Political leanings: Conservative/Libertarian

2020 total spending: $60.6 million for the super PAC alone

Americans for Prosperity, a “social welfare” organization, along with Americans for Prosperity Action and Americans for Prosperity Foundation are conservative/libertarian groups heavily financed by Koch Industries, which is owned largely by billionaire Charles Koch. 

Americans for Prosperity says it engages in “broad-based grassroots outreach to advocate for long-term solutions” to “unsustainable government spending and debt, a broken immigration system, a rigged economy, and a host of other issues.” 

Emily Seidel, the former director of special projects at Koch Companies Public Sector, has been the chief executive officer of AFP since 2017. As reported by the Washington Post, Tim Phillips, who had served as the president since 2006, was “forced out of the organization” in late 2021. Phillips’ biography page has been removed, and Seidel is now listed on the site as AFP’s president and CEO.

Americans for Prosperity is registered with the IRS as a 501(c)(4), meaning it can operate for the “promotion of social welfare,” and can’t spend more than half of its budget on political activities. It does not have to disclose its donors.

AFP Foundation is a public charity registered with the IRS as a 501(c)(3).

AFP Action, which was established in September 2018 in Arlington, Virginia, is registered as an independent-expenditure-only committee, also known as a super PAC, with the Federal Election Commission. As a super PAC, it can raise and spend an unlimited amount of money, but can’t coordinate spending with political campaigns or donate directly to candidates. It must disclose its donors.

In June 2019, Seidel announced that AFP would be adding four, issue-specific PACs to its network: Uniting for Economic Opportunity, Uniting for Free Expression, Uniting for Free Trade and Uniting for Immigration Reform. These PACs can contribute directly to candidates. The four traditional PACs combined raised less than $120,000 in 2020.

During the 2020 election cycle, AFP Action raised $60.4 million, including nearly $6.5 million from the Freedom Partners Action Fund PAC and $8 million from Koch Industries, FEC filings show. Freedom Partners Action Fund is a super PAC that was unveiled in 2014 as part of Koch’s growing network of political committees. 

Charles Koch took over his father’s oil refinery in the 1960s and rebranded it as Koch Industries. The company has since diversified its portfolio by expanding into energy, finance, agriculture and technology. In 2020, Koch Industries had revenue of $115 billion. 

In 1980, David Koch, who helped establish Americans for Prosperity with his brother, Charles, ran as the vice presidential candidate for the Libertarian Party. David Koch died in August 2019.

AFP Action spent nearly $60.6 million in the 2020 election cycle, focusing largely on tight Senate races. Its largest independent expenditures were in support of Republican incumbents, including about $13 million for Sen. David Perdue of Georgia, who lost to Democrat Jon Ossoff in a runoff election. AFP Action spent an additional $3.6 million on ads opposing Ossoff. The group also successfully spent $9.7 million in support of Sen. Thom Tillis in North Carolina and $3.4 million to aid Sen. John Cornyn in Texas. 

For the 2022 election cycle, as of May 31, AFP Action had raised more than $20 million, including $6.5 million from Koch Industries.

Other major donors included Ronald Cameron, owner and chairman of Mountaire Corporation, T. Denny Sanford, founder of First Premier Bank, and Craig Duchossois, the executive chair of the Duchossois Group. Cameron gave $1.5 million, and Sanford and Duchossis both gave $1 million each.

AFP Action has spent more than $1.6 million in support of Eric Schmitt, who is running for the U.S. Senate in Missouri. It also spent more than $1.3 million supporting David Purdue, who lost his bid to become the 2022 Republican nominee for governor in Georgia.

FactCheck.org Undergraduate Fellow Sydney Nixon contributed to this article. 

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Political leanings: Conservative/Libertarian

2018 total spending: $10 million for the super PAC alone

Americans for Prosperity, a “social welfare” organization, along with Americans for Prosperity Action, a super PAC, and Americans for Prosperity Foundation are conservative/libertarian groups heavily financed by Koch Industries, owned by billionaire Charles Koch. 

Americans for Prosperity states its purpose as promoting “broad-based grassroots outreach to advocate long-term solutions” to issues including “unsustainable government spending and debt, a broken immigration system, a rigged economy.” AFP has 38 statewide chapters and claims to have recruited over 3.2 million activists and 100,000 financial supporters.

Tim Phillips, a Republican political consultant, has been president of AFP since 2006. Americans for Prosperity is registered with the IRS as a 501(c)(4), meaning it can operate for the “promotion of social welfare,” and can’t spend more than half of its budget on political activities. It also doesn’t have to disclose its donors.

AFP Foundation is a public charity registered with the IRS as a 501(c)(3). AFP Action is the political action committee for AFP. AFP Action was established in September 2018 in Arlington, Virginia. As a super PAC, it can raise and spend an unlimited amount of money, but can’t coordinate spending with political campaigns or donate directly to candidates. It also must disclose its donors.

AFP Action’s mission statement highlights a dedication to lowering taxes, eliminating trade barriers and other “regulations that stifle innovation,” decreasing health care costs, reforming criminal justice and immigration, improving education, and maintaining veterans’ benefits. In June 2019, Americans for Prosperity’s CEO, Emily Seidel, announced that AFP would be adding four, issue-specific PACs to its network: Uniting for Economic Opportunity, Uniting for Free Expression, Uniting for Free Trade and Uniting for Immigration Reform. These PACs can contribute directly to candidates. 

During the 2020 election cycle, AFP Action has raised $47.5 million, as of Oct. 14; nearly $6.5 million came from the Freedom Partners Action Fund PAC, and another $7 million came directly from Koch Industries.

Freedom Partners Action Fund is a super PAC that was unveiled in 2014 as part of Koch’s growing network of PACs. 

Charles Koch took over his father’s oil refinery in the 1960s and rebranded it as Koch Industries. The company has since diversified its portfolio by expanding into energy, finance, agriculture and technology. In 2018, Koch Industries had revenue of $110 billion. 

In 1980, David Koch, who helped established Americans for Prosperity with his brother, ran as the vice presidential candidate for the Libertarian Party. David Koch died in August 2019.

Americans for Prosperity Action has focused largely on tight Senate races in the 2020 cycle. As of Oct. 26, AFP Action’s largest independent expenditures have been in support of Republican incumbents: nearly $11 million to help reelect Sen. Thom Tillis in North Carolina, about $7.5 million for Sen. David Perdue of Georgia and $3.1 million for Sen. John Cornyn in Texas. 

During the 2018 midterm elections, Americans for Prosperity Action also targeted key Senate races. Most notably, AFP Action spent $1.4 million opposing Democrat Bill Nelson in Florida, and more than $3 million supporting Republican Marsha Blackburn in Tennessee. In the 2018 cycle, AFP Action raised $12.6 million, and had independent expenditures, which are expenditures for communications advocating for or against certain candidates, totaling more than $6.7 million.

According to 990 forms filed with the IRS, American for Prosperity, the 501(c)(4), received nearly $57 million in contributions and grants in 2017 and spent $2.9 million on political campaign activities. AFP Foundation raised $17.7 million in contributions and grants that year.

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Political leanings

Spending target: Part of a network aiming to spend $400 million

Americans for Prosperity is a “social welfare” organization that belongs to an influential network of politically active groups backed by Charles Koch, the libertarian billionaire owner of Koch Industries.

In June, company officials announced that David Koch, the other half of the famous “Koch brothers,” was stepping away from the family business he co-owned, and the conservative political operation he helped establish, because of health complications.

Active since 2004, AFP currently has 36 state chapters and says it “exists to recruit, educate, and mobilize citizens in support of the policies and goals of a free society at the local, state, and federal level.” The group’s longtime president is Tim Phillips, a Republican campaign strategist, and its five-person board of directors includes James Miller III, a former Federal Trade Commission chairman and budget director under President Ronald Reagan.

Americans for Prosperity is registered with the IRS as a 501(c)(4) and does not, nor is it required to, disclose its donors. The free market advocacy group claims it “has received financial support from more than 100,000 Americans in all 50 states.”

AFP is also the sister organization of Americans for Prosperity Foundation, a public charity registered as a 501(c)(3), and is linked to Americans for Prosperity Action, or AFP Action, a super PAC (political action committee) that was unveiled in September.

As a super PAC, AFP Action can raise unlimited amounts of money for elections, so long as it doesn’t donate directly to candidates or coordinate its spending with their campaigns. It must also periodically report its donors to the Federal Election Commission.

AFP reported receiving nearly $108 million in contributions and grants during the previous two-year election cycle, according to the 990 form it filed with the IRS for 2016. It also reported spending more than $13.4 million on “political campaign activities,” which were almost exclusively independent expenditures, or TV ads and other forms of political communication, that advocated against the election of Democrats in nine Senate and House contests. All but one of the candidates AFP targeted in 2016 lost their races.

It was widely reported in January that the Koch network of groups planned to spend as much as $400 million during the 2018 midterms. For its part, Americans for Prosperity already had spent nearly $9 million as of mid-October on independent expenditures, with more than $6.3 million going to oppose two Democratic incumbents, Sen. Tammy Baldwin of Wisconsin and Sen. Claire McCaskill of Missouri. 

Americans for Prosperity Action says on its website that it is “committed to working with anyone to advance positive policies” that will, among other things, “foster economic growth,” “eliminate burdensome regulations,” “eliminate trade barriers,” and “get our veterans the care they deserve.” But it, too, has spent millions of dollars on independent expenditures that only oppose Democrats or support Republicans.

In the Senate race in Tennessee, for example, AFP Action has spent over $2 million on ad campaigns promoting Rep. Marsha Blackburn and attacking former Gov. Phil Bredesen on health care.

And the super PAC recently “announced a seven-figure digital ad buy to supplement its grassroots and direct-mail efforts urging Floridians to vote against” Sen. Bill Nelson. Nelson “had 30 years” in the Senate “and made health care worse,” the ad says.

Information on how much AFP Action has raised, or who its donors are, is not currently available. Bill Briggs, a spokesman, told us the group will file quarterly financial reports to the FEC, which means it’s not required to submit its first report until Oct. 15.

Update, Oct. 19: AFP Action has received contributions totaling more than $7 million as of Sept. 30, according to its filing with the FEC. Ronald Cameron, chairman of Mountaire Farms, gave $1 million, and the group received $500,000 donations from Roger Stone, executive chairman of KapStone Paper, and Wayne Laufer, the retired former CEO of an oil and natural gas company. The largest donation — $5 million — came from Freedom Partners Action Fund, another super PAC in the Koch network.

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The conservative group Americans for Prosperity stretches the truth to attack Sen. Mark Pryor of Arkansas for “higher gas and grocery bills.”

• AFP blames Pryor’s vote to ban drilling in Alaska’s Arctic National Wildlife Refuge (ANWR) for higher gas prices. But the Energy Information Administration says drilling in ANWR would translate to little, if any, drop in prices at the pump.
• As for higher grocery bills, AFP cites Pryor’s vote to increase ethanol production, which raised the demand for corn and the price of livestock. But the Department of Agriculture says the impact on overall retail food prices was less than 1 percent.

The Arkansas race is one of nine competitive races considered critical to whether Republicans can regain control of the Senate. Already, there has been more than $7.5 million in outside money spent on the race, according to the Center for Responsive Politics.

The ad from Americans for Prosperity claims Pryor has “made things harder” for the state’s unemployed and working families “living paycheck to paycheck.” It shows images of downcast men and women, who could be “your neighbor, your friend, your daughter.”

AFP TV Ad: You know who they are. Your neighbor, your friend, your daughter. Maybe it’s you. 84,000 Arkansans out of work. Families living paycheck to paycheck. And Mark Pryor has made things harder. Voting with Barack Obama 90 percent of the time. Higher gas and grocery bills. Higher healthcare costs from Obamacare. Driving up the debt we owe China. Tell Mark Pryor Arkansas families need jobs, not bigger government.

It’s true, as the ad claims, that were 84,000 Arkansans out of work in May, according to the Bureau of Labor Statistics. But that’s the fewest number since November 2008.

As for the claim that Pryor has voted with President Obama 90 percent of the time, that was true last year, according to a vote analysis by CQ Weekly. But as we noted once before, Pryor also voted against Obama more than any other Senate Democrat last year.

More importantly, AFP provides weak evidence to support its claims that Pryor is responsible for such things as “higher gas and grocery bills” and “higher healthcare costs from Obamacare.”

Gas Prices

AFP cites three votes Pryor cast against domestic drilling to support its assertion that Pryor is responsible for higher gas prices. The three votes were for amendments which would have banned drilling in Alaska’s Arctic National Wildlife Refuge (ANWR).

ANWR covers over 19 million acres of land and water in northeastern Alaska. In 1980, the Alaska National Interest Lands Conservation Act (ANILCA) designated most of the area as protected wilderness, except for a section of about 1.5 million acres. This area along the coast — since referred to as the “1002 Area” after the section of the bill that defined it — is subjected to studies that relay to Congress the potential impacts of oil and gas exploration and development. ANILCA placed the area in limbo, and whether or not to authorize drilling in ANWR has been a political issue for nearly 40 years.

A 2008 report by the Energy Information Administration examined the impact of drilling in ANWR and concluded that oil production in that area would not significantly influence world oil prices. The projected potential price reduction would be around 41 cents to $1.44 per barrel of low-sulfur, light (LSL) crude oil in 2026/2027. The price of oil is currently a little over $100 per barrel. According to EIA, U.S. refineries produce about 19 gallons of motor gasoline from one barrel of crude oil. So, that translates to pennies per gallon at the gas pump. But since oil is a global commodity, EIA warned that there may not be any impact at all.

EIA, 2008: Assuming that world oil markets continue to work as they do today, the Organization of Petroleum Exporting Countries (OPEC) could neutralize any potential price impact of ANWR oil production by reducing its oil exports by an equal amount.

For some context, the average price of regular conventional gasoline was $2.34 per gallon when Pryor cast the last of the three votes cited by AFP, and it was $3.56 on July 14, according to EIA data. The price of gasoline fluctuated a good deal between those dates, and was $1.83 per gallon when Obama took office in January of 2009. In 2011, we looked into some of the claims about whether Obama was to blame for higher gasoline prices and found that much of the rhetoric was misplaced.

Finally, the claims about higher gas and grocery bills come immediately after the ad blames Pryor for “voting with Barack Obama 90 percent of the time.” That may leave the false impression that Pryor voted with Obama to raise prices, but, in fact, the ANWR votes cited by AFP were cast in 2003 and 2005, long before Obama became president — although then-Sen. Obama voted in favor of the two bills in 2005.

Grocery Bills

How was Mark Pryor responsible for “higher grocery bills”? Because he voted for the Energy Independence and Security Act of 2007, according to AFP. This, too, is a stretch.

In 2005, a section of the Energy Policy Act created the Renewable Fuel Standard program. That program mandates that a specified level of renewable fuel be blended into gasoline. In 2007, the program was expanded, increasing the required volume of renewable fuel. The rapid increase in demand for ethanol, which increased prices of livestock and corn products.

However, increased renewable fuel mandates were not the only cause of rising food prices. Other factors, such as “low global stocks, droughts, exchange rates, policy responses by some major trading countries, and rising incomes in some countries such as India and China, have also contributed to price increases,” according to the USDA.

In fact, the USDA said, in 2008, that the inflated price of corn had very little affect on overall retail food prices. According to the USDA’s Economic Research Service, “higher corn prices increase animal feed and ingredient costs for farmers and food manufacturers, but pass through to retail prices at a rate less than 10 percent of the corn price change.” Because food using corn as an ingredient makes up less than one-third of retail food spending, the report states, “overall retail food prices would rise less than 1 percentage point per year above the normal rate of food price inflation when corn prices increase by 50 percent.”

In April 2009, the nonpartisan Congressional Budget Office estimated that about 10-15 percent of the rise in food prices in 2008 could be attributed to ethanol subsidies. Food prices that year rose 5.1 percent, so the effect of ethanol subsidies was responsible for less than a 1 percent increase in the price of food that year.

CBO, April 2009: CBO estimates that from April 2007 to April 2008, the rise in the price of corn resulting from expanded production of ethanol contributed between 0.5 and 0.8 percentage points of the 5.1 percent increase in food prices measured by the consumer price index (CPI). Over the same period, certain other factors — for example, higher energy costs — had a greater effect on food prices than did the use of ethanol as a motor fuel.

The retail cost of food has, historically, risen about 2.5 percent to 3 percent a year, said Ephraim Leibtag of the USDA’s Economic Research Service. Factors such as weather, production issues and changing consumer demand, all effect the overall price of food, he said. And a spike in the price of any single commodity, such as corn, generally translates to only a small overall increase in retail food prices.

It is worth noting that the Energy Independence and Security Act passed the Senate with bipartisan support, 86-8. (Seven Republicans and one Democrat opposed it; and then-Sens. Obama, Hillary Clinton, Joe Biden, as well as John McCain, did not vote). And it was signed by then-President George W. Bush, not Obama, although the ad implies otherwise.

Food prices are up under Obama, but not as much as they were before he took office. The index measuring the average consumer price of all food and beverages (including restaurant meals) was 10.7 percent higher in May than it was when Obama took office five and a half years earlier, according to figures from the Bureau of Labor Statistics. For some perspective, food prices rose by 21.9 percent in the five and a half years prior to Obama taking office.

Health Care Costs From Obamacare

The ad also claims Pryor’s vote for the Affordable Care Act, aka Obamacare, is responsible for higher health care costs. AFP cites a Forbes story reporting on an analysis from the conservative Manhattan Institute that concluded that individual market premiums would rise by an average of 49 percent due to the new health care law.

But the ad does not mention that it is referring only to those who buy insurance on their own as opposed to through an employer. Just over 120,000 Arkansans, or 4 percent of the state’s population, purchased insurance on the individual market in 2012, according to the nonpartisan Kaiser Family Foundation.

A couple other big qualifiers (which we have noted previously when the Manhattan Institute report has been cited in attack ads): The institute didn’t adjust for the fact that the ACA requires certain minimum benefits, which many pre-ACA individual market plans didn’t meet. By and large, the post-ACA plans are more robust (whether purchasers like or want that or not). So it is not comparing similar types of plans before and after the ACA. And the institute’s figures don’t account for federal subsidies, which the Congressional Budget Office estimated would be extended to 80 percent of all those buying exchange plans nationwide.

As we have said repeatedly, premiums in the individual market can go up or down, perhaps significantly, depending on the individual.

And most Arkansans — 40 percent of the population — have insurance through their workplaces. Nationwide, employer-sponsored premiums for family plans went up 3.8 percent, on average, in 2013, according to the Kaiser Family Foundation’s annual employer health benefits survey. Since the ACA was passed in 2010, those premiums have gone up 5.9 percent, on average, per year, while in the five years before the ACA, premiums went up 4.8 percent, on average, per year.

When we have explored this issue in the past, we noted that experts attributed a small increase in work-based premiums directly to the ACA. When family premiums jumped 9 percent from 2010 to 2011, for example, experts told us that the law was responsible for a 1 percent to 3 percent increase, with the remainder due to higher medical costs. That was expected, as the law required the elimination of preexisting condition exclusions for children, the coverage of dependents on their parents’ plans up to age 26, free coverage of preventive care, and an increase in caps on annual coverage. Since that initial jump, however, the yearly employer-based premiums have risen at historically low rates.

Another 38 percent of Arkansans have government-sponsored health insurance, primarily Medicare or Medicaid, which would not be affected by the changes in the individual market.

— Eden Everwine and Robert Farley

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Americans for Prosperity is again citing an unscientific survey on health premiums to attack Democratic supporters of Obamacare – this time claiming in a new TV ad that premiums are up “by nearly 40 percent” in Michigan.

But the ad – which targets Democratic Rep. Gary Peters in the Michigan Senate race – ignores some important caveats about the 40 percent figure:

• The ad leaves the false impression that the rate hike applies to all health premiums, but the figure refers only to the no more than 5 percent of Michiganders who get insurance on the individual market.
• The 40 percent figure is based on a survey of six insurance brokers in the state, and according to a survey expert has no statistical validity.
• The figure, even if it were accurate, doesn’t account for improved coverage or government subsidies, which 80 percent of those in the new individual market exchanges are expected to receive.

The AFP ads began airing statewide in Michigan on May 28 and will run for several weeks. Peters, a three-term congressman, is locked in a see-saw battle with Republican and former Michigan Secretary of State Terri Lynn Land to succeed Sen. Carl Levin, who is retiring. Americans for Prosperity, which was founded by billionaire businessman and conservative/libertarian political activist David Koch, has actively opposed Peters for his support of the Affordable Care Act, though its ads have not always been accurate about the effects of the law.

The ad’s narrator talks about rising costs for Michigan families and alleges that Peters is “making things worse, voting for Obamacare, driving up our health premiums by nearly 40 percent.”

The ad suggests health insurance premiums are going up nearly 40 percent for everyone in Michigan, and that’s simply not the case. Employer-sponsored plans, where most Americans (and Michiganders) get their coverage, have seen premiums growing at historically low rates in the past few years.

Employer-sponsored premiums for family plans went up 3.8 percent on average in 2013, according to the Kaiser Family Foundation’s annual employer health benefits survey. The 2014 figures have not yet been published. Since the ACA was passed in 2010, employer-sponsored premiums have gone up 5.9 percent on average per year, while in the five years before the ACA, premiums went up 4.8 percent on average per year.

Health experts attributed to the ACA a 1 percent to 3 percent increase in employer-based premiums between 2010 and 2011 — when the law was first put into place — due to its required elimination of preexisting condition exclusions for children, the coverage of dependents on their parents’ plans up to age 26, free coverage of preventive care, and the increase in caps on annual coverage. But Kaiser Family Foundation CEO Drew Altman attributed at least some of the 2013 slowdown to the ACA as well.

That’s the picture for the employer-based plans held by most people in the state, but it turns out the AFP ad’s claim only relates to the no more than 5 percent of Michiganders in the individual market. Small print in the ad cites an April 7 story in Forbes, which is about a survey of 148 insurance brokers by Morgan Stanley, to help guide investor decisions about stock purchases. A state-by-state chart suggests a 35.6 percent increase in rates in the individual market in Michigan in 2014, according to responses from six insurance brokers in the state.

We’ve cautioned our readers before not to put too much stock in this Morgan Stanley survey.

Previously, it had been cited by AFP and others as the basis for a claim that rates have gone up 90 percent in New Hampshire — based on the response of one insurance broker in that state. Robert Santos, senior methodologist at the Urban Institute and past president of the executive council at the American Association for Public Opinion Research, told us then that the survey has no scientific validity with regard to the aggregated nationwide results. And that’s particularly true of the state results, which are based on so few responses, he said.

“Anyone would be on very tenuous ground in trying to make a state-specific inference,” Santos said. (A small notation below the state chart uses technical jargon to warn the same thing.)

Nonetheless, that’s exactly what AFP has done in Michigan.

It is quite possible, even probable, that rates have gone up in the individual market in Michigan. The Affordable Care Act requires plans to offer a minimum set of benefits, and that increases the cost of some plans. Those changes also make it extremely difficult, if not impossible, to compare individual market rates in 2014 to those in previous years for comparable policies.

We reached out to Michigan’s Department of Insurance and Financial Services for premium information on the individual market to see how the Morgan Stanley figures stand up. Caleb Buhs, a spokesman for DIFS told us that while the state did compile rate information for 2014 in the individual market, there is no comparable data from previous years.

“It would be difficult to compare 2014 rates to previous years anyway due to the changes required by the ACA; it wouldn’t be an apples-to-apples comparison,” Buhs wrote to us in an email.

DIFS is headed by Director Ann Flood, who was appointed in November 2013 by Republican Gov. Rick Snyder.

As we have said before, those in the individual market faced the biggest changes under the law. Premiums in that market could go up or down, perhaps significantly, depending on the individual. The market has seen great variation in pricing and the level of benefits offered. This makes it “difficult, if not impossible, to make generalized statements of the effect of the new law on premiums,” Linda J. Blumberg, a senior fellow with the Urban Institute’s Health Policy Center, wrote in a July 2010 report. And experts say that’s still the case.

In a September 2013 report, KFF said the changes in the market because of the law — such as essential health benefit requirements and no denial or price variation based on health status — “make direct comparisons of exchange premiums and existing individual market premiums complicated, and doing so would require speculative assumptions and data that are not publicly available.”

In 2009, the nonpartisan Congressional Budget Office said that the average premium per person in the individual market would be about 10 percent to 13 percent higher in 2016 because of the health care law compared with what the average would have been in that same year without the law’s passage. But it added that for most, subsidies would push their costs “well below” what they would have been charged in the absence of the law. In its latest report, the CBO says about 80 percent of an estimated 25 million joining the exchanges by 2024 will receive subsidies.

Last month, CBO reported that its 2009 estimate of premium increases in the individual market was too high. CBO expected plans in the new exchanges would closely resemble employer-based plans, but it has found, in general, “lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than employment-based plans do.” In other words, the plans so far aren’t quite as advantageous as employer plans.

CBO estimated the average cost of individual policies for the second-lowest-cost “silver” plan in the exchanges is about $3,800 in 2014. That’s expected to rise slightly to $3,900 in 2015, and then increase by about 6 percent a year until 2024.

All of that CBO data is looking at 2014 — when the exchanges were created — forward to 2024, not from 2013 to 2014 (which the ad highlights). Again, there likely was some increase in individual market rates this year due to new minimum requirements for individual market plans. So some are paying more to get better insurance, whether they wanted it or not. But for many, those increased costs were offset by government subsidies. And some individuals who previously faced higher rates because of medical conditions will pay less under the ACA, which requires that insurers not price individual market plans based on health status.

None of that is considered in the Morgan Stanley survey. And perhaps most important, it would be unwise to put much stock in a survey of six insurance brokers in Michigan to arrive at a solid number on premium increases in 2014.

— Robert Farley

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In the Alaska Senate race, the special interest battle is on: A radio ad from GOP frontrunner Dan Sullivan complains of “outright lies” in a TV ad from a super PAC supporting Democratic Sen. Mark Begich. The pro-Begich ad, meanwhile, complains about the billionaire Koch brothers supporting Sullivan’s campaign. We didn’t find “outright” falsehoods, but both ads are misleading.

Sullivan says that Begich “was unconcerned” about the closing of an oil refinery near Fairbanks and the loss of 80 jobs there. The ad claims Begich said, “It’s the private sector making a decision.” But that was only part of Begich’s response. He went on to say: “We have to do everything we can to be sure those who have jobs, those families, have opportunities.”

Meanwhile, the super PAC, Put Alaska First, claims in its TV ad that Sullivan “remained silent about jobs being lost” at the refinery, which is owned by Koch Industries. Not exactly. Sullivan’s campaign “remained silent” not on the lost jobs, but on an anti-Koch brothers campaign by the Democratic Senatorial Campaign Committee that highlighted the fact that Koch Industries is closing the Alaska refinery while Americans for Prosperity, an advocacy group created by David Koch, is spending hundreds of thousands attacking Begich.

Both sides are stretching the facts in an attempt to make the other look uncaring on the loss of Alaskan jobs and beholden to outside special interest groups.

Koch Ads and Refinery

In this toss-up Senate race, Begich has been weathering a storm of attack ads from Americans for Prosperity, to which David and Charles Koch, co-owners of Koch Industries, have been major contributors. Begich has fought back with ads saying these “billionaire outsiders” should “go home” and highlighting the fact that Koch Industries is closing the Flint Hills Resources oil refinery.

In late April, the pro-Begich super PAC released another ad featuring the Flint Hills closing, but this time going after Sullivan, the former Alaska attorney general whose poll numbers put him neck-and-neck with Begich. The ad says Sullivan “remained silent” on the loss of jobs at the refinery, and it says the Koch brothers are “supporting his campaign.”

The ad features an Alaska resident saying to camera: “When the North Pole refinery closes, 80 jobs are gone. Those jobs mean everything for a lot of folks around here. But for those lower 48 billionaires that are shutting it down, those jobs are just numbers on a spreadsheet.”

Koch Industries owns Flint Hills Resources, which announced in February that it was closing its North Pole refinery and laying off 81 employees by Nov. 1. Pollution of the local water supply, which was an issue before Koch acquired the refinery in 2004, was one reason the refinery said it was ending its operations. Jeff Cook, Flint Hills’ regional director of external affairs, told Anchorage’s KTUU-TV that the groundwater cleanup costs were “in the tens of millions of dollars, and along with the economic challenges of refining in Alaska, [it’s] caused us to make this decision.”

The Alaska Dispatch reported that weeks before the closing announcement the refinery had asked the state Department of Environmental Conservation to allow much higher concentrations of the chemical sulfolane in groundwater than the state had considered acceptable. The Dispatch wrote: “The company has tangled with the state Department of Environmental Conservation over what the appropriate level of cleanup is for the site and on property near the refinery. It is also battling the former owner of the refinery in court over liability for the spill.” While it will no longer refine oil, the facility will be an oil shipping and storage terminal.

The loss of 80 jobs at a refinery owned by Koch Industries — and the fact that the Koch-backed Americans for Prosperity is spending heavily in the race — has made the closing a focal point of this campaign.

The Put Alaska First ad goes on to say that Sullivan “remained silent about jobs being lost here,” while on screen viewers see: “Sullivan’s campaign has declined comment.” The citation is for a March 6 post by Alaska political blogger Amanda Coyne, who wrote about the DSCC’s campaign, called “GOP addicted to Koch,” which highlights the refinery closing and Americans for Prosperity’s spending on ads attacking Begich. Coyne wrote: “The DSCC is pressing the Senate GOP challengers for a response. Dan Sullivan’s campaign has declined comment.”

So, his camp declined to comment on Democratic criticism of the Koch brothers’ actions in Alaska and advertising in the Senate race.

Sullivan’s camp counters in its radio ad that Sullivan “worked hard to keep the Flint Hills refinery open while he was our [Department of Natural Resources] commissioner.” That’s a reference to a DNR-negotiated contract extension in 2013 for the state to sell barrels of royalty oil to the refinery. Kevin Banks, director of DNR’s Division of Oil and Gas, told Fairbanks’ Daily News Miner that the state wanted to sell the oil at a competitive and reasonable rate. “We were interested in negotiating a contract that would ideally keep these guys in business,” Banks said. But a year later, the refinery is closing.

The super PAC’s ad then ties Sullivan to the heavy anti-Begich spending by Americans for Prosperity, saying, “And those same billionaires, the Koch brothers, are supporting his campaign.” On screen, the ad says: “Close to $1 million on ads.” The citation is for a March 19 Alaska Public Radio story that said Americans for Prosperity had “already spent close to $1 million on ads against Mark Begich.”

The AFP ads haven’t mentioned Sullivan, nor has the group or the Koch brothers given directly to Sullivan. Some voters may get the impression from the ad that Sullivan had spent close to $1 million on ads thanks to Koch money. And Sullivan counters in his radio ad that he “has never taken a dime from the Koch brothers.” True, but it’s certainly reasonable to say that ads attacking the incumbent are, by extension, ads supporting the leading challenger. Whether Sullivan wanted AFP’s help or not, he’s getting it.

Sullivan’s Radio Response

Sullivan responded to the Put Alaska First attack with a radio ad in late April that begins: “Mark Begich’s liberal allies have no shame, telling outright lies about former Attorney General Dan Sullivan.” The PAC’s ad was misleading, mainly on its characterization of Sullivan’s response to the refinery closing. But “outright lies”? It doesn’t rise to the level of an outright falsehood, let alone a “lie,” which would mean there was intent to deceive, something we don’t know.

Sullivan’s ad goes on to offer its own misleading take on Begich’s response to the loss of jobs at the refinery. It says: “It was Begich who was unconcerned about the closing of the Flint Hills Refinery, saying quote, ‘It’s the private sector making a decision.’ ” Begich did say this, but he followed it up with, “We have to do everything we can to be sure those who have jobs, those families, have opportunities.”

The news story that includes that quote, from KTUU-TV, also paraphrased Begich as saying “that the closure could cause a trickle-down effect that will impact businesses like shipping, as a local source of jet fuel disappears, and the Alaska Railroad, which moves product from Flint Hills south, as many as 30 cars a day, five days a week.”

Voters can make up their own minds as to which candidate cares more — or less — about the refinery jobs. But the very article the Sullivan campaign cites shows that Begich wasn’t “unconcerned.”

Sullivan’s ad accurately says that he “has never taken a dime from the Koch brothers” and that Begich “has taken campaign cash from the Kochs.” The pro-Begich ad didn’t claim that Sullivan took money from the Kochs, only that the brothers are “supporting his campaign.” Voters should know the Koch Industries money to Begich was a $5,000 donation in 2010 to his leadership PAC. That’s 0.5 percent of the total amount the Great Land PAC has raised since the 2010 cycle (a total of $989,000). The PAC gives money to other Democratic congressional candidates and funds non-campaign expenses.

The ad goes on to say that “Begich’s false attacks on Sullivan are funded by liberal special interests in Washington, D.C., not Alaskans.” That’s a point Sullivan’s spokesman, Mike Anderson, also made to us via email: “[W]hat is at the height of hypocrisy is the fact that Put Alaska First is attacking the influx of outside spending when the PAC is almost entirely funded by liberal billionaires who are not from Alaska,” he said.

Indeed, Put Alaska First, headed by local lobbyist Jim Lottsfeldt, has received 82 percent (or $645,000) of its contributions from Senate Majority PAC, a group partly run by former aides to Senate Majority Leader Harry Reid.

But outside-of-Alaska money is the norm in this race, and both candidates are relying on those dollars heavily. According to the Center for Responsive Politics, 75 percent of Begich’s contributions and 89 percent of Sullivan’s are from out-of-state sources. This is perhaps not surprising: As the Center for Responsive Politics notes, Senate candidates from “the most sparsely populated states may get nearly all their money from out of state,” and Alaska ranks 47th among the states in terms of population.

Still, each candidate attempts to challenge the Alaska credentials of the other in these ads. Put Alaska First says, “Maybe if Sullivan was actually from Alaska, he’d care more about our jobs than his own,” while Sullivan’s radio ad counters, “Begich lives in a million-dollar house in Washington, D.C., not Alaska.”

Sullivan isn’t from Alaska – he’s from Ohio – but made Alaska his home from 1997 to 2002, then worked in Washington under then-National Security Adviser and later Secretary of State Condoleezza Rice, and came back to Alaska in 2009. As the Anchorage Daily News explains, his “Alaska authenticity” has been questioned by both Begich and GOP candidate Lt. Gov. Mead Treadwell. Begich — who, of course, now works in Washington as a senator — is a former mayor of Anchorage and was born and raised in that city.

— Lori Robertson, with Rachel Finkel

The post ‘Outright Lies’ in Alaska? appeared first on FactCheck.org.

The Line: The Affordable Care Act is hurting families.

The Party: Republican

Several ads attacking the Affordable Care Act make the general claim that the law is “hurting” families. It’s true that some who bought their own insurance on the individual market could end up paying more. But millions of uninsured families will gain coverage under the law, many of them through free or low-cost Medicaid or Children’s Health Insurance Program coverage. And millions of insured families will get federal subsidies to help pay for coverage.

The “hurting families” claim has been a tagline on several Americans for Prosperity ads, including ones against Rep. Gary Peters of Michigan and Rep. Bruce Braley in Iowa. A March ad from Republican Sen. Thad Cochran in Mississippi also says, “Sen. Thad Cochran understands Obamacare hurts our families.” An ad from Senate candidate Sid Dinsdale in Nebraska features a small-business owner saying of Dinsdale: “He understands how Obamacare and regulations hurt our families.”

In January, an Americans for Prosperity ad attacking Arizona Rep. Ron Barber said the ACA “means higher costs for struggling families.” And in another version of the struggling-families theme, Senate candidate Paul Hollis attacked Sen. Mary Landrieu in Louisiana in an ad, saying that families in the state deserve better than “the high premiums, large deductibles and canceled policies of Obamacare.”

As we’ve explained before, some Americans who buy their own insurance will pay more, and some will pay less, depending on the individual. So, some families could be “hurt” or “struggling,” while others are helped with lower costs. How many? We don’t know.

But we do know that millions of uninsured families will gain coverage under the law — the nonpartisan Congressional Budget Office estimates that there will be 25 million fewer uninsured Americans due to the ACA as early as 2016. And many — 12 million — will gain free or low-cost Medicaid or Children’s Health Insurance Program coverage. (Research by the Urban Institute and RAND Corp. indicates that millions of the previously uninsured have already gained coverage.)

Those with adult children also could benefit from the law’s provision allowing dependents up to age 26 to be on their parents’ plan (the administration estimates 3 million young adults have gained coverage because of that requirement). Others will save money on insurance through subsidies, which are available to a family of four buying its own coverage and earning between $23,850 and $95,400 (that’s between 100 percent and 400 percent of the poverty level).

For instance, in Arizona, where the AFP ad said that “struggling families” were facing “higher costs,” the Medicaid expansion would provide insurance to an additional 240,000 Arizonans, as estimated by Republican Gov. Jan Brewer, and enable the state to continue Medicaid coverage for 50,000 adults without children in their homes. An additional 210,000 residents who were previously eligible for Medicaid are expected to sign up now, prompted by the law, as estimated by the Kaiser Family Foundation.

The expansion makes Medicaid available to those earning up to 138 percent of the federal poverty level, which is $32,913 for a family of four. The eligibility level pre-ACA varied by state.

Louisiana, Mississippi and Nebraska are among the 19 states that have decided not to expand Medicaid under the law. But even there, KFF estimates that 58,000, 57,000 and 20,000 residents, respectively, would newly join Medicaid. These folks would have been eligible previously but will now sign up, likely prompted by news of the law and the individual mandate to have insurance or pay a fine. If the states do decide to expand Medicaid, KFF estimates 398,000 would be added to the rolls in Louisiana, 231,000 in Mississippi, and 88,000 in Nebraska. More than half of the uninsured in Louisiana and Mississippi earn 138 percent of the poverty level or less. In Nebraska, 26 percent to 47 percent of the uninsured are in that category.

Those who qualify for subsidies in 2014 to buy their own coverage on the exchanges include an estimated 313,000 in Arizona, 344,000 in Louisiana, 204,000 in Mississippi, and 122,000 in Nebraska, according to KFF estimates. Qualifying for subsidies, however, doesn’t necessarily mean their costs would be lower than what they had been paying for insurance before. The subsidies are on a sliding scale, and are based on a maximum percentage of income that individuals would pay for a benchmark plan where they live.

For instance, those earning 100 percent of the poverty level would pay a maximum of 2 percent of their income for insurance, with subsidies making up the difference, while those earning up to 400 percent of the poverty level pay a maximum of 9.5 percent of their income. The Kaiser Family Foundation further explains: “If the premium that a person or family faces for the benchmark plan in their area is higher than the maximum percent of income defined in the law for their income, they are eligible for a tax credit and the tax credit is equal to the difference between the premium for the benchmark plan and the defined percent of their income. The benchmark plan is the second-lowest-cost plan in the silver cost-sharing tier offered through the marketplace for the area where they live.”

It’s a bit complicated. A family of four earning $90,000, then, would pay a maximum of $8,550 for the year for the second-cheapest “silver” plan, or $713 per month. On HealthCare.gov, we found cheaper insurance — $562 per month — for a bronze-level plan for a hypothetical family of four (nonsmokers) living in Adams County in southwest Mississippi. The second-lowest-cost silver plan, with a lower deductible, was $715 per month, after subsidies. (The KFF subsidy calculator showed similar results.)

Whether any of that is a good deal depends on the family and various individual factors — such as health status and the coverage it had before. It’s just one example of how blanket statements about “struggling” or “hurting” families attempt to paint the law in black and white when reality isn’t so clear-cut.

One more example: We recently fact-checked another AFP ad in which a Michigan mother says that her family’s “new plan is not affordable at all” and that the law is “destroying the middle class.” But we found her situation is an example of how families can benefit from the law. The Michigan family of seven could have selected a cheaper exchange plan, as opposed to the unsubsidized private plan it chose, but the family did not want the children to be on the Children’s Health Insurance Program.

— Lori Robertson

The post ACA ‘Hurting’ Families appeared first on FactCheck.org.

The Line: Premiums and health care costs are ‘skyrocketing’ under the Affordable Care Act.

The Party: Republican

Several anti-Obamacare ads have made the claim that premiums or health care costs have gone up under the law. And “skyrocketing” is the word of choice in these attack ads. That’s misleading. Premiums for those who buy their own private insurance will go up or down, in some cases significantly, depending on individual circumstances. Employer-sponsored premiums, where most Americans have coverage, are not “skyrocketing,” and neither are health care costs. In fact, the growth of both has been at historically low rates in the past few years.

Three Americans for Prosperity ads in January used the word, including an ad against Michigan Rep. Gary Peters that said, “Families are losing their doctors and health care costs are skyrocketing.”

An AFP ad against Sen. Mary Landrieu of Louisiana said that “millions of Americans have lost their health care and millions more are facing skyrocketing costs.”

A third ad, this one against Iowa Rep. Bruce Braley, said, “Our plans canceled. Our doctors lost. Our premiums skyrocketing.”

And that’s not all. Another AFP ad supporting Montana Rep. Steve Daines said the congressman opposed Obamacare and “fought against rising health care costs.” Another ad against Sen. Jeanne Shaheen in New Hampshire said that “families are paying more for expensive health plans.”

Most Americans — 48 percent of the population — have insurance through their workplaces. Employer-sponsored premiums for family plans went up 3.8 percent on average in 2013, according to the Kaiser Family Foundation’s annual employer health benefits survey. Since the ACA was passed in 2010, those premiums have gone up 5.9 percent on average per year, while in the five years before the ACA, premiums went up 4.8 percent on average per year. Not exactly “skyrocketing.”

Overall national health care spending is growing at historically low rates. President Obama has boasted that “health care costs overall are actually going up more slowly over the last three years than in the last 50,” which is true. From 2009 to 2012, the growth has been under 4 percent per year. Drew Altman, CEO of the Kaiser Family Foundation, wrote in September 2012 of the slow recent growth in both premiums and spending: “These are strikingly low numbers to those of us who have been studying health costs for a long time.”

But, as we’ve pointed out a few times, experts, including those at KFF and the Centers for Medicare & Medicaid Services, say that’s mainly due to the slow economy. The ACA could be having some indirect impact, though, as Altman explained in a September 2013 column.

As more Americans gain insurance, and the general population increases, health care spending overall will go up. But costs per individual won’t necessarily go up; they’ll vary. National health care spending includes all spending on health care, by individuals, businesses, insurers, and the government.

A small increase in work-based premiums can be linked directly to the ACA. When family premiums jumped 9 percent from 2010 to 2011, experts told us that the law was responsible for a 1 percent to 3 percent increase, with the remainder due to higher medical costs. At the time, the law had required the elimination of preexisting condition exclusions for children, the coverage of dependents on their parents’ plans up to age 26, free coverage of preventive care, and the increase in caps on annual coverage.

It’s the individual market, where people buy their own coverage, and small-employer market that face the major changes under the law. And that’s where premiums can go up or down, perhaps significantly, depending on the individual. It’s difficult to draw general conclusions about what’s happened to people’s premiums in the volatile individual market, where policyholders frequently switch plans or leave the market. And it may remain difficult in the years to come. Five percent of Americans — about 15.8 million people — bought their own private insurance on this market in 2012, according to the Kaiser Family Foundation.

The market has seen great variation in pricing and the level of benefits offered. This makes it “difficult, if not impossible, to make generalized statements of the effect of the new law on premiums,” Linda J. Blumberg, a senior fellow with the Urban Institute’s Health Policy Center, wrote in a July 2010 report. And experts say that’s still the case.

In a September 2013 report, KFF said the changes in the market because of the law — such as essential health benefit requirements and no denial or price variation based on health status — “make direct comparisons of exchange premiums and existing individual market premiums complicated, and doing so would require speculative assumptions and data that are not publicly available.”

From 2009 to 2010, the average increase in individual market premiums, for those who had such coverage for more than a year, was 15 percent, according to a Kaiser Family Foundation survey. That’s five times the average increase for employer-sponsored family plans that year, and three times the average increase of employer plans for the five years before the ACA.

But premiums can vary state to state, with different state regulations, and person to person, as insurers were able to price based on medical conditions and gender. Under the ACA, insurers on the individual and small-group market are limited to pricing premiums based on family size, geography and, to a limited extent, age and tobacco use. Insurance companies also can’t deny coverage based on preexisting conditions.

That’s a major change in how those policies are priced. The obvious implication is that those with health conditions could well pay less in premiums than they did when their health was a cost factor. And the reverse is likely true: Healthy individuals could end up paying more. (For example, one Arizona man who has leukemia had been paying $855 per month for a single policy on the individual market; last fall he was able to find a cheaper plan. But his previous premium was also very expensive: In 2010, the Arizona per person per month average was $241, according to KFF. That means some would have had significantly cheaper plans than this man to begin with, and so, they may not have saved money with new insurance.)

The change in price would depend on what type of coverage one had before: Bare-bones plans have to be upgraded with more generous benefits and limits on out-of-pocket costs. Those added benefits may be welcomed by some and scorned by others who preferred a cheap plan with fewer benefits. The ACA requires individual market and exchange plans to include essential health benefits, including maternity coverage, prescription drug coverage and preventive care benefits. More generous benefits do cost more, and unless those moving to more generous plans also received subsidies, they probably paid more.

The other factor that impacts total out-of-pocket costs is whether one qualifies for federal subsidies, available to those earning up to 400 percent of the federal poverty level, which is $46,680 for a single person. The nonpartisan Congressional Budget Office has estimated that 80 percent of those buying policies on the exchanges — which would include at least some who previously bought their own insurance as well as those who didn’t have insurance — will qualify for subsidies, with an average subsidy of $4,700 in 2014.

So, are premiums “skyrocketing”? Overall, no. But some individuals who buy their own insurance could face significantly higher rates, depending on their health status, previous plan and other factors. Other individuals — particularly those with health conditions and those who qualify for subsidies — could pay less.

A series of Americans for Prosperity ads also claims that “millions are paying more and getting less,” a reference to those who had their individual market policies canceled because they didn’t meet the law’s requirements. But there’s no evidence of that, either.

A few of the personal stories that Americans for Prosperity has mentioned or highlighted in other ads show that some who were on the individual market are paying less. But while some will find better coverage and better deals on the exchanges — particularly if they qualify for subsidies — it’s certainly true, as we’ve said, that not everyone will come out on the “winning” side.

But “paying more and getting less”? We can’t say that there aren’t some individual cases that might fit such a description, and whether one gets “less” can be a subjective call. But there’s no evidence that “millions” are in such a predicament.

The millions of uninsured who are expected to gain coverage under the law may or may not pay “more,” depending on their medical costs and subsidy status. But they’re certainly not “getting less.”

— Lori Robertson

The post ‘Skyrocketing’ Premiums appeared first on FactCheck.org.

The Line: Millions of people have lost their health insurance and their doctors because of the Affordable Care Act.

The Party: Republican

President Obama gave ad-makers plenty of fodder last year when his promise — “If you like your health care plan, you can keep your health care plan” — clearly was proven false. We had said years earlier that Obama couldn’t make that promise to everyone, but the claim made headlines when Americans received cancellation notices for individual market plans that no longer met the law’s requirements.

Critics of the law now say millions lost their health insurance. But that’s misleading. Those individual market plans were discontinued, but policyholders weren’t denied coverage. And the question is, how many millions of insured Americans had plans canceled, and how does that compare with the millions of uninsured Americans who gained coverage under the law.

There is evidence that far more have gained coverage than had their policies canceled.

The conservative Americans for Prosperity has made the canceled policies a theme in its advertising. In one series of ads, a soft-spoken woman says: “Millions of people have lost their health insurance. Millions of people can’t see their own doctors.” That ad, which aired in February and March, targets Democratic senators in three states: Sens. Mark Udall in Colorado, Mary Landrieu in Louisiana and Mark Pryor in Arkansas. The ad aired against Sen. Kay Hagan in North Carolina in November, and it’s also been used to target a few House members.

Another AFP ad targeting Landrieu — and airing in January — said that “millions of Americans have lost their health care.”

It’s true that insurance companies discontinued health plans that had covered millions of people who had bought them directly rather than through an employer. That’s because those plans didn’t meet the coverage standards of the new law.

But those policyholders didn’t lose the ability to have insurance. In most cases, insurers offered them an alternative plan, though there were some instances of companies exiting the individual market altogether.

Whether offered an alternative or not, individuals could shop for insurance on the federal and state marketplaces, or through a broker or insurance carrier directly. Many were likely eligible for federal subsidies to help pay for insurance, resulting in better coverage and lower rates for some. But the specific plan they had was indeed discontinued. (More than half of those with canceled policies were likely to be eligible for federal assistance, according to Urban Institute research, and about 80 percent of all those buying plans on the exchanges are expected to qualify for subsidies, according to the Congressional Budget Office.)

How many individual market cancellations were there?

The most commonly used figure is 4.7 million, based on reporting by the Associated Press last December. But there’s reason to doubt the accuracy of that figure. An analysis of a more recent poll by researchers at the Urban Institute puts the figure at somewhere around 2.6 million.

An AP story that ran Dec. 26 said that “at least 4.7 million Americans received the cancellation notices,” and gave state-by-state figures for the “number of policies scheduled to be canceled.”

But the news agency didn’t say exactly how it arrived at the other figures that went into the 4.7 million total, making the reporting impossible for outsiders to verify. In three states, the figures appear to be inflated. Washington state’s insurance commissioner, for example, has publicly stated that the AP’s figure of 290,000 discontinued policies in that state is “inaccurate.” In a news release on his official website, Insurance Commissioner Michael Kreidler said that there were only 278,000 total in the individual market at the end of September. Recent reports by our fact-checking colleagues at Politifact.com and the Washington Post show the numbers were too high in Florida and Kentucky.

And now, new research also gives reason to think the AP estimate may be inflated.

In a March 3 posting on the website of the journal Health Affairs, two researchers from the Urban Institute analyzed findings from a nationwide poll and said, “Our findings imply that roughly 2.6 million people would have reported that their plan would no longer be offered due to noncompliance with the ACA.” And in this case, the methodology is made explicit.

In December 2013, the Urban Institute’s quarterly Health Reform Monitoring Survey of adults ages 18-64 included this question: “Did you receive a notice in the past few months from a health insurance company saying that your policy is cancelled or will no longer be offered at the end of 2013?” And of the 522 people polled who were covered by non-group policies, 18.6 percent said yes, their old plan would no longer be offered because it didn’t meet the new coverage standards that went into effect Jan. 1.

And if 14 million people were covered by non-group policies nationwide (as indicated by the National Health Information Survey of the U.S. Centers for Disease Control and Prevention), that percentage translates to 2.6 million non-group policies discontinued, the authors stated.

To be sure, there is always a statistical margin of error in any random-sample poll. Lead author Lisa Clemans-Cope told us in an email that statistically, there is a 95 percent certainty that the true percentage whose non-group policies were discontinued falls somewhere between 16.2 percent and 23.3 percent. That would put the number at anywhere between about 2.3 million and 3.3 million.

That range could be higher or lower depending on what number is used for the total who had non-group coverage in the first place. The Urban Institute authors cite a study published last year that found estimates of the total number of people covered by non-group policies ranged from 9.55 million to 25.3 million. So if 18.6 percent of non-group policyholders got notices that their policies were being dropped because of the new law, as the poll indicates, then the actual number whose plans were dropped could be as low as about 1.8 million or as high as 4.7 million (coincidentally, the same as the AP’s figure), depending on how many had such policies in the first place.

The authors, as noted, picked an estimate that fell in the middle of this range to arrive at their figure of 2.6 million discontinued policies. Until and unless better evidence comes along, that’s the most solidly based figure available.

How many “millions” so far have gained coverage?

The early numbers on enrollment in the exchanges and Medicaid don’t tell us how many of the enrollees were previously uninsured — despite some claims from Democrats to the contrary. The Obama administration disclosed on April 10 that 7.5 million had signed up for plans on the exchanges, but we don’t know how many previously had insurance. The Medicaid rolls increased by more than 3 million through the end of February, the administration also said, a figure that would reflect both those newly eligible under the law and previously eligible but now signing up.

But a survey funded by the Robert Wood Johnson Foundation and conducted by the Urban Institute indicates that many of those signing up for the exchanges and Medicaid may have been uninsured. It found that 5.4 million of the previously uninsured had gained coverage between September and the beginning of March. The exchanges launched Oct. 1.

An April 8 report by the nonprofit RAND Corp. put the figure of newly insured higher. Based on a nationwide poll, Rand estimated that there had been a net gain of 9.3 million insured “adults” as of mid-March, when the poll was being conducted. That includes marketplace and Medicaid enrollment, as well as an increase in employer-based enrollment.

Neither of those figures includes an estimated 3 million young adults who gained coverage in 2010 and 2011, likely because of the law’s provision allowing them to stay on their parents’ policies.

RAND also estimated that 700,000 who previously had individual market plans were now uninsured. The survey didn’t ascertain whether those newly uninsured were due to cancellations or voluntarily dropped coverage.

It will be some time before more concrete coverage numbers are available. The RAND numbers are extrapolated from a survey, and one with sizable margins of error. The estimate of 9.3 million newly insured has a margin of error of 3.5 million people, meaning researchers have a high degree of confidence that the true number would be between 5.8 million and 12.8 million. And the estimate of 700,000 uninsured who previously had individual market plans carries a margin of error of 900,000, putting the likely real number somewhere between zero and 1.6 million people.

Millions more are expected to gain insurance because of the law nationwide in the coming years. The nonpartisan Congressional Budget Office estimates that there will be 25 million fewer uninsured due to the ACA as early as 2016.

Losing Doctors?

The AFP ad also makes the claim that “millions of people can’t see their own doctors,” but there’s no evidence that all those who had individual market policies discontinued ended up not being able to keep their own doctors. Anecdotally, we know of some folks who were able to keep the same doctor on a new insurance policy. But those are only a few individual stories. One of our guiding principles here is the saying, “The plural of anecdote is not data.”

It is true that using a smaller network of providers is one way insurers can reduce premium costs, and there is evidence that insurers are indeed doing that for exchange plans. As Deborah Chollet, a senior fellow at Mathematica Policy Research, a nonpartisan research firm, told us in December: “The narrow-network plans offered by some issuers are intended to (a) maximize negotiating leverage with providers by narrowing their PPOs; and (b) thereby reduce premiums to attract consumers.”

Limited networks have existed for some time, as anyone with an HMO, PPO and the like can attest. There are no available statistics showing whether the plans on the new exchanges have more or less narrow networks than existed in the individual market previously. But, again, insurers certainly are limiting their networks to price their plans competitively.

Karen Pollitz, a senior fellow at the Kaiser Family Foundation, told us: “It’s definitely the case (based on conversations with insurers and with providers) that insurers have decided to limit networks in some instances in order to price their health plans more competitively.” She continued: “It’s also definitely the case that some providers have declined to participate in some of the new health insurance networks, holding out for higher fees from some insurers in return for a promise to participate exclusively in their networks. This is market competition at work — not entirely transparent, unfortunately, so it’s not yet clear what the impact will be on patients.”

— Lori Robertson and Brooks Jackson

The post ‘Millions’ Lost Insurance appeared first on FactCheck.org.

In a classic case of misdirection, the Senate Majority PAC claims the “out-of-state billionaire Koch brothers” are spending millions to elect Republican Bill Cassidy so that he will “fight for them” on issues such as their “fight to let flood insurance premiums soar.” The problem: Cassidy championed the flood insurance legislation the Koch brothers opposed.

The ad also makes a wholly indefensible claim that the Koch brothers — through the conservative advocacy group Americans for Prosperity — “cut off hurricane relief for Louisiana families.” AFP opposed a Sandy relief bill — because it said the bill was laden with pork and should be offset with other budget cuts. AFP maintains that it did not oppose funding for legitimate Sandy relief. But more importantly, that had nothing to do with aid to “Louisiana families.” Other evidence cited by the Senate Majority PAC for this claim is even thinner.

The Senate Majority PAC, a Democratic super PAC, has gone on the offensive against the Koch brothers in an attempt to educate voters about the agenda behind Americans for Prosperity, which has invested heavily in attacking Louisiana Sen. Mary Landrieu and other Democratic candidates in the midterm elections.

Announcer: We’ve been battered by hurricanes, lost everything to floods. And for thousands of Louisianans, flood insurance and hurricane relief were our only protection. But the out-of-state billionaire Koch brothers funded the fight to let flood insurance premiums soar, helping the insurance companies. And cut off hurricane relief for Louisiana families. Now they’re spending millions to buy a Senate seat for Bill Cassidy, so he can fight for them. If the Kochs and Cassidy win, Louisiana loses.

Let’s start with the claim that the “Koch brothers funded the fight to let flood insurance premiums soar, helping the insurance companies.” This relates to the National Flood Insurance Program, which is billions of dollars in the red. In 2012, the House passed legislation that sought to phase in premium hikes to bring them in line with the actual cost of risk — so that taxpayers aren’t left picking up the difference. The bill, however, threatened to result in “stratospheric” flood insurance rate hikes for many homeowners in flood-prone areas such as in Louisiana.

Late last year, legislation was proposed to soften the blow of rate hikes by reinstating grandfathered rates and capping premium increases. AFP and a coalition of other conservative groups opposed the legislation, arguing that it is not “reasonable to leave taxpayers on the hook for insuring private property.”

But here’s the rub: Cassidy — the target of the Senate Majority PAC ad — led the charge for the legislation, which ultimately passed and was signed into law by President Obama. In a letter to New Orleans’ Times-Picayune, Republican Rep. Michael Grimm, who introduced the bill, thanked Cassidy for his efforts in shepherding it to fruition.

Grimm, March 22: The process to bring this critical legislation across the finish line was by no means easy and would not have been possible without the hard work and leadership of Rep. Bill Cassidy of Baton Rouge.

… I am extremely grateful to Dr. Cassidy for being such a dedicated partner in our efforts to protect homeowners throughout the country. Without his contributions, the House’s ability to forestall the catastrophic effects of Biggert-Waters and pass a far-reaching relief bill for the hard-working folks from the Big Apple to the Big Easy may never have been realized at all.

Cassidy, himself, put out a press release with a timeline highlighting his involvement in the legislation at every stage. In other words, here’s the logic: A is funded by B. B supports position C. Therefore, A supports C. Except, in this case, A does not support C. In fact, A worked against C. As Glenn Kessler, our fact-checking colleague at the Washington Post, put it: “If anything, Cassidy could run an ad saying that he took on the Kochs — even though they are backing him — and beat them.”

‘Cut Off Hurricane Relief for Louisiana Families’?

This is the second Senate Majority PAC ad that targets Cassidy by going after the Koch brothers. The first ad makes a similar, but more generic claim that the Koch brothers/AFP “even tried to kill relief for hurricane victims.” It’s true that AFP urged senators to vote against the Hurricane Sandy disaster-aid supplemental, H.R. 152, “unless the legislation is fully offset with other spending reductions.” AFP President Tim Phillips said it was also concerned that “Washington politicians are using this tragedy to secure billions in spending for their own pet projects like fisheries in Alaska, new cars for Homeland Security or tree planting on private property.”

Americans for Prosperity wasn’t the only group unhappy with the bill. Taxpayers for Common Sense, a nonpartisan group that tracks government earmarks, raised concerns about extraneous and non-emergency spending in the bill, and argued that at least the non-emergency spending should have been offset.

“I don’t think supporting offsets and calling for stripping non-emergency funding is the same thing as trying ‘to kill relief for hurricane victims,’ ” Steve Ellis of Taxpayers for Common Sense told us via email. “Especially since a lot of that bill wasn’t about relief at all.”

AFP spokesman Chris Neefus assured us via email that AFP did not oppose the underlying hurricane relief. He noted that AFP supported South Carolina Rep. Mick Mulvaney’s amendment to offset $17 billion in Sandy disaster relief by cutting 1.63 percent from every federal agency, including the military — though the amendment failed 162-258. AFP also supported an amendment from Sen. Mike Lee to offset the full cost of Sandy relief through across-the-board cuts from defense and domestic appropriations. That amendment failed 35-62.

Nonetheless, a comment from AFP’s New Jersey director at the time gave us pause. Steve Lonegan, then Americans for Prosperity’s New Jersey state director — who went on to run unsuccessfully for the U.S. Senate in New Jersey in 2013 — made a comment to reporters in December 2012 that suggested opposition to any kind of federal disaster aid.

“Tragic things happen every day to people – worse things than having your house flood – and we don’t hand them a check,” Lonegan said. “Having your shore house flood doesn’t rank … This is not a federal government responsibility. We need to suck it up and be responsible for taking care of ourselves.”

AFP’s Neefus told us Lonegan is no longer with AFP and that he was expressing his personal opinion, not that of AFP.

“Let me be unequivocal that AFP believes disaster relief funds are a reasonable function of government,” Neefus said. “We have weighed in on the side of responsible disaster budgeting, not eliminating disaster relief.”

More important, the latest ad makes the claim that the Koch brothers “cut off hurricane relief for Louisiana families.” The Sandy relief bill — which was cited atop back-up material the Senate Majority PAC sent us for the claim — has nothing to do with Louisiana residents. The other articles cited by Senate Majority PAC to back up the claim are even more tenuous. For one, the Senate Majority PAC cites AFP’s efforts in 2006 to strip $14 billion in pork spending from a Senate emergency bill to, in part, pay for repairs related to Hurricane Katrina. But it’s one thing to oppose pork attached to a spending bill, and quite another to oppose the underlying hurricane relief. There’s simply nothing to this claim.

More generally, the Senate Majority PAC points to AFP’s opposition to the 2012 Budget Disasters Act on the grounds that Congress ought to offset disaster relief spending with cuts from elsewhere in the federal budget. In addition, they note that AFP supported Rep. Paul Ryan’s 2013 budget plan, which called for nearly $5.3 trillion less in spending over 10 years than did Obama’s budget. Some liberal groups warned that could lead to cuts in disaster aid, but as we have noted in the past, the Ryan budget plan didn’t include enough detail to justify that kind of specific speculation.

In short, there is not enough there to justify a claim that the Koch brothers, “cut off hurricane relief for Louisiana families.” Nor is there any shred of evidence to speculate that Cassidy would support such efforts if elected to the Senate.

— Robert Farley

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