Today, Fox News' Neil Cavuto hosted Betsy McCaughey to discuss health care reform, and as happens nearly every time McCaughey discusses health care reform, McCaughey made a false claim about what health care means.
Discussing an Institute of Medicine panel that has begun work on advising the government on what essential benefits should be covered by all insurance plans bought through the new exchanges set up by the health care reform law, McCaughey again advanced the false claim that the law pushes "virtually everyone into a one size fits all plan."
By way of example, McCaughey later misleadingly claimed: "Say a family of four can't choose a plan that skips over infertility coverage and is heavy on pediatric care."
McCaughey herself partially debunked her "one size fits all" claim later in the segment, acknowledging to Cavuto that the section of the bill to which she is referring, § 1302, applies only to "plans that are sold in the exchanges, people who buy their own health insurance," not people who receive insurance coverage through employers. Kaiser Permanente reports that "employer-provided health insurance [will] remain dominant" under the health care law. Thus, McCaughey is not talking about "virtually everyone" as she originally claimed.
Furthermore, even for the minority of people who buy individual plans through the exchanges, McCaughey's "one size fits all" claim is simply untrue. The law provides a floor, not a ceiling. There is nothing in the bill that stops insurance companies from offering additional benefits.
And contrary to McCaughey's claim, it's not likely that people who have no need for infertility coverage will be forced to purchase plans that cover infertility. Whether the plans are offered through the exchange or not, nothing in the bill requires coverage for infertility treatment.
The section of the law McCaughey cites lists several items that all plans offered through the exchanges must cover:
(A) Ambulatory patient services.
(B) Emergency services.
(D) Maternity and newborn care.
(E) Mental health and substance use disorder services, including behavioral health treatment.
(F) Prescription drugs.
(G) Rehabilitative and habilitative services and devices.
(H) Laboratory services.
(I) Preventive and wellness services and chronic disease management.
(J) Pediatric services, including oral and vision care.
Beyond those 10 items listed in the bill, the Secretary of Health and Human Services is given the power to "define the essential health benefits."
But not even the American Society for Reproductive Medicine (ASRM) -- an organization of fertility doctors -- thinks that the Secretary of Health and Human Services will require infertility coverage. According to an August 2010 ABCNews.com report, Sean Tipton, a spokesman for ASRM said that, despite the health care reform law: "I am not terribly optimistic that this country is suddenly going to treat infertility appropriately. ... We have a crumby history."