A Conservative’s argument, dissected (part 2)

This is the second part of my dissection of my conservative relatives’ arguments against The Patient Protection and Affordable Health Care Act. Part One can be found HERE.  Part Three can be found HERE.
 

Here is the first article one of my relatives offered to support their position:

15 Reasons Why The Obamacare Decision Is A Mind Blowing Disaster For America
 

Here is the link to the  actual text of the ACA:

The Patient Protection and Affordable Health Care Act
 

From now on, any counter-arguments you make about the law must contain references to the law.  No excuses, because, hey, I’ve given you the link to the act.
 

So here are the second group of five reasons out of the fifteen outlined by Michael Snyder for End Of The American Dream:

#6 Obamacare is going to impose nightmarish paperwork burdens on doctors, hospitals and the rest of the healthcare system.  This is going to significantly increase our healthcare costs as a nation.

Here’s the thing; I actually worked at a 200 bed hospital’s billing department.  And I can assure, our current network of private insurance companies created nightmarish paperwork burdens many years ago.  Which is why, in 1975, Congress created the National Uniform Billing Committee  (NUBC) to simplify health insurance paperwork.  It’s still in business, and the ACA doesn’t override it in any way.
 

Sadly, the link Mr. Snyder supplied is dead, and so is any possibility of analyzing its evidence in support of reason #6.  But Politifact has looked into similar claims made by Junior Senator Ted Cruz on this subject.

The tracker that Cruz relied upon has unexplained holes, miscalculates some burdens and folds in paperwork associated with non-health-care programs such as student loan changes. Significantly, too, we could not tell how the document’s largest single entry--46 million of the declared hours--was calculated.

We rate this statement, based on a partially unsupported hour count plus unrealistic Mount Rushmore math, as Mostly False.

So much for Reason #6.

#7 Obamacare is going to send health insurance premiums soaring.  This is especially true for younger Americans.

So, the first supporting evidence offered by Mr. Snyder is another article by Mr. Snyder.  This doesn’t bode well, does it? Interestingly, Mr. Snyder notes a WSJ article that pointed out that Americans already pay more for healthcare than anyone else on the planet, with a very low return on the investment.  But then he references another WSJ article entitled “Health Insurers Plan Hikes”.

Aetna Inc., some BlueCross BlueShield plans and other smaller carriers have asked for premium increases of between 1% and 9% to pay for extra benefits required under the law, according to filings with state regulators.

Funny, he skipped this statement:

…the increases apply mostly to the new policies insurers write after Oct. 1, consumers could be subject to the higher rates if they modify their existing plans and cause them to lose grandfathered status.

In other words, if you currently have insurance with theses companies, you probably will not see any increase in your rates or premiums.
 

Now, for new policy holders, or people changing their current policies, yes, your rates could go up between 1% and 9%.

But the WSJ article does go on and on about the rate increases, giving the impression that everyone’s rates are going to skyrocket, even though they don’t offer any actual evidence of it in the article.  The actual rate increases mentioned are actually quite low:

Aetna, one of the nation's largest health insurers, said the extra benefits forced it to seek rate increases for new individual plans of 5.4% to 7.4% in California and 5.5% to 6.8% in Nevada…

…Regence BlueCross BlueShield of Oregon said the cost of providing additional benefits under the health law will account on average for 3.4 percentage points of a 17.1% premium rise for a small-employer health plan…

…Celtic Insurance Co. says half of the 18% increase it is seeking comes from complying with health-law mandates.

The WSJ gives the appearance of higher rates by including the NON related increases.  The BC/BS of Oregon’s increase is only 3.4%.  Celtic’s increase is really 9%, the highest increase in the article.

“Soaring?”  Really?
 

The second source is an opinion piece written back in 2009 by Prateik Dalmia, an international studies major at Johns Hopkins University.

Young people are  least likely to need health insurance because we tend to be healthier than the remaining population. With good reason, we often choose to go uninsured…   we are the poorest segment of the population. We have not had time to build up capital, many of us have accrued student loans and after graduation we face a crippled economy due to no fault of our own…

Mr. Dalmia is absolutely correct that the young are least likely.  But he’s dead wrong that that means they don’t need or shouldn’t have health insurance coverage.
 

Senator Angus King  (I-Maine) was a young man once, and talks about his first experience of having health insurance with Salon:

Forty years ago, when King was 29 years old, he was provided health insurance as a staffer for then-Sen. Bill Hathaway, D-Maine, and for the first time in a decade went to a clinic for a checkup.

“I had a health policy that included in it a free annual physical as a part of the policy and they had evening clinic hours. And I wouldn’t have taken the day off — and if that hadn’t been covered under the insurance there’s no doubt in my mind that I wouldn’t have gone to have the checkup,” King said.

“It was a routine checkup and the doctor found this mole, and I went in a week later to have the stitches out. The doctor told me I’d better sit down and that I had melanoma…. A month later I found myself having every cancer test you could imagine. Ultimately I had a fairly major surgery. The point of the story is that without the surgery I would have died.”

The ACA works several ways to help; first off, refer to page 14:

‘‘SEC. 2714. EXTENSION OF DEPENDENT COVERAGE.
‘‘(a) INGENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child (who is not married) until the child turns 26 years of age.

That will cover most young adults for a few years after college, and through the period where a young person is trying to find a full-time job.  And even then, there are tax credits and other assistance to help someone at a low income level acquire coverage.
 

So we have to dismiss reason #7; its citations fail to support claims of “soaring premiums.”

#8 Many small businesses are going to be absolutely crushed by the provisions in Obamacare that require them to provide expensive health insurance coverage for their employees.  This is going to make them even less competitive with companies in other countries where businesses are not required to provide healthcare for their workers.  This is also going to make it even less attractive for businesses to hire new employees.

I want to highlight something that jumped out at me:

This is going to make them even less competitive with companies in other countries where businesses are not required to provide healthcare for their workers.

Which countries is Mr. Snyder referring to?  Japan?  Germany?  Both are highly industrial nations with strong, first-world economies.  And employers are not required to pay for healthcare because their governments already do so.  If Mr. Snyder is calling on Congress to completely dismantle our polyglot network of numerous health insurance and healthcare providers in order to replace them with a nationalized healthcare system, I am duly impressed.  Certainly, going that route would remove a tremendous burden from every level of business nationwide.  In fact, it would also eliminate the paperwork burden, as well as the income problem.
  

But the article he cites does not call for nationalized healthcare; it’s a press release from the National Retailers’ Foundation saying they are “dismayed” that the SCOTUS upheld the ACA.
  

But neither Snyder nor the NRF refer to Title 1, Part V, Subtitle E, Part II, SMALL BUSINESS TAX CREDIT, SEC. 1421. CREDIT FOR EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL BUSINESSES.   It starts at the bottom of page 119.  They can get a credit for up to half of what they spend.
  

We can also take a look at the model system: “Romneycare.”  A 2008 survey found that “a majority of firms” had a positive experience meeting the Massachussetts mandate.
  

Politifact found that 87% of small businesses employing 25 to 49 people already offer health benefits.  94% of companies with 50 to 199 employees already offer coverage.  And those with less than 25 employees may already qualify for the tax credits mentioned above.
  

I conclude that #8 doesn’t offer any evidence that businesses will be “absolutely crushed.”

#9 Obamacare is going to make the emerging doctor shortage in America a lot worse.  Surveys have found that we could potentially see hundreds of thousands of doctors leave the medical profession because of Obamacare.

In this case, Mr. Snyder turns to… himself.  He wrote an article for The Economic Collapse Blog about “The Coming Doctor Shortage.” To prove his case there, he references an opinion piece in The New York Post. The only citation offered there is a discredited poll.  But Mr. Snyder backs himself up by referring to another article he wrote himself.  And in that article, he refers to the same NY Post opinion piece, as well as the discredited poll used in the Post column.
  

So far, we’ve got one survey that he’s referenced several times.  And it was a survey that even Fox “News” admitted had no scientific merit.
  

But back in 2011, the Association of American Medical Colleges looked at the doctor shortage:

A physician shortage was already expected before ACA was signed into law in March 2010, and now that gap could worsen. According to projections released last fall by the AAMC Center for Workforce Studies, there will be a shortage of about 63,000 doctors by 2015, with greater shortages on the horizon…

So in fact, there was already a doctor shortage, even before the ACA.  That is “the emerging doctor shortage.”
  

But then we learn this little tidbit:

Several factors are contributing to the growing demand. On top of the 32 million Americans who will get insurance cards if the ACA is fully implemented, 15 million more will become eligible for Medicare in the coming years. Meanwhile, physician supply is projected to drop because of baby boomer retirement and other factors.

In other words, while we we are losing doctors because they are reaching retirement age, most of the shortage is due to millions of Americans receiving health insurance that will for the first time make a doctor visit affordable.  But what are the “other factors?”  Are they ACA related?  This article doesn’t say, but it does report that the ACA does have provisions to ease the crisis:

The ACA did take steps to address the shortage. For example, the reform law will redistribute some unused residency slots and increase funding for the National Health Service Corps..

But the AAMC report concludes that the biggest hurdle to training new doctors is funding for training, and regulations that require residencies in hospitals in order to earn their doctorates. Residencies limited by recent budget cuts at both the state and federal level.
  

AARP reports that simply enrolling more medical students isn’t the issue; the matter of student debt is the true culprit:

While students may enter medical school wanting to practice primary care medicine, they graduate saddled with heavy debt — $250,000 is not unusual — which prompts them to switch to a more lucrative specialty. The starting salary for a primary care physician is $150,000 to $170,000; a radiologist or gastroenterologist can make two to three times that.

Only one in five graduating internal medicine residents plans to go into primary care medicine, the Journal of the American Medical Association reports.

But what about doctors retiring?  Fortunately, MedPage Today links to a Deloitte Study for Health Solutions took a survey that has some answers.
  

Deloitte summarizes the study:

Most U.S. physicians are concerned that the future of the medical profession may be in jeopardy and consider many changes in the market to be a threat. They believe that the performance of the U.S. health care system is suboptimal, but the Affordable Care Act is a good start to addressing issues of access and cost.

Most also believe that…

• Medicaid and Medicare reimbursements may be problematic, prompting many physicians to limit or close their practices to these enrollees.
• Physician-hospital integration is expected to increase.
• Clinical decision support information technologies that reduce unnecessary services and increase clinician adherence to evidence-based practices are of interest to physicians

So while there is indeed a shortage of doctors, and the Affordable Care Act will create many new patients who will increase demand for a shrinking pool of doctors, the ACA is seen primarily as a tool to help address the problem.
  

So I’ll have to pass on #9 being a valid reason to dump the ACA.

#10 Obamacare has already forced the cancellation of dozens of doctor-owned hospitals.

This time, Michael Snyder’s reference is a blog post at Survival Blog written by someone identified only as… Michael.  I don’t think that’s a coincidence, I think this is yet another occasion where Mr. Snyder is referencing himself.  In the Survival article, the first reference leads us to a comment in a forum at God Like Productions which in turn links to an article at something called CNS News. It is a spinoff of the Media Research Center, a conservative propaganda service.
  

Already, this one has a bad smell to it.
  

But it is the first story to actually reference the  ACA!  Specifically, Title VI, Section 6001 of the Patient Protection and Affordable Care Act.
  

CNS News summarizes the affects thus:

Physician-owned hospitals are advertised as less bureaucratic and more focused on doctor-patient decision making. However, larger corporate hospitals say doctor-owned facilities discriminate in favor of high-income patients and refer business to themselves.

The new health care rules single out such hospitals, making new physician-owned projects ineligible to receive payments for Medicare and Medicaid patients.

And what does the act say?  It’s pages of updates to Section 1877 of the Social Security Act (42 U.S.C. 1395nn) . Fortunately, the Centers for Medicare and Medicaid Services sums it up nicely:

Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to qualify for the whole hospital and rural provider exceptions. A physician-owned hospital is now generally prohibited from expanding facility capacity. However, a physician-owned hospital that qualifies as an applicable hospital or high Medicaid facility may request an exception to the prohibition from the Secretary.

So the ACA does limit expansion of doctor-owned hospitals, and we have to admit that building a new hospital would certainly count as expansion.  But what about payments for Medicare and Medicaid patients?

Section 1877 of the Social Security Act (42 U.S.C. 1395nn) prohibits physicians from referring Medicare patients for certain designated health services (DHS) to an entity with which the physician or a member of the physician's immediate family has a financial relationship unless an exception applies. It also prohibits an entity from presenting or causing to be presented a bill or claim to anyone for DHS furnished as a result of a prohibited referral.

So in fact, the limits on payments for doctors referring patients to facilities owned by said doctor were already in place before the ACA.  But it does not flat-out deny claims for Medicare and Medicaid completely.
  

Bloomberg Law explains the origin of this limit on Medicare and Medicaid payments for referrals, The Stark Law:

The Stark law essentially prohibits a physician from referring Medicare, Medicaid, and other federally covered patients to a provider that provides designated health services (DHS).1 The first DHS was clinical laboratories owned by physicians. The federal government determined that physicians may be over utilizing lab services and billing for those services where the physician owns the lab. Later, the government expanded DHS to include inpatient and outpatient hospital services.2 Again, the concept underlying the prohibition was that if physicians had any financial relationship with entities providing DHS, the physicians would overutilize those services because they would be financially compensated.

Whether or not such abuse is commonplace is a subject of much debate.  The Stark Law went on to include Whole Hospital Exception:

The federal government recognized the ramifications of the Stark law and adopted a number of different exceptions to it, including the Whole Hospital Exception, which allowed physicians to own a hospital or part of a hospital as long as the investment interest is in the entire hospital.3 The exception included hospitals in existence at the time the law was adopted and those that were developed after the law was adopted.

So, to bring you up to speed, the government made it illegal for doctors to refer patients for additional services from laboratories and other facilities owned by said doctor so that said doctor would be tempted to pad his bill by ordering extra services or diagnostics.  However, as long as a physician’s investment was in the ENTIRE hospital, as opposed to just the lab, or just an operating room, he could refer Medicare and Medicaid patients to the hospital for treatment.
  

The ACA removed the Whole Hospital Exception, as well as limiting the expansion of hospitals.

But how has that affected these facilities ability to operate profitably – or at all?  The Wall Street Journal reports:

The Affordable Care Act aimed to end a boom in doctor-owned hospitals, a highly profitable niche known for its luxury facilities. Instead, many of the hospitals are wiggling around the federal health-care law's growth caps and even thriving.

Meanwhile, to grow without running afoul of the rules, some of the country's roughly 275 doctor-owned hospitals are expanding their operating hours, increasing procedures in ways not restricted by the law and rejecting patients on Medicare, the federal insurance program for the elderly and disabled.

 In 2011, the first year of the law's restrictions, more than half of the 30 largest doctor-owned hospitals showed operating margins that either matched or surpassed their 2010 figures, and some had operating margins of more than 40%. Only a handful showed drops of more than a few percentage points that year, according to American Hospital Directory data.

So it may be premature to weep for the doctors who own hospitals. Kaiser Health News goes so far as to categorize physician-owned hospitals as “the biggest winners under two programs in the health law.”
  

And as for construction of new physician-owned hospitals? 

Physician-owned hospital breaks ground in Austin

Other than the press release from Physician Hospitals of America (PHA), we can’t find documentary evidence of “60 hospitals canceled due to Obamacare.”  It certainly is possible that 60 planned hospitals have been canceled, but the ACA is helping the existing facilities make money hand-over-fist, and it hasn’t stopped at least one new hospital from being built.
  

So I must rate Reason # 10 as possible, but irrelevant.  Thousands of projects get canceled every day for a variety of reasons, and since new facilities can still be built, citing the ACA can only be an excuse, not a reason.
  

This ends the second part of the dissection; we’ll handle “Reasons 11-15” next.

Reasons 1-5 * Reasons 6-10 * Reasons 11-15

A Conservative’s argument, dissected (part 1)

I’m afraid I have to admit that I have some conservative family members.  And I don’t mean simply deep-rooted Republicans, they are rabid Tea Party lunatics.
 

I actually started dissecting the arguments they’ve been making last week, but Blogger hiccupped, and four hours of composition was completely lost.  So now I’m using an off-line blog editor, and I’m breaking it down into smaller pieces.
 

My relative offered up an article to defend his views on The Affordable Care Act:
 

15 Reasons Why The Obamacare Decision Is A Mind Blowing Disaster For America
  

It’s an article on a right-wing propaganda site called End Of The American Dream.  And of course, they can’t bring themselves to call the Patient Protection and Affordable Health Care Act by its proper name, referring to it simply as “Obamacare.”  the fact that they can’t use proper nomenclature should set alarm bells ringing, followed by klaxons when you find that at no time do they ever cite any actual portion of the ACA to support their arguments.  But the thing about being a rabid Tea Party conservative is that intellectual processes are considered a hindrance.
 

So first, I’ll supply a link to the ACA, and I will reference it as it applies.
 

The Patient Protection and Affordable Health Care Act
   

From now on, any counter-arguments you make about the law must contain references to the law.  No excuses, because, hey, I’ve given you the link to the act.
  

So here are the first five reasons outlined by Michael Snyder for End Of The American Dream:

#1 According to the U.S. Supreme Court, the federal government has the power to force you to buy private goods and services.  Now that this door has been opened, what else will we be forced to buy in the future?

“This door has been opened” back in 1790. The New England Journal of Medicine reports that in that year, Congress mandated all ship owners to provide medical insurance for seamen in their employ. Eight years later, they required all seamen to buy hospital insurance for themselves.
  

And what have we been mandated to buy?  Well, car insurance, for one.  Sure, this is at the state level rather than the federal level, but it’s still a mandate from a governing body that applies to all people governed by that body.  Strange that I haven’t seen Tea Party conservatives holding signs demanding we repeal the car insurance mandate.
  

For what it’s worth, the link is dead.  Which gives it as much life as the argument it was supposed to support.
  

So reason #1 must be dismissed for lack of merit.

#2 Obamacare is another step away from individual liberty and another step toward a “nanny state” where the government dominates our lives from the cradle to the grave.

Interesting leap of logic: by requiring every individual in this country to take responsibility for providing their own health insurance coverage, the United States will become a “nanny state.”

Let me look up this term; perhaps I’m not clear on what a “nanny state” actually is:

nanny state  n, (Government, Politics & Diplomacy) a government that makes decisions for people that they might otherwise make for themselves, esp those relating to private and personal behaviour

OK, that’s what I thought it meant.  Of course, the ACA isn’t making any decisions about “private and personal behaviour.”  It’s tasking us with lifting up our share of the burden of health insurance costs.  And of course, this is a ludicrous argument coming from a group that regularly attempts to legislate what a woman can and can’t do with her very body.  If becoming a nanny state is a legitimate conservative concern, they’d be denouncing every conservative that introduces legislation related to the human reproduction system.  Can being told to have health insurance coverage really be less invasive than forcing a woman to have an internal sonogram before she can have an abortion?

We should note that the individual is still free to choose any provider they like, with several different layers of coverage.  This falls under Title 1, Subtitle F Part 1, Section 1501, which is on page 124 of the ACA.
 

Reason #2 makes claims, but does little to support it the claim beyond offering a dead link.

#3 The IRS is now going to be given the task of hunting down and penalizing millions of Americans that do not have any health insurance.  In fact, the Obama administration has given the IRS 500 million extra dollars “outside the normal appropriations process” to help them enforce the provisions of Obamacare that they are in charge of overseeing.

This one is simply a whopping lie with two parts.  Part 1; there is nothing in the bill anywhere that authorizes the IRS to hunt down and penalize anyone for failing to have healthcare.  I’ve given you the link; check it out.  If you can find such an order in the document, please leave the exact citation in the comments section.
 

The second part is even worse; it links to another blog, where one Sam Baker states that the IRS was given funding “to impliment healthcare law.”  The problem?  The article offers absolutely no evidence.  Nothing. Nada.  It doesn’t offer a single document.  Not one recording.  Not even names or dates.

My verdict on #3: it’s a whopping lie. 

#4 Obamacare imposes more than 20 new taxes on the American people.  You can find a comprehensive list of Obamacare taxes right here.  If you love paying higher taxes, then you are going to absolutely love Obamacare once it is fully implemented.

The link in this one leads to Americans for Tax Reform, a partisan political action committee founded by Grover Norquist, who never met a tax that he liked.  He also doesn’t believe in government. And he doesn’t have a grasp of economics, being a firm believer in the Reagan era policy of “starve the beast” that has led to record deficits.
  

Many of the taxes listed at this website are real, although they make it tough to research by failing to provided references to the document so you can analyze their claims for accuracy.  So we’re going to scrutinize this one in a separate article later.  But suffice to say, almost all the taxes it references only come in to play if you don’t have insurance if you’re an individual, or don’t provide insurance if you’re a large company.
  

So #4 is correct that there ARE new taxes, but incorrect that they mean you will be paying higher taxes.  Stay tuned for closer examination.

#5 In an attempt to “control costs” and “promote efficiency”, Obamacare limits the treatment options that doctors and patients can consider.  This is likely to result in a decrease in life expectancy in the United States.

Oooh, another whopping lie.  And this shows very clearly that the person making this claim has never read the ACA.

SEC. 1554. ACCESS TO THERAPIES.
Notwithstanding any other provision of this Act, the Secretary of Health and Human Services shall not promulgate any regulation that—
(1) creates any unreasonable barriers to the ability of individuals to obtain appropriate medical care;
(2) impedes timely access to health care services;
(3) interferes with communications regarding a full range of treatment options between the patient and the provider;(4) restricts the ability of health care providers to provide full disclosure of all relevant information to patients making health care decisions;
(5) violates the principles of informed consent and the ethical standards of health care professionals; or
(6) limits the availability of health care treatment for the full duration of a patient’s medical needs.

This can be found under Title 1, Subtitle G, on page 141 of the ACA. As you can see, this states in no uncertain terms that treatment will not be limited to “control costs” or to “promote efficiency.
  

But what does the link say?  It’s a blog that quotes a letter by Senator Tom Coburn published in the Wall Street Journal.  Dr. Coburn claims that section 3403 and 2021 “explicitly empowers Medicare to  deny treatment based on cost.”
  

What can we find in the ACA about this?  First, section 3403, which starts on page 372 of the ACA.  Here are the parts that specifically address Dr. Coburn’s claims.

SEC. 3403. INDEPENDENT MEDICARE ADVISORY BOARD.

(a) BOARD.—
(1) IN GENERAL.—Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), as amended by section 3022, is amended by adding at the end the following new section:

‘‘INDEPENDENT MEDICARE ADVISORY BOARD

Section 1899A

‘‘(c) BOARD PROPOSALS.—

‘‘(2) PROPOSALS.—
‘‘(A) REQUIREMENTS.—Each proposal submitted under this section in a proposal year shall meet each of the
following requirements:

(ii) The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost- sharing (including deductibles, coinsurance, and copay-ments), or otherwise restrict benefits or modify eligibility criteria

‘‘(B) ADDITIONAL CONSIDERATIONS.—In developing and submitting each proposal under this section in a proposal year, the Board shall, to the extent feasible—
‘‘(i) give priority to recommendations that extend Medicare solvency;
‘‘(ii) include recommendations that—
‘‘(I) improve the health care delivery system and health outcomes, including by promoting integrated care, care coordination, prevention and wellness, and quality and efficiency improvement; and
‘‘(II) protect and improve Medicare beneficiaries’ access to necessary and evidence-based items and services, including in rural and frontier areas;

Dr. Coburn must be referring to some OTHER section 3403, because THIS section 3403 does the exact opposite of what he claims.
  

Now for section 2021.  The relevant section is found on page 668, under TITLE VI, Subtitle H- Elder Justice Act.

‘‘PART I—NATIONAL COORDINATION OF ELDER JUSTICE ACTIVITIES AND RESEARCH
‘‘Subpart A—Elder Justice Coordinating Council and Advisory Board on Elder Abuse, Neglect, and Exploitation
‘‘SEC. 2021. ELDER JUSTICE COORDINATING COUNCIL.

‘‘(a) ESTABLISHMENT.—There is established within the Office of the Secretary an Elder Justice Coordinating Council (in this section referred to as the ‘Council’).

And reading through it, it says nothing about explicitly denying care; this is as close as it gets:

‘‘(f) DUTIES.—
‘‘(1) IN GENERAL.—The Council shall make recommendations to the Secretary for the coordination of activities of the Department of Health and Human Services, the Department of Justice, and other relevant Federal, State, local, and private agencies and entities, relating to elder abuse, neglect, and exploitation and other crimes against elders.

Basically, this section deals with creating a panel to administer complaints and failures of the system, and says nothing about limiting health care for anyone for any reason.
  

So I must conclude that reason #5 is false.
  

This ends the first part of the dissection; we’ll handle “Reasons 6-10” next.

Reasons 1-5 * Reasons 6-10 * Reasons 11-15