The PR War Over the ACA

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Health Care, Obama Administration

By now you may have seen this chart showing that about 3 percent of Americans are expected to have to pay a higher premium for insurance next year because of the ACA. This was not unexpected. But I fear the rightie noise machine has pumped it up to a BIG BLEEPING DEAL. See, for example, this Wall Street Journal op ed by a cancer patient whose policy was canceled, and none of her new options will let her see all of her doctors.

That’s very sad. However, it turns out, the cancellation wasn’t because of the ACA.

(Update: Looks like that’s not the only thing the subject of the article left out.)

Sundby shouldn’t blame reform — United Healthcare dropped her coverage because they’ve struggled to compete in California’s individual health care market for years and didn’t want to pay for sicker patients like Sundby.

The company, which only had 8,000 individual policy holders in California out of the two million who participate in the market, announced (along with a second insurer, Aetna) that it would be pulling out of the individual market in May. The company could not compete with Anthem Blue Cross, Blue Shield of California and Kaiser Permanente, who control more than 80 percent of the individual market.

Not that Wall Street Journal readers are likely to find that out.

The Washington Post dutifully reports on the “growing backlash”

Americans who face higher ­insurance costs under President Obama’s health-care law are angrily complaining about “sticker shock,” threatening to become a new political force opposing the law even as the White House struggles to convince other consumers that they will benefit from it.

The growing backlash involves people whose plans are being discontinued because the policies don’t meet the law’s more-stringent standards. They’re finding that many alternative policies come with higher premiums and deductibles.

There aren’t enough of them by themselves to become a “new political force,” of course. What the Washingon Post doesn’t bother to mention, but the New York Times did, is that nobody’s policy was cancelled, strictly speaking, because of the ACA. instead, they were upgraded. A lot of those old “cancelled” policies were junk. (See also.)

Making the “sticker shock” worse, however, is that insurers are hiding benefits from customers and trying to gouge them as well.

Across the country, insurance companies have sent misleading letters to consumers, trying to lock them into the companies’ own, sometimes more expensive health insurance plans rather than let them shop for insurance and tax credits on the Obamacare marketplaces — which could lead to people like Donna spending thousands more for insurance than the law intended. In some cases, mentions of the marketplace in those letters are relegated to a mere footnote, which can be easily overlooked.

The extreme lengths to which some insurance companies are going to hold on to existing customers at higher price, as the Affordable Care Act fundamentally re-orders the individual insurance market, has caught the attention of state insurance regulators.

Making this worse is the fact that a lot of people facing higher premiums can’t get on the website yet to find out what better deals might be out there. So we’re in for a bumpy ride for awhile, I’m afraid.

Update and off topic — Smirking Chimp is holding a fundraiser to help it stay online.

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12 Comments

12 Comments

  1. moonbat  •  Nov 4, 2013 @3:21 pm

    I’m glad to read that it’s supposedly only 3-6% who will be affected (and I am one of them).

    There’s an article on Forbes (yes it’s Forbes) that goes into detail about this, but it never mentions how small this fraction is relative to the whole. Article is informative – despite its bias – anyway: 49-State Analysis: ObamaCare to Increase Individual Market Premiums by Average of 41%.

    re – The cancer patient who lost her coverage – while this may not have been strictly due to ACA, it is true (or likely, not sure which) that doctor networks (choice, essentially) will be reduced under ObamaCare, and so her story is emblematic of how certain people are going to be out of luck under ACA.

    The more I learn about ObamaCare, the more soured I am on it, but not so much that I’d want to see the whole thing scrapped. It strikes me as a great big bandage over the great cancerous rot that is our healthcare system, that really doesn’t do much to control costs. It just shifts them around, while attempting to bring in more people. The bottom level bronze plans are little more than bankruptcy protection plans, IMO. The copays and deductible are ridiculous for minor things like urgent care.

    My current plan may have been junk, but it was junk that gave me what I needed at a price I could bear. It was more than just bankruptcy protection.

    I am intrigued by the court challenges that are coming up. Some of the challenges seem ridiculous, but this one seems to have legs:

    …Under the Affordable Care Act, subsidies are only available for state exchanges. But through regulation the Internal Revenue Service has extended subsidies to federal exchanges too.

    …Several groups are challenging the federal subsidies. Judge Friedman ruled that their case could go forward, disappointing the administration. The Justice Department argued that the court should throw out the case because the plaintiffs had no standing. After the judge’s ruling, the plaintiffs are standing tall.

    …The implications are immense. Family plans will cost $20,000 a year in 2016, according to the IRS. If Americans on the federally run exchanges do not qualify for health-insurance subsidies, few will sign up. Plans will be simply unaffordable. Obamacare will collapse not because of Congress, but due to flaws in the structure of the law.

    The idea is that ObamaCare did not explictly grant the IRS the right to reimburse people for subsidies, and that the IRS took it upon itself to do so. Plaintiffs are arguing that the IRS has no right to do so. The law’s writers didn’t expect such heavy dependence on the federally run exchange – they thought a lot more states would step up to the bar. And so the case is about the IRS overstepping its bounds.
    If the IRS cannot provide subsidies, then it all collapses.

  2. Swami  •  Nov 4, 2013 @4:30 pm

    The extreme lengths to which some insurance companies are going to hold on to existing customers at higher price, as the Affordable Care Act fundamentally re-orders the individual insurance market, has caught the attention of state insurance regulators.

    That’s why single payer is the only solution. The states will now be faced with implementing the tweeks to Obamacare. It will become obvious before long to the states that they’ll be dealing with a system they can’t just repeal and that the only way to tamp down the howls of their citizens is to work toward a system that eliminates the inequalities of the current Obamacare system.
    They’re kicking against the goads now, but once they realize they’ve already been ensnared they’ll come around to embracing single payer.
    I don’t pretend to have any edge in understanding this whole Obamacare business, but I do have a sense of strategy that tells me that once the individual mandate was secured by law the game was over. Sorta like getting the first move in a game of tic tac toe when you know which box to place your mark in order to control your opponents futile attempts to counter an inevitable outcome.
    I might not get there with you…but I’ve been to the mountain top and I’ve seen the single payer Obamacare.

  3. joanr16  •  Nov 4, 2013 @4:43 pm

    I am so sick of the “Benghazi”-ing of the ACA that I just don’t know what to say. Just keep telling the truth in the face of idiocy and lies, please.

    A little OT but amusing: in 2001 I was laid off by an employer along with three of my coworkers, because all four of us had serious medical conditions while on the company’s health insurance. Yesterday I learned that my ex-employer was bought out in 2010 by…. (drum roll!)

    Bain Capital.

    (I love my current job… I love my current job… I love my current job…!)

  4. Stephen Stralka  •  Nov 4, 2013 @4:51 pm

    Well, for the sake of argument, let’s all agree that ObamaCare sucks. The question is, now what? To say we should scrap ObamaCare because it sucks is to say we should return to a status quo that also sucked. You could maybe have a debate over whether ObamaCare sucks more or less than what we had before ObamaCare, but we don’t really have enough data yet, and anyway I’m more interested in building a healthcare system that doesn’t suck. So really the only way to fix the problems we’re seeing is to move forward, not back.

    After all, this would all be a lot simpler if we could have had the public option.

  5. c u n d gulag  •  Nov 4, 2013 @5:32 pm

    moonbat,
    The problems with PPACA are BECAUSE of its innate Conservatism.

    The use of private insurance companies, the individual mandate, and pretty much every other problem with the program – outside of the roll-out, which the Republicans, typically, refused to help finance – is due to its Conservative nature.

    We have to hope that the website and call center issues can be fixed – and fixed, ASAP!

    And then, and only THEN, can we Liberals make our pitch to go to the next level – “Single-payer.”

    Because, unlike W’s disastrous Medicare Part D roll-out, when the MSM took its typical snooze, the problems with PPACA are attracting mucho-macho attention – deserved or not!
    Remember, it took a long time to get the MSM to notice Iran-Contra.
    But let a President get a blow-job from an intern, and Saweeeeet Jayzoos, we’re off to the races!

  6. Tom_B  •  Nov 4, 2013 @5:32 pm

    Moonbat: “…Several groups are challenging the federal subsidies. Judge Friedman ruled that their case could go forward, ”

    I’m in a no exchange / no medicare expansion state. The other shoe hasn’t dropped: if idiots are going sue the federal gov’t for PROVIDING reimbursments to dumber states, I would expect citizens in dumber states to sue the Feds– or their state gov’ts– for failure to provide benefit equity (that is, usable exchanges, medicare) to citizens for the simple crime of living in F’ed-up states. I’m surprised it hasn’t happened already.

  7. Bonnie  •  Nov 4, 2013 @6:29 pm

    For any American to believe that health insurance companies are NOT scumbags and to trust them shows just how dumb America has become. And, no, Stephen, I do not believe that Obamacare sucks. There is not enough information to make that conclusion yet.

  8. Bonnie  •  Nov 4, 2013 @6:34 pm

    TPM has an investigative report on the insurance companies and what they are doing to keep people from better health insurance through Obamacare:

    http://talkingpointsmemo.com/dc/insurance-companies-misleading-letters-obamacare

  9. Swami  •  Nov 4, 2013 @8:25 pm

    joanr16 …Shouldn’t that be Bane Capital?

  10. erinyes  •  Nov 4, 2013 @9:42 pm

    The right is always bragging about how the Israelis get stuff right. Well they indeed got healthcare right, and we help subsidize it. Can we please have an Israeli single payer universal health care system?

  11. goatherd  •  Nov 5, 2013 @8:08 am

    As Swami wrote above, I don’t have any special understanding of the ACA. But, in my previous career, I was very familiar the whole stinking morass that the ACA is trying to address. Of course, my view is somewhat jaundiced because I saw and endless stream of personal tragedies, traumatic injuries, bankruptcies and the line of price gougers and, eehhmm, entrepreneurs, happily picking everyone’s pocket. For you libertarians, never once during twenty some years did I have anyone come in the door who had foreseen their misfortune and had wisely purchased the exact insurance package they needed, covering only TBI and SCI with no deductible!

    So many of the people that I dealt with who were bankrupted by a medical event had insurance, which they often found out was worthless when the need came. But, it was cheap! It was a rathole they’d been tossing money down for so many years in exchange for a false sense of security.

    At this point the waves of misinformation and vitriol have just about overwhelmed my feeble attempts to sort things out. Like a few of you, I find the prospect of “single payer” very appealing due to its simplicity. But, there are alternatives like the French system, which has a government run, not for profit, insurance agency. Their cost in terms of GDP, is about half of ours. The alternative I can’t abide is going back to the misery that we are just crawling out of.

  12. Sondra  •  Nov 6, 2013 @1:27 pm

    As I mentioned above – there are disadvantages to PPOs which this article defines very well. It’s curious that they chose a PPO when they could have afforded better more comprehensive coverage and even more odd that they went with United instead of one of the 2 bigger more advantaged companies in California.

    As to the rest of the article, the Healthcare.gov site was up and running for a long time and it was very simple to use. You just plugged in the answers to a few questions like the number of people in your family, clicked on the State were you live and an estimate of the bronze and silver plans would show the cost to you. It also included the amount of government subsidy for which you could qualify and/or tax credits you’d receive based on your income: the site provided information such as a family of 4 at 400% of the poverty level guidelines which = $94,000.

    I advised many people to check out the site before registering so they could see just how much money they could expect to pay and it worked perfectly. The questions they asked me were easy to answer even though I am not an expert – just an informed Democratic activist – mainly…why are you not insured now? and Why wouldn’t you want to be insured? Seems like a no brainer…what if you get hit by a bus? What do you do then?

    My point is that NO ONE HAD TO WAIT UNTIL THE LAST MINUTE TO FIND OUT ABOUT THE COST OF GETTING INSURANCE WHEN EVERYONE KNOWS THEY WILL NEED IT EVENTUALLY.
    Mercy! I am sick of the subject already. I’ll probably continue to help people become informed, but I’m very tired of trying to persuade people to do what they ought to know they need to do.



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