the individual market over this four-year period.” This also means some with HealthCare.gov plans in 2017 weren’t getting individual market plans in 2013.

The nonpartisan Congressional Budget Office expects the mix of insured on the individual market would change under the House-passed American Health Care Act. The GOP bill would allow insurers to charge older people more, and, as a result, there would be a disproportionate increase in the number of low-income older individuals without insurance, and higher premiums for those in that demographic who remain in the nongroup market, CBO says.
One thing the report doesn’t mention is that 83 percent of the people buying on the exchanges get premium tax credits that keep their out-of-pocket premiums costs at a certain percentage of their income, according to a March HHS report. So most people on the exchanges aren’t actually paying the premium prices in 2017 that HHS includes in its report. But, of course, 17 percent of those on the exchanges, plus those buying off-exchange plans, don’t get those tax credits.

Not surprisingly, the report found that states that already had insurance benefit requirements similar to those that went into effect in 2014 under the ACA, “had smaller premium increases between 2013 and 2017.”

As previous HHS analyses of individual market premiums have shown, there was variation among the states, ranging from a 12 percent premium increase in New Jersey to a 223 percent increase in Alabama. Twenty-four of the 39 states, however, had average increases of 100 percent or more.

And, as we’ve often noted, how the premium increases affect those who buy their own insurance depends on the individual. For those who are healthy and were happy with less-generous benefits, their premiums likely went up. For those with preexisting conditions, their premiums may have gone down, even before factoring in tax credits.

A Kaiser Family Foundation 2014 survey asked those who bought insurance on the individual market in 2013 and again in 2014, under the ACA requirements, about their experiences. Whether those individuals paid more or less for their premiums, after tax credits, was largely split: Forty-six percent said their monthly out-of-pocket premium was lower, while 39 percent said their premium was higher. Fifteen percent said it was about the same.

Pence Misleads on Premiums
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