END OF 2018 OPEN ENROLLMENT PERIOD (41 states)

Time: D H M S

Dear NY TImes: "Up To" means "Up To".

Linda Qui is a NY Times Fact Checker, formerly of PolitiFact. She cited me as a fact-check source twice for PolitiFact: Once in October 2015 and again just before the election last fall (I can't find the link for that one). The first time around it was about Donald Trump's claim that premiums were skyrocketing (again, this was back in 2015, referring to 2016 rates increases). After a phone discussion, here's what I wrote her:

Yes, some people in some plans through some carriers in some states are, indeed, looking at rate hikes of “35 - 50%” if they stick with those plans in 2016. Alaska, Minnesota and Hawaii, for instance, are all looking at 30-40% average hikes, and individual plans (or individual carriers) in a few states are indeed jacking up rates by that much.

However, by my current estimates, here’s the state-by-state breakdown:

  • 30-40%: Alaska, Hawaii, Minnesota
  • 20-30%: ID, MD, IL, DE, IA, KS, OR, AL, UT, OK, MT, NC, SD, TN
  • 10-20%: NJ, WY, GA, PA, AZ, KY, NH, MS, MO, LA, TX, SC, NE, ND, WV
  • 5-10%: VT, MA, MI, RI, NY, VA, OH, FL, NV, CO
  • < 5%: IN, ME, CT, CA, NM, WA, DC, AK

There’s also one more important thing to keep in mind: A percent increase can have dramatically different meaning depending on the dollar amount.

  • a $200/mo policy going up to $300 = 50% hike.
  • a $500/mo policy going up to $600 = 20% hike.

In other words, it was important to keep context and variables in mind. She did an excellent job of presenting all the variables, caveats and disclaimers, and in the end stated:

Our ruling

Trump said, "People’s premiums … are going up 35, 45, 55 percent."

Some insurance plans in the federal exchange will see price hikes at the levels that Trump is suggesting. But he’s cherry-picking the high end of premium changes to come. Estimates for the national average are far below Trump’s figures, ranging from 4.4 percent to 13 percent.

Trump’s claim is partially accurate but takes things out of context. We rate it Half True.

...which I felt was perfectly reasonable.

I'm rehashing this tonight because Ms. Qui, not at the New York Times, is catching a ton of heat tonight over a new "fact check" which literally included the infamous and dreaded "Both Sides" headline:

Pre-Existing Conditions: There’s Truth-Stretching From Both Sides.

WASHINGTON — In the debate over how the effort to replace the Affordable Care Act would affect those with pre-existing health conditions, opponents and supporters alike have offered misleading talking points.

Faced with polling indicating public support for protections, and after an emotional appeal by the television host Jimmy Kimmel that has gone viral, Republicans are making a dubious case that their updated bill provides similar coverage for those who are less healthy, while Democrats are overstating claims about how many are affected.

Here’s an assessment:

She then goes on to cite two quotes by GOP Speaker Paul Ryan and GOP Rep. Steve Scalise as being "misleading" and "false" respectively...followed by two quotes from Democrats, both of which she concludes are "misleading".

Here are the quotes in order:

Paul Ryan: "VERIFIED: The MacArthur amendment protects people with pre-existing conditions. The amendment is very clear: Under no circumstance can people be denied coverage because of a pre-existing condition.”

Qui says that this is "misleading". If Ryan had stopped at the first sentence, "misleading" would be accurate...but he then went on to say it was "very clear" that "under no circumstance can people be denied" due to having pre-existing condtions. Since states can get waivers to opt out of that restriction, this is far more than "misleading"...it's simply false.

Steve Scalise: "It actually provides multiple layers of protection for people with pre-existing conditions in ways that Obamacare doesn’t do.”

Qui says this is false...and good for her, because this is a load of hooey; Obamacare is far stronger at pre-existing condition protection.

The reason people are so infuriated, however, comes with the her scoring of the two Democratic quotes:

Nancy Pelosi: “Up to 17 million children who have pre-existing conditions can no longer be denied coverage by insurers.”

Qui claims that Pelosi's statement is "misleading" because the report cited by Pelosi gave a range of 4-17 million children; Qui says that because she only listed the upper limit of that range, it's "misleading".

If Pelosi had left out the "Up to" in front of the quote, then I would agree. But...she didn't. She said "UP TO 17 million...", which is 100% accurate.

Qui also says that most of the children referred to had coverage prior to the ACA. This is true, I'm sure...but having coverage is very different from being protected from losing coverage.

Pelosi's statement was 100% accurate, both factually and in context. Qui should change this to "True" without caveats or disclaimers.

Rep. Frank Pallone, Jr: "The current version of Trumpcare allows insurance companies to discriminate against the 129 million Americans with pre-existing conditions.”

Qui claims Pallone's statement is "misleading" because, once again, the report gave a range of 50-129 million, and Pallone used the upper end of the range. Now, Pallone probably should've thrown an "Up to" in there as well...but on the other hand, the actual title of the HHS report cited by both Pelosi and Pallone is literally "At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans: 129 Million People Could Be Denied Affordable Coverage Without Health Reform".

Furthermore, a more recent analysis by the Center for American Progress put the estimate of non-elderly Americans with pre-existing conditions at around 134 million total...slightly higher than the 2011 report, which makes sense due to population growth.

The other reason Qui claims Pallone's 129M figure is "misleading" is that it includes those with coverage through their employer (group coverage), who supposedly would not be subject to pre-existing discrimination.

The problem with this is that, similar to the "most of the children were already covered" argument...people lose their jobs or switch to jobs which don't provide healthcare benefits all the time...and sometimes they have a gap in coverage. The report in question gave this number as 82 million at the time, but no matter how high it is, the fact remains that under the ACA, no one can be denied coverage for having a pre-existing condition no matter what, period. I suppose Pallone should've worded it as "The current version of Trumpcare could allow insurance companies to discriminate..." as a caveat, but again, that's a minor quibble.

For the record, my own estimate of how many people on the individual market have pre-existing conditions is around 8.9 million nationally...but again, the other ~120 million people with pre-existing conditions are also protected under the ACA whether they have group coverage, individual coverage or don't currently have coverage at all, which is an important point. Even those without coverage today have the peace of mind of knowing that if and when they ever do sign up for a healthcare policy of whatever category, they don't have to worry about being denied due to their condition.

Here's the larger point, though: It's not just about how accurate a statement is, but how important being absolutely, 100% precise is to the point that they're making or claiming.

Ryan and Scalise were both trying claim that the AHCA would absolutely protect everyone with pre-existing condtions more strongly than Obamacare does...which is utter BS. They're both flat-out lying here about something vitally important.

Pelosi and Pallone both stated that millions of people are at least potentially in jeopardy of losing coverage and/or even dying if the AHCA becomes law...which is factually accurate.

Now, fact-checking can be a tricky business, and sometimes good journalists make honest errors. Lord knows I've done so myself more than once, although I do try to correct them and admit my error when they're pointed out.

The larger problem with Qui's piece is that she tried to force a "Both Sides" argument in when there's simply no moral equivalence whatsoever. If Pelosi had gone with 10.5 million children (mid-range of 4-17 million) as her number, it wouldn't have changed the larger point she was making on iota, nor would it change Pallone's if he had used 89.5 million (mid-range of 50-129). Either way, you're still talking about a buttload of people.

By contrast, if Ryan or Scalise had included caveats stating that yes, some people could indeed be denied coverage for having pre-existing conditions under the AHCA, that would have completely destroyed the claim they were trying to make.

As noted at the top of this entry, Ms. Qui is clearly pretty good at her job most of the time, so I'll leave it at that, but given the endless series of "Both Siderism" which Democrats have had to put up with for some time now (and especially over the course of the 2016 campaign, when minor gaffes by Hillary Clinton were treated as bad if not worse than repulsively offensive behavior and statements by Donald Trump), many on the left are more than a little outraged at this sort of incident.

Anyway, for what it's worth, the Times seems to already have sort of gotten the message, since this is the headline as of 2:00am Thursday...although the actual content of the piece hasn't been corrected yet:

Pre-Existing Conditions: Evaluating Competing Claims