Throw-granny-from-the-cliff ad asks what the U.S. would be “without Medicare"

Amid discussion of the Medicare overhaul proposed by Rep. Paul Ryan, R-Wis., an ad created by the Agenda Project, a liberal group, cut through the clutter quite dramatically -- though with critics saying it was literally over the top.

The ad, set to "America the Beautiful," shows a man pushing an elderly woman in a wheelchair toward a scenic overlook. At first, the woman is happy, enjoying the sights. But then the man picks up the pace, veers past warning signs and rushes toward a cliff. When he reaches the edge, he tips over the wheelchair, and the woman falls dramatically over the ledge. The man walks calmly away.

The ad contains no dialogue, so its point is made through a series of superimposed statements: "In 1965, Americans made Medicare into Law. Today, Medicare provides the health insurance for 46 million Americans. More than half of Americans on Medicare live on less than $28,000 a year. Now, Republicans want to privatize Medicare. Is America beautiful without Medicare?"

We decided to check two claims in this ad. One, which we’ll look at in a different item, is whether the Ryan plan would "privatize Medicare." The other, which we’ll investigate here, is whether the Ryan budget proposal would leave the country "without Medicare."

First, we’ll provide a summary of the Ryan plan, which was passed by the House in a near-party-line vote and which has more recently prompted some Republicans to oppose it, amid fears that voters will not be comfortable with its approach.

Ryan’s plan would dramatically cut federal spending in the name of fiscal discipline. One of its major features is dramatically restructuring Medicare, the government-run health insurance program for those 65 and older. Right now, Medicare pays doctors and hospitals set fees for the care beneficiaries receive. Medicare beneficiaries pay premiums for some types of coverage, and younger workers contribute payroll taxes.
   
Ryan’s plan leaves Medicare as is for people 55 and older. In 2022, though, new beneficiaries would be insured by private insurance companies rather than the federal government,  although they would receive "premium support" -- financial assistance from the government for buying insurance. People who need more health care would get a little more money.

The proposal requires private insurers to accept all applicants and to charge the same rate for people the same age. The plans would comply with standards set by the U.S. Office of Personnel Management, which administers the Federal Employees Health Benefits Program. The plan gradually raises the Medicare eligibility age to 67 and provides smaller premium support to high earners.
   
We looked at this question before, in relation to an ad run by the Democratic Congressional Campaign Committee, the House Democrats’ campaign arm. In part, the ad claimed that by passing the proposal in the House, Republicans had "voted to end Medicare." In conjunction with other misrepresentations, that formulation earned the ad a rating of Pants on Fire.

We concluded that, while the Ryan plan represents a dramatic change in Medicare, it was not a proposal to "end" Medicare. Seniors would continue to be offered coverage under the proposal, and the program’s budget would increase every year although at a rate not expected to match the rise in medical costs. The government would still play a critical role in directing the program and setting standards.

Many Democrats criticized our ruling, arguing that the Ryan proposal would change the program so fundamentally -- revoking its status as a government-run, single-payer system -- that the plan ends Medicare. As Erica Payne, the founder and president of the Agenda Project, put it, "While it is true that a rose by any other name will smell as sweet, a rose with no petals is just a thorny stick."

But we disagree, because dramatically changing a program is not the same as ending it.

When we contacted Payne for her view, she said that PolitiFact drew the wrong conclusion from the ad’s use of the phrase "without Medicare." To Payne, the question asks a broader philosophical question rather than making a statement about the Ryan plan.

The ad "seeks to broaden the discussion around this specific issue by posing a question of national philosophy," Payne said. "‘Is America beautiful without Medicare?’ is a question all Americans should be discussing. In these budget-challenging times, it is critical to examine what we value most, and which of those things that we value are actually critical to our national pride, indeed to our identity. ... A lawmaker who believes our country is as ‘beautiful’ without Medicare would probably be more likely to support gutting the program to a shadow of its former self."

We understand her argument, but we think a reasonable viewer -- especially having just "seen" an old lady being dumped over a cliff -- would take away a more concrete meaning to the question, namely that the Ryan plan ends Medicare. Because we found other problems in the DCCC ad that we did not find in the Agenda Project ad, we’re not giving this particular claim a Pants on Fire rating. But the notion that the Paul Ryan budget proposal would leave the country "without Medicare" merits a rating of False.

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