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Checking the facts on Medicare claims

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When Rep. Paul Ryan, R-Wis., was chosen as Mitt Romney’s running mate on the Republican ticket, Democrats in the north country were gleeful.

Mr. Ryan’s plans for Medicare had helped sink a Republican in a right-leaning district in 2011. Democrats here thought they could do the same thing to Republican Matthew A. Doheny, running against Rep. William L. Owens, D-Plattsburgh, by relentlessly tying him to Mr. Ryan’s Medicare plans.

But Republicans had their own Medicare riposte: Mr. Owens, they said, voted to “cut” Medicare.

How do the claims stack up? According to the experts, they’re half-true at best, and downright misleading in some instances. Republicans, the Doheny campaign and outside groups have made varying claims, employing varying degrees of fact.

Let’s start with what did happen.

Mr. Owens voted for President Barack Obama’s health care law. The law included $716 billion in Medicare spending reductions over 10 years, accomplished via cuts in payments to hospitals and insurance companies. The law specifically states that Medicare benefits won’t be touched.

An ad from the Center for Individual Freedom, a nonprofit political group, claims that Mr. Owens broke an election-year promise not to cut Medicare.

“He said he’d oppose Medicare cuts. But one day after taking office, Owens voted for a government takeover of Medicare,” the ad states. “He voted for Obamacare.”

Supporters of the law and health-care experts say that the Affordable Care Act is far from a government takeover of health care. And more broadly, the Owens promise on Medicare was to oppose cuts to benefits. And Mr. Owens stuck to his promise. He didn’t vote to cut benefits. The ad leaves viewers with the opposite impression.

But what about those spending reductions?

The claim has been repeated many times, and the fact-checking website PolitiFact.com has rated similar claims as “half-true” at best.

In a National Republican Congressional Committee ad launched last week, Mr. Owens is accused of supporting $716 billion in cuts to the Medicare program. A Doheny ad made a similar accusation, while splicing in menacing photographs of Mr. Owens, House Minority Leader Nancy Pelosi and President Obama.

Some argue that the $716 billion in Medicare spending reductions is a cut. Others say that it isn’t. That dispute largely boils down to semantics.

But at the end of the day, will it hurt beneficiaries? That’s a question that straddles an ideological debate. Conservatives tend to say yes; liberals tend to say no.

“It doesn’t come out of benefits,” said Igor Volsky, a deputy editor of Think Progress, a production of the liberal Center for American Progress. “You simply lower the rate of growth over 10 years.”

So the law, Mr. Volsky said, cuts spending, but does so by eliminating “waste, fraud and abuse.” In the end, the lifespan of the Medicare program is extended to 2024, he said.

The spending reductions don’t touch beneficiaries; instead, they change the way that hospitals and insurance companies are paid for providing services, particularly the Medicare Advantage program, Mr. Volsky said. The government pays 18 percent to 19 percent more for private Medicare Advantage plans than it does for typical Medicare, Mr. Volsky said.

Indeed, Mr. Owens said that Medicare Advantage inefficiencies were exactly the reason that those spending reductions were included in the Affordable Care Act.

“Those cuts are there, but the way they’re being characterized, that’s inaccurate,” he said. “I think the Affordable Care Act is a very good down payment on lowering costs for health care, and particularly Medicare.”

Rea Hederman, an official at the conservative Heritage Foundation in Washington, D.C., said that hospitals won’t be able to cope with those spending reductions. And he said that Congress will have to come back and make up for a hole in funding to hospitals, meaning that, eventually, Mr. Obama’s health-care law won’t be “deficit-neutral,” as supporters claim. Either that, or 15 percent of hospitals and nursing homes could go bankrupt, Mr. Hederman said.

“It’s impossible for (health-care providers) to live up to the cuts in Obamacare,” Mr. Hederman said. “They don’t think it’s going to happen.”

Democrats are often quick to point out that those same spending reductions are included in the budget put forward by Rep. Ryan.

Mr. Doheny has assiduously refused to tie his own fortunes to the Ryan budget, but mapped out a blueprint for Medicare that is similar, in some ways, to the Ryan budget’s plan by allowing more private competition to enter the marketplace.

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