Weiner mangles details of health care reform

Rep. Anthony Weiner went on the Fox News Channel to offer a spirited defense of House Democrats' plans for health reform, taking questions on the show Fox & Friends .

Brian Kilmeade, one of the Fox & Friends hosts, asked him, "What if your company who gives you health care insurance, which you know happens more often than not, says: 'You know what? I'm looking at my budget. I'm going to go the public option, because it's cheaper. The quality might not be as good, but when I come to balance my books, I'm still offering my people insurance. The quality is dropped and I save some money.'"

"Prohibited under the plan," said Weiner, a Democrat from Brooklyn, N.Y. "Under the plan, for the first five years your employer not only has to keep the coverage, but you can't migrate to the public plan. The concern was we didn't want a giant movement."

Weiner's point that employers can't immediately shift workers to the public option is right. But almost all the other details are wrong.

We've read the 1,000-page House bill and there is no rule that employers have to keep coverage for five years, for example. We asked Weiner's office for an explanation and didn't hear back.

To examine the rest of his comments, let's recap the basics of the House bill: Employer-provided insurance stays in place. Individuals and small businesses go to a new national health care exchange, where they can comparison shop for health insurance. Private insurers compete on the exchange, but one of the plans is a public option, a low-cost, basic insurance plan offered by the government.

During year 1, small businesses with 10 or fewer employees can use the exchange. During the year 2, it's 20 or fewer employees. During year 3, a health choices commissioner has the authority to phase in businesses with more employees. The legislation doesn't say if or when every employer would be allowed on the exchange.

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The health bill would also set new standards for coverage, requiring insurers to cover basic procedures and adhere to new consumer protection rules.

Employer-sponsored insurance will have to meet those same consumer protection rules, but they have a five-year grace period before they have to comply. (See Section 102 on page 17 of the House bill.) So employers can keep their current plans for up to five years before the plans have to conform to the new rules. But there's nothing in the bill that forces them to keep their current coverage. They can change insurance providers just as they do now. Only if they choose to drop coverage would they have to pay an additional tax.

Weiner also says, "you can't migrate to the public plan." That's true only if you're talking about large employers having access to the exchange. Individuals are allowed to shop on the exchange right away, if they're willing to drop their employer-sponsored coverage. "You" might not want to, though: In most cases, employers pay part of their workers' insurance premiums. A worker with a large employer who drops coverage from their job to go to the exchange would lose that contribution.

In fact, this point also undermines the premise of Kilmeade's question. He said that if he's an employer, he can "go the public option, because it's cheaper. The quality might not be as good, but when I come to balance my books, I'm still offering my people insurance." This is not an accurate description of how employers are allowed to use the exchange.

The bill clearly states that employers cannot select a particular insurance plan for their employees on the exchange. (See Section 202, page 81.) The employers can contribute a set amount to help cover their employees, but they can't force their workers to pick the public option if the workers are willing to pay more to get private insurance. So the idea that employers can sign their workers up for the public option to save money is wrong.

Getting back to Weiner's statement, he said that an employer has to keep coverage for the first five years. But there's nothing in the legislation that forces companies to keep coverage, although large employers would face a tax penalty if they dropped it altogether.

He also says you can't migrate to the public plan. It's true that employers can't force their workers onto the public plan, but individuals can select it if they choose to. The only thing Weiner gets right is that employers can't dump their workers into the public option. Almost all the details are wrong. We rate his statement Barely True.