On Monday, several news outlets highlighted comments that Sen. Rand Paul (R-KY) made to the Iowa Republican Party earlier this month in which he mocked an Obamacare provision for being burdensome and silly. Paul ridiculed the health law for forcing doctors to use 122,000 new medical diagnostic codes for describing Americans’ injuries to the government, including for “injuries sustained from a turtle” and “walking into a lamppost.”
The new codes do, admittedly, exist. There’s just one problem with Paul’s claims — they were adopted by the George W. Bush administration, long before Obamacare was even being debated.
Paul is referring to the transition from the ICD-9 — the current system of medical code classifications that originated from the World Health Organization (WHO) — to the far more detailed ICD-10. That’s a change that was mandated by the Bush White House in its waning days and is reflective of changing international standards for coding care. Many countries have been using the updated codes for over a decade.
In a press release from August 15, 2008, Bush’s Department of Health and Human Services (HHS) wrote that it had issued rules to implement “a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10 code sets, effective Oct. 1, 2011.”
Several medical groups, including the American Medical Association (AMA), balked at that timeline, arguing that it was too short a window for implementing such a large, complicated change to the way that hospitals code Americans’ procedures, injuries, and diseases. The Bush HHS listened to those concerns, delaying ICD-10 implementation to October 2013. The Obama administration sustained that postponement, and then delayed implementation even further to to October 2014 at the request of the health care industry.
It’s possible that Paul’s confusion stems from the shifting timeline, since much of Obamacare also goes into effect in 2014. But the health law has nothing to do with the specific codes that Paul mocked in his speech — and as the Bush HHS release shows, the decision to shift to the ICD-10 started before President Obama even took office.
Paul — who is himself a doctor — isn’t alone in his confusion. One poll found that 32 percent of surveyed health workers inaccurately thought the ICD-10 was linked to health care reform, 29 percent were unsure, and the other 39 percent answered correctly that the two were unrelated.
Paul’s office had not returned a ThinkProgress request for comment as of press time.