True or False, with Senator Ted Cruz

Sen. Ted Cruz wrapped up a 21-hour grandstanding session Wednesday on the evils of Obamacare, a typically “Cruzian” address that included a bizarre comparison of the law’s implementation to the Nazi domination of Europe and a reading of the Dr. Suess classic Green Eggs and Ham.

Let’s look at the falsehoods concocted in Mr. Cruz’s rambling speech:

Ted Cruz: “I rise today in opposition to Obamacare. I rise today in an effort to speak for 26 million Texans and for 300 million Americans. All across this country Americans are suffering because of Obamacare. Obamacare isn't working.”

Status of Mr. Cruz’s claim: FALSE

Mr. Cruz speaks neither for 26 million Texans nor for 300 million Americans. Instead, as a recent Pew Poll shows, the tactics of Mr. Cruz and the Tea Party to cut off funding for Obamacare through the current spending bill are not popular with most Americans. Fifty percent are against the tactic; 38% support it.

Ted Cruz: “I understand why many supported Obamacare in the beginning. But if you look at the facts, if you look at the evidence, if you look at what is happening when the American people have tried it, it is not working.”

Status of Mr. Cruz’s claim: FALSE

A significant number of the provisions of Obamacare insurance provisions do not become available to the American public until 2014, so it is unclear what isn’t working if it isn’t even operational yet. Indeed, some of the provisions that have taken effect, like allowing children to stay on their parents' health insurance until their 26th birthday, are highly popular. Mr. Cruz’s hysteria is being driven by the impending signup period for purchasing coverage via the insurance exchange marketplaces that were mandated by Obamacare. Enrollment opens for six months on Tuesday, Oct. 1. Coverage under those polices doesn't begin until Jan. 1. If you need more information about signing up for Obamacare, you can find it at the website. You can also access a calculator for figuring out if you and your family qualify for subsidies in the form of tax credits to reduce the price of your insurance.

Ted Cruz: Obamacare “is driving up health care costs.”

Status of Mr. Cruz’s claim: FALSE

This is just not true. Although it is too early to tell what long-term impact on costs the law will have, recent data indicates a slow-down in health spending that has been attributed partly to the health-care law (and partly to the recession). The Obama administration also claims, in statistics released on Tuesday, that health care premiums will be 16% lower, on average, than initially estimated. It will cost an individual, on average, $328 per month (before tax credits which will substantially lower costs for low income individuals and families) to purchase insurance. But rates will vary depending on variables including income, state of residence (some examples from New Jersey and Southeastern Pennsylvania are here), and family size. Using the Kaiser Family Foundation health care premium calculator, a family of three (one adult, two kids) living in Philadelphia with an income of $40,000 would pay, after tax credits, $2,587 per year.

Ted Cruz: “It is the government that decides who gets health care and who doesn't. And you know what? Americans overwhelmingly don't want that.”

This kind of inflammatory rhetoric doesn’t reflect the reality of what Obamacare is designed to do. While most the discussion about the Affordable Care Act involves the reform of insurance coverage to eliminate things like the exclusion of those with pre-existing conditions and the use of tax credits to make that insurance available to those with low incomes, the ACA also links hospital reimbursements for Medicare to quality of outcomes, supports new efforts to prevent chronic disease, promote public health and increase the supply of health-care workers – and, of course, expands Medicaid in states that agree, insuring millions more Americans.

It is also important to consider the preventive/public health aspects of the law. For example, the ACA requires coverage of a number of preventive services, such as well child visits and screenings for disease. The rules on current insurance policies and coverage as well as on mandated coverage for all policies beginning Jan. 1 are here. Under the ACA you are eligible for many free preventive screenings, including vaccinations. You are eligible for blood pressure and cholesterol tests, mammograms, colonoscopies, cervical cancer screenings, and other measures depending on your age and vulnerability.

Janet Golden, a Rutgers University history professor, specializes in the histories of medicine, childhood and women. Michael Yudell is an associate professor at Drexel University School of Public Health.

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