On April 15, Sen. Bernie Sanders (I-Vt.) became the first and only presidential candidate so far to attend a Fox News town hall for the 2020 cycle. In the midst of a heated exchange regarding the cost of health insurance, Sanders claimed that the average self-employed family of four pays $28,000 a year for health care.
Does Sanders’ statement correctly characterize the health care costs for the average self-employed family?
During the Fox News town hall, Sanders attempted to explain how he would pay for his “Medicare for All” system. To make his point, Sanders offered up a hypothetical picture of what the single-payer system could look like for the average self-employed family of four:
“Let’s just say, hypothetically, you are self-employed, and you have — you’ve got a husband and two kids, OK? Family of four. You know how much that family is paying today for health care? $28,000 a year.
[…] We are saying to that family of four, ‘You ain’t gonna pay that $28,000. You’re not paying any more premiums, you’re not paying any more co-payments, you’re not paying any more deductibles. How’s that?’ $28,000, you’re not paying. But does that mean you’re not gonna pay something? Of course it does. You’re going to pay more in taxes.”
Watch the video below:
Sanders appears to be alluding to data from the 2018 Milliman Medical Index (MMI). The MMI reported that the average cost of health care in 2018 for a typical family of four who gets its insurance through an employer was $28,166. The MMI broke down the costs into the following three categories:
- 56% ($15,788) – Employer contribution
- 27% ($7,674) – Employee contribution
- 17% ($4,704) – Employee out-of-pocket
However, Sanders is specifically discussing a “self-employed” person who would be purchasing insurance through the health insurance exchange. Sanders appears to be using this data as a proxy for the figure for the self-employed family.
IJR reached out to a number of sources, including the folks at HealthCare.gov, to try to find information on what the average family of four who purchases insurance through the exchange is paying, but there doesn’t seem to be a national database where these numbers are calculated.
There are a few reasons for this. First, the costs of going through the exchange vary from state to state. Also, depending on a person’s income, many people who purchase health care via the exchange are eligible for partial subsidies, which result in fluctuating costs.
Additionally, according to a Gallup poll, a rising number of people may have elected not to get health insurance altogether in 2018 due to factors such as the repeal of the Affordable Care Act’s (ACA) individual mandate and the rising costs of the premiums associated with the ACA health insurance plans.
In order to get a more definitive conclusion as to whether or not it was appropriate to utilize the MMI’s data to speculate about the health care costs of self-employed individuals, IJR reached out to Jeremy Engdahl-Johnson, who is the director of media relations at the New York branch of the MMI.
“The Milliman Medical Index measures the health care costs for a typical American family of four covered by an employer-sponsored PPO,” Engdahl-Johnson said when asked about the extent to which one could argue that self-employed individuals face the same costs.
Fact or Fiction
There are simply too many factors at hand (fluctuating costs, subsidies, the uninsured) for Sanders to assume that the MMI’s numbers are cross-applicable to the self-employed family. Sanders claimed that self-employed families are paying $28,000 a year in health care costs and that “you ain’t gonna pay that” anymore under Medicare for All.
Even when examining the employee who does get insurance through an employer, this claim doesn’t hold up. As stated above, the MMI differentiates between the money that an employer spends toward an employee’s health care costs and the contributions the employee makes. Of the $28,166, an employee actually pays $12,378.
While the figures above indicate his plan is likely to save families some money, the amount he arrives upon is an overstatement that falsely bolsters what it truly stands to save the average family.
In light of the assumptive nature of Sanders’ leap that the self-employed family is paying the same as the family who gets insurance through an employer, as well as the fact that he is overstating what the latter family pays in the first place, IJR rates this claim as fiction.
IJR made numerous attempts to reach out to Sanders’ campaign for comment regarding the data pool used to come up with the figure and clarification on some components of Sanders’ position but had not received a response at the time of publication.