I’m familiar with this particular lie. At issue was a provision that was in a draft version of the ACA. The dishonest claim by Mr. Akins suffers two major flaws:

  1. The provision was removed in the final bill, thus it is not “in there” as Akins falsely claimed.
  2. It was never any kind of death panel in any event.

The provision at issue in early drafts of the ACA related to advance care planning counseling from a physician. These provisions proposed to amend to 42 U.S.C. Section 1395x(s)(2) that “medical and other health services” covered by Medicare.

The ACA draft simply added “advance care planning” to the existing definition of “medical and other health services.” It didnot mandate that anyone must have these counseling services anymore than it is mandating that anyone must have any of the other myriad services it includes in this definition of “medical and other health services” covered by the act. It is simply said that such consultation services would be included in that definition if the individual has not received any within the last five years.

Thus, it is said that once every five years (with some exceptions) Medicare will COVER advance care planning (as defined by the act). That Medicare would cover it does not mean that Medicare is making it “mandatory” to have this counseling anymore than the fact that Medicare will cover a heart bypass means that everyone must have a heart bypass.

So the claim that the bill would have required mandatory counseling of any kind is a flat out lie. It’s total complete dishonest trash. The draft bill simply would have expanded Medicare coverage to allow coverage of such counseling every five years.

While it was removed from the final bill, the Centers for Medicare and Medicaid Services eventually included coverage for advanced care directive planning by regulation. This was not because of any change related to the ACA but rather based on authority granted CMS by the statute prior to the ACA. Thus, patients if they want can receive such counseling from their physician, and the physician can bill Medicare for providing it.

Mr. Akins was wrong and not the crowd.

Written by

Retired lawyer & Army vet in The Villages of Florida. Lifelong: Republican (pre-Trump), Constitution buff, science nerd & dog lover. Twitter: @KeithDB80

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