We anticipated this research would impact PolitiFact's fact-checking of GOP reform efforts, and National Review's Ramesh Ponnuru delivers the expected assessment in "PolitiFact, Wrong Again on Health Care."
When House Speaker Paul Ryan (R-Wis.) said most of those losing insurance under a GOP proposal were choosing not to buy something they did not want instead of having something taken away, PolitiFact rated his statement "Mostly False."
The root problem is that (PolitiFact's Jon) Greenberg assumed that the fines on people without insurance—Obamacare’s “individual mandate”—operate only in the market for individually purchased health insurance and that getting rid of them has no effect on Medicaid enrollment. So he thinks that all of the decline in Medicaid enrollment that CBO projects are the result of reforms to Medicaid that would have kept people who want it from getting it, and Ryan is exaggerating the effect of the fines.Here's how Greenberg explained it in PolitiFact's fact check (bold emphasis added):
The biggest single chunk of savings under the Senate bill comes out of Medicaid. The CBO said that compared with the laws in place today, 15 million fewer people who need insurance would be able to get it through Medicaid or anywhere else.It looks like Ponnuru has Greenberg dead to rights.
Ryan’s answer flipped the CBO presentation. According to the CBO, the Senate bill’s impact on people who would get coverage through Medicaid is double that of people who buy on the insurance market. That’s where people make the kind of choices Ryan was talking about.
We made the same assumption as Greenberg, though not published in a fact check, which led us to puzzle how to reconcile the high impact of the individual mandate for the CBO's prediction for insurance loss in 2018 with the apparently shrinking impact of the individual mandate in 2025.
Ponnuru's article helps explain the discrepancy, and his explanation exposes one of PolitiFact's claims as false: "The CBO said that compared with the laws in place today, 15 million fewer people who need insurance would be able to get it through Medicaid or anywhere else."
A decent slice of that 15 million, about 7 million by Ponnuru's estimate, will still maintain Medicaid eligibility. They simply won't sign up if not threatened with a fine. But they can sign up after they fall ill and obtain retroactive coverage for up to three months. If that segment of the population needs Medicaid insurance, it can get Medicaid insurance, contrary to what PolitiFact claimed.
Yes, PolitiFact was wrong again.
Considering PolitiFact's penchant for declining to change its stories even after critics point out flaws, we wonder if PolitiFact will update its stories affected by the truths Ponnuru mentions.