Quick fact: Wallace falsely claims health bills direct task force to decide what services “aren’t covered”
On Fox News Sunday, host Chris Wallace falsely claimed that it’s a “fact” that the House and Senate health care bills direct the U.S. Preventive Services Task Force to “determine what services, what tests, screening, are covered and aren’t covered,” and asked whether that amounts to “government rationing.” In fact, the bills require insurers to implement task force recommendations in favor of specific preventive care, but they are not required to adopt those that recommend against preventive screening.
Wallace falsely claims under health bills task force “will determine what services … aren’t covered”
From the November 22 edition of Fox Broadcasting Co.’s Fox News Sunday:
SEN. DEBBIE STABENOW [D-MI]: As the only woman on this panel, let me say, first of all, I don’t agree with that recommendation, and thank goodness it’s not going to have any impact. It was only a recommendation. But the bigger issue here for us is the fact that what we’re doing is, for the first time, making sure that women have maternity care and actually have mammograms covered. That’s what’s in our basic plan.
WALLACE: If I may bring Senator [Arlen] Specter [D-PA] in, because you have had a battle — a personal battle with cancer yourself for years, sir. While the mammograms study set off a political storm and Health Secretary [Kathleen] Sebelius backed away from it, the fact is both in the House bill and in the Senate bill, it repeatedly refers to this preventative services task force and says that it will determine what services, what tests, screening, are covered and aren’t covered. Isn’t that going to be government rationing?
SPECTER: The legislation pending specifically provides for testing. The report made on mammograms and pap tests not binding on us in any way. The bill up — provides for testing just as I had an MRI, which was very, very beneficial to me. Listen, Chris, the real issue here is whether we’re going to have governance.
Fact: Neither Senate nor House health bills require insurers to adopt recommendations against preventive services
The Senate health care reform bill, the Patient Protection and Affordable Care Act, requires insurance companies only to cover screenings that the United States Preventive Services Task Force recommends, those rated as an A or B recommendation; it does not require insurers to adopt guidelines that recommend against preventive screenings:
SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES.
(a) IN GENERAL. — A group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide coverage for and shall not impose any cost sharing requirements for -
(1) evidence-based items or services that have in effect a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive Services Task Force
Similarly, the House health care reform bill, the Affordable Health Care for America Act, requires insurance companies to cover the A or B recommendations of a new task force, the Task Force on Clinical Preventive Services, but does not require that insurers adopt recommendations against preventive services:
SEC. 3143. RESEARCH ON SUBSIDIES AND REWARDS TO ENCOURAGE WELLNESS AND HEALTHY BEHAVIORS.
[…]
(c) INCLUSION IN ESSENTIAL BENEFITS PACKAGE. — If, on the basis of the findings of research and demonstration projects under subsection (a) or other sources consistent with section 3131, the Task Force on Clinical Preventive Services determines that a subsidy or reward meets the Task Force’s standards for a grade A or B, the Secretary shall ensure that the subsidy or reward is included in the essential benefits package under section 222.
