Donald Trump and Hillary Clinton have very different views on how to manage health care in the US. Clinton has made many claims and statements about the issue. CNN’s Reality Check Team put her statements and assertions to the test. The team of reporters, researchers and editors across CNN listened throughout the speech and selected key statements, rating them true; mostly true; true, but misleading; false; or it’s complicated. Reality Check: Clinton on Obamacare insuring African-Americans February 11, 2016 By Kate Grise, CNN During Thursday’s Democratic debate, Hillary Clinton said that “the Affordable Care Act has helped more African-Americans than any other group to get insurance, to be taken care of.” While there is no doubt that the Affordable Care Act – Obamacare – helped a large number of African-Americans get health insurance, the legislation has actually resulted in more Latino adults gaining coverage than any other group. By the end of 2015, the uninsured rate for Latinos had declined 7.8% since 2013, according Gallup-Healthways Well-Being Index. During the same time frame, the uninsured rate among African-Americans dropped 7.4 percentage points. Open enrollment for 2016 recently ended, but the federal government has not yet released official data about the enrollment totals. The Affordable Care Act has been criticized for creating a “coverage gap” that many African-Americans fall into. People are at risk of falling into this coverage gap when they are make too much money to qualify for Medicaid programs in states that chose not to expand their programs, but not enough to qualify for subsidized insurance on the federal health care exchanges. The Affordable Care Act was engineered to help people who were not covered by Medicaid expansion be able to afford coverage in the market place, but there are 19 states that had not expanded Medicaid eligibility. It is in those states that the coverage gap appears. According to a study by the Pew Charitable Trusts, 1.4 million of the 4 million Americans in the coverage gap are black. At the time of the study published in January 2015, 23 states had not expanded Medicaid, so the coverage gap may have shrunk since then. When Obamacare first rolled out, Latinos were less likely to enroll in the federal exchange, even though the administration put a lot of emphasis on reaching the Latino community – with a Spanish-language site and a call center with representatives fluent in Spanish. It would certainly be unfair to say that the Affordable Care Act has not helped many African-Americans gain coverage, but the legislation has helped more Latinos get coverage than any other group. Verdict: FALSE Reality Check: Clinton on drug overdose deaths in New Hampshire February 3, 2016 By Lisa Rose, CNN After taking a question on the topic of medical marijuana, Clinton expressed concern about substance abuse in New Hampshire. She said drug overdoses are a leading cause of death in the state, adding, “There have been more deaths by overdoses than car crashes.” Clinton is correct in that assessment, according to data from the Centers for Disease Control and Prevention and the National Highway Traffic Safety Administration. In 2014, 334 people died of drug overdoses in New Hampshire, according to the CDC. There were 95 traffic fatalities in New Hampshire the same year, according to the NHTSA. Although it’s questionable to conflate the topics of medical marijuana and opioid addiction, Clinton’s numbers are on the mark. We rate her claim TRUE. Reality Check: Clinton on numbers of people with health coverage January 17, 2016 By Nadia Kounang, CNN Clinton cited the Affordable Care Act as providing 19 million more Americans with insurance since its inception. However, according to the Department of Health and Human Services, only 17.6 million more Americans have been added to the rolls. Clinton may have been referring to a June 2015 Congressional Budget Office report, which estimates that if the ACA was repealed, 19 million Americans would lose health care coverage. Verdict: FALSE Reality Check: Clinton on health care costs January 17, 2016 By Tami Luhby, CNNMoney In defending the Affordable Care Act, Clinton said, “We now have driven costs down to the lowest they’ve been in 50 years.” First of all, it’s the annual growth in health care costs that had been at the lowest rate since the federal government began keeping records in 1960, not the costs themselves. It’s true that the growth in health care spending was at historically low levels of about 4% for several years following the Great Recession, according to federal statistics. But Obamacare doesn’t deserve the majority of the credit, experts say. About three-quarters of the slowdown was due to the weak economy, the Kaiser Family Foundation and Altarum Institute, a health research group, concluded in a 2013 report. The rest stemmed from efforts to keep spending down, including measures introduced under Obamacare. Also, the growth rate of health care spending is on the rise. In 2014, expenditures grew by 5.3%, driven primarily by the 8.7 million people who gained health insurance through Obamacare and by rapidly rising prescription drug costs. And the growth in spending is expected to pick up in coming years. Verdict: FALSE Reality check: Clinton on drug prices December 19, 2015 By Debra Goldschmidt, CNN Clinton said, “I want Medicare to be able to negotiate for lower drug prices just like they negotiate with other countries’ health systems. We end up paying the highest prices in the world.” Americans pay some of the highest prices for prescription medications – two to six times more for brand-name prescription drugs, according to the International Federation of Health Plans. For example, the arthritis drug Humira costs Americans $2,246 for a one-month prescription, compared to $881 in Switzerland and $1,102 in England. Medicare, the largest provider of medications, is prohibited from negotiating prices with drug companies. Some lawmakers have argued this is what’s behind the high prices. The pharmaceutical industry group PhRMA says the high prices are due to the cost of research and development to bring drugs to the market. Prescription drug spending increased 11.4% in 2014 and 9.6% in 2015 after steadily declining from 2000 to 2013, according to the Peterson-Kaiser Health System Tracker. The group attributes this to patents expiring and decreases in generic drug prices. Verdict: TRUE
