In a current Facebook ad, U.S. Rep. Peter Roskam accuses his Democratic challenger of supporting "disastrous health care policies for your family," among them "doubling premiums," and "cutting current health care plans."

It’s no surprise that Roskam, a six-term Republican incumbent fighting to keep his 6th District seat in the Western suburbs, doesn’t see eye-to-eye on health care with Sean Casten, a clean-energy entrepreneur from Downers Grove.

Roskam was a key architect of last year’s congressional tax overhaul that struck the controversial Obamacare penalty for not having health insurance. Casten has made protecting and expanding health care access under Obamacare, formally known as the Affordable Care Act, a top priority of his campaign.

Republicans have been complaining about the effects of Obamacare for years, but Roskam is taking some wild swings with this attack on Casten. There’s a lot here to unpack, so to keep it simple this fact-check focuses on the ad’s unsubstantiated health care claims.

"Doubling premiums"

Veronica Vera, a Roskam campaign spokeswoman, said the ad connected the dots between Casten’s support for Obamacare and a federal report—itself containing a number of caveats—that found premiums sold to individuals on the federal health care exchange were 105 percent higher in 2017 than premiums for existing individual market plans available in 2013 before the exchange opened.

If it happened in the past it surely then will happen in the future, Vera reasoned, and so to the Roskam campaign that means Casten backs a doubling of premiums.

One obvious problem with that line of thinking is that the Roskam campaign could provide no evidence that Casten had ever said such a thing.

What’s more, experts say a major factor behind recent premium spikes on the individual market was uncertainty over the law’s future given frequent attempts by Roskam and other Republicans, including President Donald Trump, to kill or weaken Obamacare.

Even so, there is evidence in Illinois that the days of Obamacare sticker shock may be over. Illinois’ largest insurer, Blue Cross and Blue Shield, has proposed a slight reduction in its premiums for Obamacare plans next year.

It’s also important to note that most Americans obtain insurance through their employers, not Obamacare. Overall, premium hikes for work-based policies have been modest in recent years.

For those who do rely on Obamacare, just a small share have been exposed to the full brunt of past Obamacare premium increases. Of the 15.2 million Americans who in 2017 purchased Obamacare coverage through the federal health care exchange, 8.2 million qualified for federal subsidies that cushioned them from increases, according to the Kaiser Family Foundation, a leading authority on health care.

Another 5.4 million Americans also purchased full-price individual insurance through the off-exchange plans that existed prior to Obamacare, according to Kaiser.

"We’re really talking about maybe 2 percent of the population that’s paying full-price premiums for the individual market overall," said Cynthia Cox, a health reform and private insurance expert with the Kaiser Foundation.

"It's important to think about these people because the ACA was intended to make insurance more affordable," she said. "But putting it into perspective, it's a relatively small share of the population."

"Cutting current health care plans"

Roskam’s other health care attack on Casten is also convoluted.

The logic works this way: Obamacare shoppers had fewer options when picking plans for 2018, so that must mean that if Obamacare were expanded as Casten wants the options would narrow even further.

"Expanding the ACA would mean limiting health care options for everyone affected," Vera wrote.

That argument is riddled with holes. Obamacare plans didn’t exist prior to 2014, so any number of options offered on the exchange are a plus, even if pared back. A key reason for the reductions was uncertainty over the law’s future following the election of Trump, who demanded it be scrapped.

And Obamacare also mandates minimum levels of coverage that did not exist prior to implementation of the health care law, which vastly expanded access to coverage for millions of Americans who previously had none, including those who didn’t qualify based on their health.

"Before the ACA, if you had a pre-existing condition, there could be any number of plans to choose from, but you couldn’t get any of them," said Cox, the insurance expert with the Kaiser Foundation.

Our ruling

Roskam alleges that Casten supports "doubling premiums" and "cutting current health care plans" for Illinois families.

Casten doesn’t support doubling premiums or reducing options—and Roskam’s campaign could point to nothing that said he did.

The crux of Roskam’s argument centers on Casten’s support for expanding Obamacare options. Premiums on the federal exchange have spiked in past years, but Illinois’ largest insurer now says it expects them to go down slightly for 2019.

What’s more, most Americans get insurance through employers, not Obamacare. But among those who do, most have been insulated from the full force of premium increases by federal subsidies.

Health care policy has more wrinkles than a Shar Pei dog, and the complexity makes it easy for partisans to demagogue. Roskam’s claims are a clear example.

They’re not just wrong, they’re absurd. We rate them Pants on Fire!