It’s a health care edition of Groundhog Friday, our feature highlighting political claims we’ve debunked before. Sens. Bernie Sanders and Ted Cruz, who both finished in second in the races for the Democratic and Republican nominations for president, respectively, appeared in a CNN debate on Feb. 7 to discuss the U.S. health care system. And they repeated some talking points with which we’re quite familiar. Follow the links to our original stories for more information on each claim.
Sanders on health care spending in the United States: “The real question, which is never talked about or very rarely talked about, is why we end up spending as a nation twice as much per capita on health care as do the people of any other country.”
Sanders made this claim three times in the CNN debate, and he has a point that the United States spends a lot more per capita than other countries on health care. But Sanders’ claim is an exaggeration. The U.S. spends twice as much as the average spent by other developed nations, but it doesn’t spend twice as much as every one of them.
We wrote about this in August 2015. There are now more recent figures from the Organisation for Economic Co-operation and Development, but they still show Sanders goes too far. The U.S. leads the pack in terms of health care spending, with $ 9,451 spent in 2015 per person. The OECD average, for 35 countries, was $ 3,814, well below half the United States’ figure.
But the U.S. didn’t spend twice as much as “any other country,” as Sanders said. The second-place country — Luxembourg — spent $ 7,765, or 18 percent less per capita than the U.S. Other countries that spent more than half the U.S. figure include, in order of spending: Switzerland, Norway, Netherlands, Germany, Sweden, Ireland, Austria and Denmark.
Cruz on premium growth: “[T]he average family’s premiums have risen $ 5,000. That’s why people are unhappy with this disaster of a law, because it’s driven up the cost of health care.”
This is a misleading take on premium growth under the ACA, and one we’ve seen before from the Republican National Committee. Cruz is citing the rise in the average premium for an employer-sponsored plan for a family — including both the premium paid by the employee and portion paid by the employer. That total average cost for a family plan rose $ 5,462 between 2008 and 2016, according to the Kaiser Family Foundation/Health Research & Educational Trust annual survey on employer health benefits. The average employee-paid portion rose $ 1,923 in that time frame.
The more problematic part of the claim, however, is that Cruz cites the increase as evidence of how the ACA has “driven up the cost of health care.” In fact, that increase in employer-sponsored premiums is lower than the premium increase for the previous eight-year period, both in raw dollars and in the rate of growth. The total average family plan cost increased by 97 percent from 2000 to 2008, but it went up by 43 percent from 2008 to 2016.
The Obama administration, in fact, frequently touted the slower rate of growth of premiums and health care spending overall in recent years as evidence that the ACA has had a positive impact on costs. But as we pointed out several times, experts said that while the ACA may have had some impact, the sluggish economy was mainly responsible for the slow growth.
“Slower Premiums Growth Under Obama,” Feb. 6, 2015
Sanders on job creation: “Aren’t we all happy that under Obama, we created 15 million new jobs in the private sector?”
Sanders used this familiar Democratic talking point, which cherry-picks the record on job creation under President Obama. As we saw throughout the 2016 presidential campaign, Democrats started the clock in February 2010, the low point of the Great Recession, to get to 15 million private sector jobs created. (The figure is now 16 million, from February 2010 to January 2017, the last month Obama was in office.) But that ignores months of job losses at the beginning of Obama’s presidency.
Cruz on part-time jobs under the Affordable Care Act: “29ers are the millions of people across this country that have been forced into part-time work that used to have full-time employment and are now working 29 hours a week because Obamacare kicks in at 30 hours a week.”
For some time, Cruz has been making claims about the ACA causing an increase in part-time work. We wrote about it during a debate a year ago, and again, just last week. Under the ACA, employers with 50 or more full-time equivalent employees that don’t offer health care coverage to full-time employees face penalties. And full-time work is defined as 30 or more hours per week under the health care law.
As the nonpartisan Kaiser Family Foundation explains, “Opponents of the law are critical of this definition of full-time worker, claiming it unduly burdens certain industries … and provides disincentives to employers to hire full-time workers.” But so far, Bureau of Labor Statistics data don’t show evidence that “millions” are being “forced into part-time work that used to have full-time employment,” as Cruz said. Since the employer requirement began to go into effect in January 2015, the number of people working part-time for economic reasons — either because their hours were cut or full-time work wasn’t available — has gone down by 996,000, or nearly a million people. BLS defines part-time work as 34 hours per week or less.
That doesn’t mean that some people haven’t been affected by the 30-hour-a-week definition for full-time work. Some employers in the 2016 Kaiser Family Foundation/Health Research & Educational Trust health benefits survey said they had made changes, or planned to, in order to get under the full-time requirements, but a larger percentage of employers said they had moved part-time workers into full-time jobs.
KFF/HRET survey, Sept. 14, 2016: Two percent [of firms with at least 50 FTEs] said they changed or planned to change the job classifications of some employees from full-time to part-time so that they would not be eligible for health benefits, while 7% said they changed or planned to change job classifications of some employees from part-time to full-time so that they would become eligible for health benefits.