Brat misstates Spanberger's stance on 'Medicare for All'

U.S. Rep. Dave Brat keeps telling voters in Virginia’s 7th Congressional District that Democratic challenger Abigail Spanberger wants a $32 trillion tax increase to pay for a "government takeover of health care."

You don’t have to look hard to find his claims.

"My opponent wants a tax increase of $32 trillion -- that's with a  'T' -- to pay for her socialist healthcare plan," Brat, a Republican, wrote in a Oct. 11 Facebook post.

"She and Nancy Pelosi want to...double down for a $32 trillion socialized takeover, government takeover, of health care," he said during and Oct. 15 debate with Spanberger.

"And we know Spanberger’s health care plan would bankrupt Medicare as we know it - a $32 trillion spending increase that would double our taxes," says a Brat TV ad that debuted on Sept. 17.

"Spanberger’s healthcare piece costs $32 trillion and will require you doubling the personal income tax rate - your personal taxes doubled - and the corporate rates doubled," Brat said during an Aug. 20 radio interview on the John Frederick Show,

Spanberger has repeatedly denied Brat’s charge. So we decided to test Brat’s claim - that Spanberger wants a $32 trillion tax increase to pay for an overhaul of health care - on the Truth-O-Meter.

Brat’s Explanation

Brat says his claim stems from a comment Spanberger made during a May 31 debate with Dan Ward, her opponent in this spring’s Democratic primary.

The candidates were asked for their "feelings about single-payer healthcare," a system in which one entity - the government - is responsible for providing health insurance and paying claims. Brat notes that Spanberger, in reply, said, "...I do, in principle, support single payer…".

Brat says those words prove Spanberger supports the Medicare for All Act of 2017, proposed by Sen. Bernie Sanders, I-Vt. The bill, which is languishing in the Senate Finance Committee, would create a Medicare program that covers all Americans under one plan. Employers would be barred from offering competing insurance. Sanders’ plan would cover primary care, hospital visits, lab services, medical devices, maternity care, prescriptions and vision and dental care. The only copayments would be for prescriptions.

The Mercatus Center, a free-market oriented research group at George Mason University, estimated Sanders’ plan would cost $32.6 trillion over 10 years. "A doubling of all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan," the study, published in July 2018, said.

The nonpartisan Congressional Budget Office has not published a cost analysis of Sanders’ plan.

Brat has company among Republicans in claiming Spanberger endorsed Sanders’ plan.  The Congressional Leadership Fund, a GOP super PAC aligned to Speaker Paul Ryan, has run a TV ad that accuses Spanberger of "supporting a $32 trillion government takeover of healthcare and raising middle-class taxes."

Full picture

Spanberger, in answering the debate question, only briefly addressed a single-payer  system. She spent most of her energy calling for the passage of Medicare X, a health care proposal that would give people under 65 an option: They could remain privately insured, or buy into a new government-run program that would use the network of Medicare providers and costs. The Medicare system is now reserved for elderly and disabled citizens.

Brat focuses on one clause in Spanberger’s answer. Here’s a fuller excerpt of her  remarks.  

"I support Medicare X, which is a public option as a path towards universal coverage in the achievement of universal coverage. I believe that a public option is the way that we can achieve that goal through government-provided insurance that does, in fact, build off the existing Medicare network, because it exists in every single zip code across the country and that is the way we can achieve health care for everyone. And I do, in principle, support single-payer, but I believe universal coverage through a public option is the method I would pursue."

Spanberger never mentioned Sanders. Nor was the senator referenced by the questioner or in the response by Ward - Spanberger’s primary opponent.

This is important because Brat not only accuses Spanberger of championing a single-payer system, he links her to Sanders’ proposal and its costs.The Mercatus Center, a libertarian research organization affiliated with George Mason University, estimates Sanders’ plan would cost $32.6 trillion over 10 years and wouldn’t be paid for even if income and corporate taxes were doubled.

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Sanders’ plan is very generous. It would cover hospital visits, primary care, medical devices, lab services, maternity care, prescriptions as well as vision and dental care. It would not subject consumers to any out-of-pockets costs, except a copay on prescriptions.

But if Congress wanted to, it could pass a single-payer system that would be cheaper than Sanders’ plan, albeit still costly. For example, some single-payer countries require copays for medical treatment, some have don’t cover dental and eye care, others don’t cover long-term care.

In other words, it’s possible to support "in principle" a single payer system but be opposed to Sanders’ plan.

Spanberger repeatedly has said she’s against Sanders’ bill and denounced Brat’s attack as "false." It’s a mystery what she meant when she said she supports single payer "in principle." We found no evidence of her making a similar statement. When we asked Justin Jones, spokesman for Spanberger’s campaign, to explain the remark, he said, "She hasn’t seen any single-payer plan she supports." He wouldn’t elaborate.

Brat says Spanberger changed her position on Sanders’ bill after an Aug.3 editorial in the Richmond Times-Dispatch criticized its $32.6 trillion estimated cost and said the measure would lead to "socializing medicine." The editorial didn’t mention Spanberger.

Final Note: Medicare X has not been subjected to a rigid cost analysis. Supporters say it would at least break even because the bill requires that premiums "cover the full actuarial cost of offering such a plan, including administrative costs." A 2013 CBO study concluded a similar program would reduce federal deficits by $158 billion over 10 years.

Our Ruling

Brat says Spanberger "wants a tax increase of $32 trillion - that’s with a `T,’to pay for her socialist health care plan."

The charge - central to Brat’s campaign - stems from Spanberger’s May 2018 comment that she does "in principle, support" a single-payer health system. Brat offers that statement as proof that Spanberger backs a very generous single-payer proposal proposed by Sen. Sanders of Vermont in which all health insurance would come the federal government.

Spanberger has caused some confusion because she’s never explained her remark. It is possible, however, to be receptive to a single-payer program that’s cheaper and more limited than Sanders’ plan.

Brat offers no evidence that Spanberger has endorsed Sanders’ plan, and she says she opposes it. On the other hand, Spanberger has repeatedly backed a Medicare X proposal that would allow the government to compete with private insurers. Unlike Sanders’ plan, people would retain choices on where to buy coverage.

Brat conveniently has chosen a position for Spanberger that she never took. We rate his statement False.