“The Last People We Should Take At Their Word”: In Shocking Development, Health Insurance Companies Still Suck
The Affordable Care Act was designed to solve the big problem of health security—namely that nobody in America had it—and find a way to get coverage for the 50 million Americans who were uninsured. It also attempted to address lots of other problems, and this week it’s a good time to remind ourselves that many of its provisions came about because, to put it bluntly, health-insurance companies are despicable scum who will literally kill people (more on this below) if it makes them more money. I bring this up because now, people in the news media are learning about a scam insurance companies are trying to pull on some of their customers, and are not only not portraying it as such, but are simply taking the insurance companies’ word and blaming the whole thing on the Obama administration.
I realize that part about “despicable scum” is a little intemperate, and without question there are employees of the insurers who are good people. But as a whole, outside of the tobacco companies or gun manufacturers it’s hard to find an industry that so frequently destroys people’s lives when they’re at their most vulnerable and fools so many people into thinking they’re safe when they aren’t. Because of the shocking behavior insurance companies are capable of, the ACA had a number of provisions meant to rein in the companies from their most horrific abuses. It made lifetime caps on coverage illegal, meaning that people with the worst illnesses and accidents won’t go bankrupt because their insurance companies abandon them. It outlawed denials for pre-existing conditions. It banned “rescission”—remember that one? That’s when you get the worst news of your life, for instance that you have cancer, and the insurance company swings into action. They start poring over every document you’ve ever signed to see if they can come up with a reason to kick you off your coverage and avoid paying for that expensive treatment. Like the woman who got a cancer diagnosis and was scheduled for a double mastectomy, then got booted from her policy because her insurance company’s diligent efforts unearthed that she had forgotten to tell them she had once been treated for acne, which allowed them to claim that her original application for insurance was fraudulent and therefore they could rescind her whole policy.
That’s what I mean when I talk about them literally killing people. If someone has a life-threatening illness and will die without treatment, and then the insurance company to which they’ve been dutifully paying premiums decides to say “screw you” and make it impossible for them to get treated, then that’s an accurate way to describe it.
And as you’ve heard, these very same companies are now sending letters to thousands of their customers, telling them that the policies they’re on (which in many cases are junk insurance that covers virtually nothing) are being cancelled, and they’ll now have to pay hundreds of dollars more every month. Those customers are naturally aghast. And reporters are running to find them and air stories about the horrible “rate shock” Obamacare is producing. What those reporters aren’t doing is asking what you’d think would be relevant questions, particularly since it’s health insurance companies we’re talking about. Questions like: Is this letter accurate? Is there something the insurance company isn’t telling this customer? Might they be trying to pull a fast one, to maximize their profits at this person’s expense?
Even though it was only last week, I think I was among the first to raise the possibility that these cancellation letters are a scam, and now it’s looking more and more like that is indeed the case. One after another of the people who have been featured on breathless news stories about insurance cancellations turns out to have much better options on the new health insurance exchanges, in many cases for better coverage at lower prices than they’re paying now. The letters appear to be an effort to lock customers into high-priced policies before they discover that they have other options available to them. But we aren’t finding out about that from the big media outlets, who just prefer to run the same credulous story over and over about the 60-year-old Florida woman with a $54 a month joke of an insurance plan whose insurance company is trying to sell her a plan for many times as much.
This whole thing should serve as a reminder that while the ACA tried to create a regulatory framework that would curb the worst abuses of the insurance industry, the whole thing was also engineered to maintain the position and profits of that very industry. And if you think they suddenly decided to value their customers’ physical and financial health over their own profits, you’ve got another thing coming.
While we’re on the topic, Brian Beutler gives us something else to think about:
Let this be a reminder to the Democrats on Capitol Hill and in the White House who killed the public option. It could’ve been designed as a default plan for cancelees. And its very existence would have imposed discipline on the system — if everyone knew they can enroll in a plan modeled on Medicare, insurers would be less inclined to swindle their customers. Ironically, but predictably, the Democrats who will face the greatest political consequences of the turbulent final throes of the old individual market are in many cases the ones responsible for leaving it in the hands of for-profit insurers. But there’s plenty of blame to go around here, including to reporters treating missives from health insurance companies as reliable testimony.
You’ll remember the absolute horror with which Republicans greeted the possibility of a public option being included in the law. They were terrified that if Americans were allowed to choose to enter a Medicare-like program, lots of them would do it, and the insurance companies would lose customers. This was a perfectly legitimate fear; if Medicare is any indication, a public option would have likely been less expensive than private insurance and produced happy customers, and every person who chose to get their insurance from it would represent a rejection of conservative ideology. President Obama claimed he favored the inclusion of a public option, but never displayed any enthusiasm for it and seemed eager to drop it as one of the many failed gestures intended to win the Republican support that never materialized.
That may be a topic to revisit on another day. But if there’s any rule that reporters should follow when reporting on the rollout of the ACA, it’s this: Don’t take insurance companies at their word. They’ve already shown us who they are, and there’s no reason to think they’ve changed.
By: Paul Waldman, Contributing Editor, The American Prospect, November 5, 2013
“Wacko Birds Of A Feather”: Right Wing Obligatory Chores Essential To Maintaining Good Relations With The GOP Base
Those who marveled at my earlier post about David Barton’s belief that legalized abortion is the cause of climate change should be aware that the “historian” is not only the chief inspiration for the whole “Christian Nation” meme that has largely been accepted as a truism by much of the American Right, but swims in some of the same waters as regular old Republican pols.
This becomes apparent if you look at one of ol’ David’s favorite organizations, the American Renewal Project, the very insider Christian Right group closely aligned with the aggressively homophobic American Family Association, and run by the famously influential David Lane, whose main vehicle is the “Pastor’s Policy Briefings” that bring pols in on the carpet to be instructed by clergy in an off-the-record context.
Barton was present at the first such event of the 2014 electoral cycle in Iowa back in July. So, too, were Rand Paul, and the man who stole the show, Ted Cruz (per this account from the Des Moines Register‘s Jennifer Jacobs:
This morning, Cruz spoke for nearly an hour at the Iowa Renewal Project, a two-day, all-expenses-paid forum organized by David Lane, a political activist from California who has been quietly mobilizing evangelicals in Iowa for six years. Two top-name GOP politicians who are likely 2016 presidential candidates – Cruz and U.S. Sen. Rand Paul of Kentucky, both born-again Christians – are the stars of today’s sessions.
Cruz lectured for 30 minutes, his voice at times rising to a shout. He answered questions for another 20 minutes, then stood at the center of a circle as pastors laid their hands on him and the whole audience – a predominantly white group with about 20 black pastors – bowed heads to pray for him.
Then there was this tidbit, which is even more interesting now that David Corn has drawn attention to a certain reverend close to the junior senator from Texas:
Cruz, who told The Des Moines Register he has never been to Iowa before, laid out his social conservative credentials in some detail, explaining all the religious issues he defended in court cases he worked on as a private lawyer and as solicitor general in Texas. He introduced his Cuban immigrant father, Rafael Cruz, who sat in the audience.
That was then. This is now, today, per Andrew Shain of The State:
Republican U.S. Sen. Ted Cruz of Texas is reaching out Monday to the same audience of South Carolina pastors that former House Speaker Newt Gingrich visited twice before his surprise victory in the state’s 2012 presidential primary.
Cruz, an expected White House hopeful who was the lightning rod during last month’s 16-day partial federal government shutdown, will speak at a Columbia hotel. It is one of many events that evangelical political operative David Lane has organized in key battleground states since 2005.
Lane’s American Renewal Project is financed by the American Family Association, the Mississippi-based Christian organization that advocates on social issues. Lane’s goal is to get more evangelicals to the polls via the “pastors’ policy briefings’’ that he has held over the years, including a half-dozen in South Carolina.
SC Sen. Tim Scott is also on the agenda for this event, entitled “Rediscovering God in America.” The preachers and pols will also hear from “historian” William Federer, who argues, among other things, that Benghazi! was an Alinskyite plot by Hillary Clinton to impose “global Sharia law.” Seriously:
I could go on and on (another speaker at the SC event, Dr. Laurence White, delivered a blood-curdling speech I happened to hear in Iowa last year attacking Christians who tolerate “the perverted standards of the ungodly who live around us” and damned anyone who would in any way compromise with baby-killing pro-choicers). But you get the point. Pundits who casually talk about pols in both parties pandering to “extremists” or “interest groups” clearly don’t get it. There is no analog among Democratic politicians–certainly those considered possible serious candidates for president–consorting with people as “out there” as Barton and Federer and White and AFA founder Don Wildmon (another speaker in Columbia) and Lane and Lord knows who else. For Republicans, it’s not only business as usual, but essential to good relations with “the base” and an obligatory chore on the road to the presidential nomination.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, November 4, 2013
“No Hero’s Welcome”: Edward Snowden Can’t Expect To Be Welcomed Back From Russia
Edward Snowden wants the U.S. government to stop treating him like a defector. Then why did he defect?
Snowden, of course, is the former government contractor who released an enormous trove of classified information to news organizations detailing the data- and intelligence-gathering activities of U.S. security agencies. The disclosures were disturbing, and revealed the extent of spying on both U.S. citizens and allies.
Some of it should not be a surprise, considering the expansion of authority a spooked Congress gave to the intelligence community after 9/11. The upside of the disclosures is that it has caused a national discussion on what authority our government should have in monitoring its own citizens.
But Snowden still broke the law, and very deliberately so. He also did not carefully expose just one troubling element of the data-mining activities he knew of, nor did he first try to go to a member of Congress with his concerns. He dumped the classified information wholesale, and then got on a plane for Hong Kong – as sure a sign as any that he knew he had violated the law and would face serious consequences for it.
Snowden is now residing in exile in Russia, and apparently is already getting antsy. Through a German lawyer, Snowden released a letter appealing to the U.S. government to stop treating him like a traitor for what he called his “moral duty to act.” Said the letter:
My government continues to treat dissent as defection, and seeks to criminalize political speech with felony charges that provide no defense. Speaking the truth is not a crime. I am confident that with the support of the international community, the government of the United States will abandon this harmful behavior.
The problem for Snowden is that speaking the truth indeed can be a crime, especially when you sign a document pledging to keep national security secrets and then very deliberately violate that pledge. And Snowden obviously knew what he had done was wrong or at least, if he didn’t think it was morally wrong, illegal. Otherwise, he wouldn’t have high-tailed it to Hong Kong and then to Moscow to escape punishment.
People have gone to prison, sometimes for many years, in defiance of a law or policy they thought was unjust. Snowden has already managed to avoid that fate. It’s asking too much to expect the government whose secrets he illegally revealed to welcome him back as a hero.
By: Susan Milligan, U. S. News and World Report, November 4, 2013
“A Range Of Options And A Very Good Deal”: Under The Affordable Care Act, Millions Eligible For Free Policies
Millions of people could qualify for federal subsidies that will pay the entire monthly cost of some health care plans being offered in the online marketplaces set up under President Obama’s health care law, a surprising figure that has not garnered much attention, in part because the zero-premium plans come with serious trade-offs.
Three independent estimates by Wall Street analysts and a consulting firm say up to seven million people could qualify for the plans, but federal officials and insurers are reluctant to push them too hard because they are concerned about encouraging people to sign up for something that might ultimately not fit their needs.
The bulk of these plans are so-called bronze policies, the least expensive available. They require people to pay the most in out-of-pocket costs, for doctor visits and other benefits like hospital stays.
Supporters of the Affordable Care Act say that the availability of free-premium plans — as well as inexpensive policies that cover more — shows that it is achieving its goal of making health insurance widely available. A large number of those who qualify have incomes that fall just above the threshold for Medicaid, the government program for the poor, according to an analysis by the consulting firm McKinsey and Company.
The latest analysis was conducted by McKinsey’s Center for U.S. Health System Reform, whose independent research has been cited by the federal government and others.
“The whole point of the law was not only to cover the uninsured, but so people didn’t have to make choices between food or drugs, or going to the doctor or dentist,” said Karen Davis, a health policy expert at the Johns Hopkins Bloomberg School of Public Health. “It’s what it is designed to do.”
Many insurers tried to price their least expensive plans so they would become free or nearly free with the addition of subsidies that are set based on a person’s income and the cost of a midlevel, or silver, plan.
Independence Blue Cross in Philadelphia has four plans that are free to some customers. But the company, along with other insurers, has been careful not to publicize its free coverage for fear of alienating customers who will need to pay more.
“We’re not advertising zero dollar,” said Brian Lobley, a senior vice president at Independence Blue Cross. But the company is promoting monthly premiums in the $20 to $30 range, he said.
The Obama administration has also stressed affordability over coverage with no monthly charge, frequently saying that the cost of coverage will be less than a monthly cellphone bill for many consumers. Officials at the Department of Health and Human Services would not comment on the McKinsey analysis, saying in a statement that the goal of the health law was to provide a range of options for people with differing needs and budgets.
The analysis found that five million to six million people who are uninsured will qualify for subsidies that will be greater than the cost of the cheapest bronze or silver plan. A million more people with individual insurance could also be eligible, according to McKinsey, although estimates of the size of the market for private individual insurance vary widely. None of the people in the analysis qualify for Medicaid.
The availability of zero-premium plans may make the deal especially enticing to the healthy young people the marketplace needs to succeed, said Mark V. Pauly, a professor of health care management at the University of Pennsylvania’s Wharton School. “This is such a good deal that you’d have to believe you were immortal not to really pick it up,” he said.
Although they vary in their design, bronze plans generally cover about 60 percent of a person’s medical costs. All plans, including bronze, must cover standard benefits like prescription drugs, maternity care and mental health treatment.
The availability of the zero-premium plans varies across the country. McKinsey found that about 40 percent of the uninsured in Missouri will be able to select a no-cost bronze plan, for example, compared with 2 percent of the uninsured in New Jersey.
Its estimate, based on an analysis of premiums for plans offered in the marketplaces in all 50 states and the District of Columbia, is in line with two other estimates, by Credit Suisse and Morgan Stanley.
The McKinsey researchers also found that about half of the people eligible for zero-premium plans were under 39 and uninsured. The Obama administration has been emphasizing the affordability of its plans for young people, a critical group because their participation in the marketplaces will help keep overall premiums low.
It is impossible to know who will actually sign up, and whether they will choose a zero-premium plan.
For many people, paying slightly more for a silver plan may be a much better option, experts said. Ninety percent of those who will have the option of buying the no-cost plans make less than 250 percent of the federal poverty level, which is $28,725 for an individual, and $58,875 for a family of four. People earning below those thresholds are eligible for the most generous assistance, but only if they choose a silver plan.
About a million of those who will qualify for free coverage will be able to buy a silver plan for no monthly cost. McKinsey, which is releasing a report about the new insurance marketplaces, estimates that the cost of silver plans for the people who qualify for a zero-premium bronze plan will range from $40 to $50 a month.
“They may be getting zero premiums, but they’re also leaving a lot of money on the table if they don’t enroll in a silver-level plan,” said Sabrina Corlette, a professor at Georgetown University’s Health Policy Institute.
All plans, including bronze policies, limit annual out-of-pocket costs to $6,350 for individuals and $12,700 for families. But insurers and advocates said out-of-pocket costs — even those under that limit — can be daunting to people with low incomes.
For Mark and Elisabeth Horst, both artists in Albuquerque, the risks of signing up for a bronze plan were outweighed by the prospect of getting it free. The Horsts, who make $24,000 a year between them, qualified for $612 in monthly subsidies, but the cost of a bronze plan was $581 a month.
“We’re in good health,” Mr. Horst said.
Besides, he said, they can always switch to a better plan next year. “At this point, it’s a little bit of a gamble.”
Not everyone selects the cheapest option. Dante Olivia Smith, a lighting designer from Manhattan, learned that federal subsidies would allow her to buy a bronze plan for $24 a month.
“It was astounding,” she said. “I almost started crying, and called my mom.”
In the end, however, she went with a silver plan for $91 a month that included dental and vision coverage. Ms. Smith, who is 30, said she opted for the more comprehensive plan because of her work, which requires her to climb ladders and use power tools.
“If I had a different job, for 24 dollars a month I would have been like ‘Woo-hoo!’ ” she said. “But the reality is, I know what my risks are in my life.”
By: Reed Abelson and Katie Thomas, The New York Times, November 3, 2013
“The Middle Class Doesn’t Write Big Checks”: The Bottom 90 Percent Have Disappeared And Have No Voice In Washington
So how to explain this paradox?
As of November 1 more than 47 million Americans have lost some or all of their food stamp benefits. House Republicans are pushing for further cuts. If the sequester isn’t stopped everything else poor and working-class Americans depend on will be further squeezed.
We’re not talking about a small sliver of America here. Half of all children get food stamps at some point during their childhood. Half of all adults get them sometime between ages 18 and 65. Many employers – including the nation’s largest, Walmart – now pay so little that food stamps are necessary in order to keep food on the family table, and other forms of assistance are required to keep a roof overhead.
The larger reality is that most Americans are still living in the Great Recession. Median household income continues to drop. In last week’s Washington Post-ABC poll, 75 percent rated the state of the economy as “negative” or “poor.”
So why is Washington whacking safety nets and services that a large portion of Americans need, when we still very much need them?
It’s easy to blame Republicans and the rightwing billionaires that bankroll them, and their unceasing demonization of “big government” as well as deficits. But Democrats in Washington bear some of the responsibility. In last year’s fiscal cliff debate neither party pushed to extend the payroll tax holiday or find other ways to help the working middle class and poor.
Here’s a clue: A new survey of families in the top 10 percent of net worth (done by the American Affluence Research Center) shows they’re feeling better than they’ve felt since 2007, before the Great Recession.
It’s not just that the top 10 percent have jobs and their wages are rising. The top 10 percent also owns 80 percent of the stock market. And the stock market is up a whopping 24 percent this year.
The stock market is up even though most Americans are down for two big reasons.
First, businesses are busily handing their cash back to their shareholders – buying back their stock and thereby boosting share prices – rather than using the cash to expand and hire. It makes no sense to expand and hire when most Americans don’t have the money to buy.
The S&P 500 “Buyback Index,” which measures the 100 stocks with the highest buyback ratios, has surged 40 percent this year, compared with a 24% rally for the S&P 500.
IBM has just approved another $15 billion for share buybacks on top of about $5.6 billion it set aside previously, thereby boosting its share prices even though business is sluggish. In April, Apple announced a $50 billion increase in buybacks plus a 15% rise in dividends, but even this wasn’t enough for multi-billionaire Carl Icahn, who’s now demanding that Apple use more of its $170 billion cash stash to buy back its stock and make Ichan even richer.
Big corporations can also borrow at rock-bottom rates these days in order to buy back even more of their stock — courtesy of the Fed’s $85 billion a month bond-buying program. (Ichan also wants Apple to borrow $150 billion at 3 percent interest, in order to buy back more stock and further enrich himself.)
The second big reason why shares are up while most Americans are down is corporations continue to find new ways to boost profits and share prices by cutting their labor costs – substituting software for people, cutting wages and benefits, andpiling more responsibilities on each of the employees that remain.
Neither of these two strategies – buying back stock and paring payrolls – can be sustained over the long run (so you have every right to worry about another Wall Street bubble). They don’t improve a company’s products or customer service.
But in an era of sluggish sales – when the vast American middle class lacks the purchasing power to keep the economy going – these two strategies at least keep shareholders happy. And that means they keep the top 10 percent happy.
Congress, meanwhile, doesn’t know much about the bottom 90 percent. The top 10 percent provide almost all campaign contributions and funding of “independent” ads.
Moreover, just about all members of Congress are drawn from the same top 10 percent – as are almost all their friends and associates, and even the media who report on them.
Get it? The bottom 90 percent of Americans — most of whom are still suffering from the Great Recession, most of whom have been on a downward escalator for decades — have disappeared from official Washington.
By: Robert Reich, RobertReich.org, Published in Salon, November 1, 2013
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