“Exploiting Consumers”: Republican Obamacare “Fix” Is Junk, Just Like The Junk Insurance Plans It Protects
In an effort to cynically score political points, the Republicans have taken up the cause of people who have received health insurance “cancellation” notices. The problem is that the Republicans aren’t helping these people, they are exploiting them. They’re peddling a “fix” that will stick consumers with lousy insurance policies, put the insurance companies back in charge of our health care and deceive people who deserve a straight answer about what’s going on with their health coverage.
If you’re one of the people who received a notice, it’s unsettling and confusing to say the least — and you don’t need a political party to play politics with your life. You need to know the truth and learn the available options.
People are receiving cancellation notices because they were sold health insurance policies that provide bare-bones coverage and expose them to financial ruin if they get sick or injured. Insurance companies sold these plans knowing full well that consumers could not keep them after the Affordable Care Act (ACA) standards are fully implemented on Jan. 1. The insurance companies didn’t tell their clients that they couldn’t keep the plans they sold them, and they certainly didn’t tell them that the plans were junk. Now the Republicans want to allow the industry to continue to sell these policies for another year in the name of letting people keep the plans “they like.” This is hypocrisy and politics at its worst, not to mention terrible policy.
There are roughly 15 million Americans who buy health plans in the individual market, and they represent 5 percent of people with private insurance. About half of them got cancellation notices, which naturally leaves people anxious to find out what they’ll do next year.
Instead of passing a law allowing insurers to keep selling bad policies that provide little for their premium money, we should tell people what their coverage options are and how much better they’ll do under the ACA. Because the enrollment web site HealthCare.gov has yet to work properly, most folks don’t realize they will save money and get better insurance if they shop in the new insurance marketplaces and take advantage of generous instant tax credits that will drastically cut their premiums.
People can save a lot of money when they buy their insurance through the online marketplaces: Seventeen million people will qualify for tax credits to reduce the cost of their insurance. As many as 7 million people may have no premium costs at all. Six of 10 uninsured Americans will pay $100 or less in monthly premiums. While it sucks to get canceled, the vast majority of those folks will see that getting coverage through the ACA marketplaces is a better deal.
The GOP-led legislation is bad public policy. It will disrupt the insurance market and make things worse now and in the future. You can’t mend our broken health insurance system if millions of people can opt out of participating in it. That’s how we got into this mess in the first place.
Allowing inferior insurance plans to exist alongside quality ACA policies will destroy the economic foundation of the law — the idea that financial risk must be spread and shared — and give our health care back to the insurance companies. Nothing could be worse for the health and the pocketbooks of everyday Americans.
For example, the Republican proposal would prompt younger, healthier people to opt out of enrolling in the marketplace plans, meaning the ACA policies will cover mostly older and sicker people who are more costly to insure. As a result, marketplace premiums would spike and millions of Americans would lose out on health coverage they can afford. People would be denied insurance or charged sharply higher premiums because of their medical history. Consumers would be at the mercy of the health insurance companies. That’s not why we enacted health reform. America reformed our health insurance system so everyone could have insurance with real benefits — not benefits that are only revealed to be phony in the middle of a medical crisis. We did it based on the simple principle that we all do better when we all do better.
The Republican bill would be a disaster for consumers. As we learned during the drive to pass the ACA, junk policies cause nothing but trouble. There are millions of stories of bankruptcy filings, homes and jobs lost, college educations abandoned and dreams deferred because someone with fake insurance got sick and was overwhelmed by medical bills. We can’t go back to those days.
The GOP is using overhyped cancellation stories as a pretext to destroy the ACA, a law they have attacked with a single-minded fervor never before seen in American politics. When the Republicans’ bill, H.R. 3350, reaches the floor, it will be the House GOP’s 46th vote to repeal Obamacare.
Any fixes to the Affordable Care Act should be judged by whether they help people and improve the law. The Republican-led proposal does neither.
By: Ethan Rome, HCAN Blog, November 14, 2013
“Another Media Black Eye”: John Boehner Inadvertently Exposes Sloppy Media Coverage Of Obamacare Costs
House Speaker John Boehner loves to tell stories about people getting a raw deal from Obamacare. This week, he decided to tell one about himself.
As you may recall, Obamacare treats members of Congress and their staff differently from other working Americans. Thanks to a provision added to the law by Charles Grassley, the Republican Senator from Iowa, certain Capitol Hill workers can’t get insurance like other federal employees—i.e., via the Federal Employees Health Benefits Plan. Instead, they must get coverage through one of the new Obamacare exchanges. For many, that means enrolling through the District of Columbia exchange.
This week, Boehner did just that. But, as his advisers later explained to media outlets, the Speaker had trouble. The website had technical problems, they said, and it took hours for Boehner to complete process. When he finally found a policy, he discovered it would cost a lot more. Politico got the full story, including a quote from Boehner spokesman Brendan Buck. “The Boehners are fortunate enough to be able to afford higher costs. But many Americans seeing their costs go up are not. It’s because of them that this law needs to go.” Soon it was all over social media.
But this story turns out to be a lot more complicated than either Boehner or the initial press accounts suggested. In fact, it’s an almost perfect example of how media coverage of Obamacare has failed to provide scrutiny, context or a sense of scale. For one thing, the circumstances of Boehner’s effort to use the D.C. website are a bit murky. Boehner had said he couldn’t get through to anybody on the Exchange’s help line. A spokesman for the exchange challenged that account, telling local NBC reporter Scott MacFarlane that a representative called Boehner’s office, only to be put on hold while patriotic music played in the background. After 35 minutes, according to this account, the representative hung up. It’s impossible to know which account is correct. But if the D.C. Exchange version is right, then, as Steve Benen observes, “Boehner complained about how long the process took, but when he got a call to complete the enrollment process, the Speaker kept the exchange rep on hold for over half an hour.”
In any event, the real issue here is what Boehner will pay for insurance next year—and what, if anything, that says about the law as a whole. It’s true that Boehner’s 2014 premiums will be higher than his 2013 premiums have been. But that’s because of a set of relatively unique factors. They’re a bit hard to explain: Michael Hiltzik of the Los Angeles Times has the full story if you want it. The simplistic version is that Boehner is paying more because he works on Capitol Hill and, at 64, he is relatively old. Unless you, too, work on Capitol Hill and are relatively old, his experience tells you very little about what will happen to you. Among other things, most large employers aren’t dropping coverage and sending their full-time workers into the exchanges. Only the U.S. Congress is—and that’s because of Grassley’s screwy amendment, which was, by all accounts, designed to embarrass the Democrats rather than become law.
Of course, the same factors that will mean higher premiums for older Capitol Hill workers will mean lower premiums for younger ones. An example of somebody benefitting from this dynamic is Drew Hammill, spokesman for House Democratic Leader Nancy Pelosi. Taking into account the employer contribution, he’ll be paying $88 a month for his insurance next year. This year he has paid $186. His story appeared in a Wall Street Journal article about the different heath insurance experiences for different workers on Capitol Hill. The article, by Louise Radofsky, was balanced and fair. It was also the exception. There have been plenty of stories focusing on the older workers paying more, but almost none about younger workers paying less. You could make a case for focusing on the former more heavily: Hardship is bigger news than unexpected good luck. But by such a lopsided margin? That’s hard to justify.
And that pattern, unfortunately, is one we’ve seen over and over in this debate. People giving up their current plans get tons of attention. People getting new coverage don’t. Those Americans paying higher premiums next year have been all over the media. Those Americans paying lower premiums haven’t. There are exceptions. In the L.A. Times, Hiltzik had a terrific article Tuesday about Californians gaining coverage and saving money through California’s exchange. But those articles are hard to find.
Obamacare is a complicated story to tell, with good news and bad news and plenty in between. The media should cover all of it. But for the last few weeks it has mostly told one side of the story—the side that Boehner and his allies want you to hear.
By: Jonathan Cohn, The New Republic, November 26, 2013
“Coverage That Is Surprisingly Affordable”: As Glitches Fade, Obamacare Approval Will Rise
The latest polls on Obamacare are bleak. A Kaiser Family Foundation survey found that almost half of those questioned last week had an unfavorable opinion of the law. Just a third had a favorable opinion, even less than the 40 percent support for the law in the Nov. 14 Gallup poll.
But those poll numbers will change as more people like Bob Freukes of St. Louis and Donna Smith of Denver are finally able to shop for coverage on the new health insurance websites — and find coverage that is surprisingly affordable.
Considering all the negative stories about the malfunctioning HealthCare.gov website and policy cancellations folks have been receiving, the steep decline in support for Obamacare shouldn’t surprise anyone.
But in the very week that poll numbers reached an all-time low, people who had tried for more than a month to enroll online in a health plan were finally able to do so.
Just minutes after the administration’s tech surge team said 90 percent of applicants were now able to enroll online, I started getting emails from people eager to share their success stories.
“My wife and I are both self-employed small sole proprietors,” wrote Freukes, a photographer. “This will be the first time in our married lives we will have health insurance.”
Freukes said that over the course of the past year, he and his wife — married 30 years and are now in their fifties — rarely went to the doctor because of the expense.
“We paid for doctor visits, prescriptions, eye glasses and everything else out of [our] own pockets, always knowing we were one major illness away from bankruptcy.
“We tried to find an affordable policy, but the going rate for my wife and me was roughly $900-$1,400 dollars a month with deductibles in the $5,000 range.” Considering that their combined annual income is often no more than $25,000, health insurance was out of the question.
Not only will they finally have coverage starting January 1, it will cost the Freukes less than they had expected because of the federal tax credits available to low- and middle-income individuals who buy coverage on the state exchanges. In fact, with the tax credits, the Freukes will not have to pay monthly premiums at all.
“I sat rubbing my eyes in amazement as the website did the math. Our portion of the premium for both plans was ZERO. No cost to us at all. I was stunned.”
Donna Smith wasn’t that fortunate, but she at long last will be able to get a comprehensive policy that she can afford.
Like Bob Freukes, it took Smith weeks of effort before she was finally able to enroll in a plan. Her delay, though, was caused by a different, though no less frustrating quirk in the system. Colorado is one of 13 states and the District of Columbia operating their own exchanges, which generally have experienced fewer problems than the federal website, where residents of most states have been sent. Several thousand people were able to begin the application process in Colorado but they had to wait — and wait and wait — while state officials checked to see if the applicants were eligible for Medicaid.
Smith knew her income was too high to qualify for Medicaid, but she nevertheless had to fill out an extensive questionnaire and was put in what she described as a “bureaucratic black hole” for 37 days. It was an agonizing wait for Smith, a cancer survivor who — along with husband Larry — had to file for bankruptcy several years ago because of medical debt. If her name sounds familiar, by the way, it might be because you’ve seen her in the movies. When she wrote filmmaker Michael Moore about her plight, he included her in the 2007 documentary, SiCKO. Since then she has been an active supporter of health care reform.
After she finally got the Medicaid denial she was expecting, Smith called Connect for Health Colorado — the name of the state exchange — and worked with an employee to complete her application.
“If people can get through the Medicaid process, I think they’ll be pleasantly surprised,” said Smith, who has been paying $875 a month for an individual policy. Beginning next year, she will be covered in a better plan, but it will cost her only $450 a month after factoring in a $72 federal tax credit.
As happy as she was to discover she will soon have affordable coverage —and that it can’t be canceled if her cancer returns, thanks to Obamacare — she still believes a single-payer, Medicare-for-all type system would be better.
She has a point. The Affordable Care Act is far from perfect. But in the coming months and years, millions of us who have been unable to find affordable coverage will at long last be insured. Poll numbers will eventually reflect that.
By: Wendell Potter, The Center for Public Integrity, November 25, 2013
“Obamacare, A Question Of Morality”: Indifference To The Needs Of Others Is, Indeed, Immoral
There was a lot of bloviating about the Affordable Care Act on the talk shows last weekend. The Obamacare critics’ chief focus was the open-enrollment fiasco, the un-kept presidential promise and the millions of cancellation notices. Overlaying the palaver was the unrestrained glee of health-reform opponents.
The same weekend, in a section of our nation’s capital where pompous politicians and self-important opinion-makers seldom venture, the Affordable Care Act was the subject of thanks and praise at the First Baptist Church at Randolph Street and New Hampshire Avenue NW.
The talk-show criticism and the pulpit defense crystallized the Obamacare debate. Drawn into sharp relief is the struggle taking place in this country between doing what is right and good and an unashamed indulgence in the immorality of indifference.
The issue couldn’t be put more simply.
Forty-nine million Americans do not have health insurance. For many of them, the ability to deal with their illnesses and injuries depends on their ability to pay. Lacking the money, some of them just go without the care they need. Better to put food on the table for the kids than to check out that awful pain in the gut. Can’t afford to do both.
Which helps explain why the Affordable Care Act is viewed more kindly by the congregation at First Baptist Church, located a few miles from the shadow of the Capitol, than by those within the governmental structure.
First Baptist celebrates its 150th anniversary this year, having been founded in Southwest Washington by freed slaves in 1863 .
The church’s broad ministry includes parts of the city where good health care is an unaffordable luxury.
The Rev. Frank D. Tucker, who has been First Baptist’s pastor for nearly 38 years, used Sunday morning’s service to address Obamacare in terms its critics do not.
He announced that First Baptist, working with the city’s health-care exchange, DC Health Link, would host a health insurance enrollment fair on Saturday. He issued an emotional call to his congregation, young and old, to enroll in the program, resorting to language associated with the battle to win the right to vote.
Tucker noted the decades of unsuccessful efforts by several presidents to extend medical care to all Americans, including those living in dire circumstances beyond their control. Not sugar-coating the problems that President Obama has encountered in bringing about health-care reform, Tucker hammered at the obligation of the uninsured to enroll in the insurance program that Obama and other health-reform advocates have worked so hard to create. The Obama administration and its congressional supporters, Tucker observed, have been opposed every step of the way, taking a beating from people in Congress and around the country. Don’t let their sacrifices be in vain by sitting on your hands, he contended. Get enrolled, he declared.
And Tucker wasn’t even Sunday morning’s featured speaker. That honor fell to William P. DeVeaux, the presiding bishop of the African Methodist Episcopal Church’s second district, which covers the nation’s capital. DeVeaux’s presence, however, made Tucker’s appeal more compelling because DeVeaux’s message drew heavily on the scriptural command to serve others. It reinforced Tucker’s appeal to give all Americans the health security they deserve.
Tucker, DeVeaux and other members of the cloth are those whom the opponents of health-care reform are up against.
Gaining access to no-cost preventive services to stay healthy, which Obamacare provides, is not a sign of indifference. Neither is giving senior citizens discounts on their prescription drugs, or allowing young adults to get health insurance on their parents’ plan, or ending insurance company abuses. Those steps represent the caring actions of government.
In his apostolic exhortation this week, Pope Francis said he begged “the Lord to grant us more politicians who are genuinely disturbed by the state of society, the people, the lives of the poor!” Referring to the “excluded and marginalized,” the pontiff said that “it is vital that government leaders . . . take heed and broaden their horizons, working to ensure that all citizens have dignified work, education and healthcare.”
That, too, is where the health-reform resisters come up short. Their horizons are too narrow to notice or care about people who lead lives stunted by lack of opportunity. Stunted lives leave the critics unmoved.
And that’s why, when the bloviators take to the airways, preachers like the Rev. Tucker, Bishop DeVeaux and Pope Francis take to the pulpit.
They know that indifference to the needs of others is, indeed, immoral.
By: Colbert I. King, Opinion Writer, The Washington Post, November 29, 2013
“The First Step Of A Long Journey”: Now’s Not The Time For Liberals To Say “I Told You So” About Obamacare
It has been a rough two months for the Affordable Care Act and its defenders. Having spent years fighting ridiculous allegations about socialized medicine and “death panels,” supporters of near-universal coverage now face something different. The performance failures in the rollout of healthcare.gov have triggered cries of “I told you so!” from some liberals. This wouldn’t have happened, they say, if only Obama had supported some form of single-payer plan, such as Medicare for all. The anger over the botched rollout is understandable, but these recriminations are poorly timed—and just plain wrong.
For starters, the ACA is working reasonably well in some places—California, Connecticut, Kentucky, Washington, and the District of Columbia, for example. These under-reported success stories show that insurance exchanges can work, if properly administered. Exchanges are successfully determining applicants’ eligibility for Medicaid or private insurance, enabling consumers to choose among competing plans, and computing the tax credits to which people are entitled. The human benefits are real, from California to Breathitt County in rural Kentucky. These successes make the federal government’s dismal rollout even more embarrassing. Republicans may have done everything within their power to dynamite the ACA, but the administration fell inexcusably short in launching Obama’s domestic-policy centerpiece.
It doesn’t help that health reform is really complicated. The U.S. health-care system is far and away the most complex in the world, one that includes employer-sponsored coverage, Medicare, Medicaid, Tricare, the Indian Health Service, and small-group and individual insurance coverage—and that’s before Obamacare was implemented.
Given that complexity, some on the left say, life would be simpler if only Congress had been willing—which it was not—to scrap all current arrangements and replace them with a single, federally administered health insurance plan. Those on the right regard this complexity and say that life would be simpler if only Congress had been willing—which it was not—to scrap all current arrangements and replace them with income-related vouchers people could use to help pay for private insurance of their choice.
Those positions enjoy loud support in the blogosphere, Twitter, and cable TV, but only niche support at each end of the political spectrum. Although their ideological values could hardly be more different, these polar-opposite camps each disdain the kludgy fixes of incremental politics. And yet, incrementalism is what most Americans want. Most people are reasonably well-insured. They like their coverage, and they want it to remain affordable. They fear legislation that threatens it. Proposals, whether from the left or right, that force most people into radically different arrangements are fated to remain politically marginal in America.
That the right, which predicted Obamacare would mean the death of liberty and ruination of the U.S health care system, feels vindicated by Obamacare’s initial woes is no surprise. But the troubles with healthcare.gov have rekindled attacks from the left, too. Consider a recent essay by American Prospect co-editor Robert Kuttner, in which he writes, “The colossal mess that Obamacare has become reflects both the character of the legislation and that of the president who sponsored it.”
We understand Kuttner’s frustration. We do not share his disdain for the ACA or for Obama. The law ended a century of legislative failures in the search for universal health insurance coverage, and enacted important reforms of our healthcare delivery system. Obama bet his historic legacy on a reform that, however imperfect, brings health insurance to millions, improves its quality, and helps slow spending growth.
The real beef of those who seek a more radical rewiring of our healthcare system is not with the president. It is with the coalition of labor, healthcare, disability, and anti-poverty groups that coalesced during 2007 and 2008 around a health reform model that later became the ACA. Candidates Hillary Clinton, Obama, and John Edwards endorsed similar health plans. They all included Medicaid expansion, regulated markets (health insurance exchanges), premium subsidies, strengthened insurance regulation, and an explicit or de facto individual mandate. Many Democrats would have preferred single-payer, but the candidates and even most single-payer supporters understood that politically this just wasn’t possible.
We wish ACA had gone farther. It could have provided more generous premium assistance and cost-sharing for working families. It could have allowed people near retirement to buy into Medicare. Alas, senators such as Joe Lieberman—not Obama—scuttled these possibilities. The ACA is only the first step in a long journey of needed health reforms.
Kuttner goes on to write: “Medicare for All would be simpler to execute, easier to understand, and harder for Republicans to oppose.” Nancy Folbre, writing in The New York Times, took the same position. Kuttner and Folbre are correct that Medicare for All would be much easier to understand. Perhaps, as Obama among others has said, Medicare for All would be preferable to our current system, were we designing that system from scratch.
But we aren’t. The slogan “Medicare for all” was never incorporated in a well-crafted legislative proposal. Had it been, it would have been even easier than Obamacare for Republicans to oppose. And implementation would have been formidably difficult. Had the transition to single-payer ever been specifically mapped out, it would immediately have become apparent that this process requires wholesale replacement or rewiring of employer-based coverage, major changes in the relations between states and the federal government. Hundreds of billions of dollars in transfers and new taxes would have been necessary. Enterprising constitutional conservatives surely would have identified plausible court challenges. What’s more, a phalanx of providers—hospitals, doctors, insurers, drug companies and device manufacturers—opposed single-payer proposals. Even such incremental moves as the public option evoked profound unease among insurers, community hospitals, and other key parts of the coalition that supported the ACA.
The backlash against the ACA is occurring because it disrupts coverage of several million people in the individual and small-group insurance market. Transition to single-payer would have been far messier, disrupting coverage for hundreds of millions of Americans, with a much larger and more explosive mix of winners and losers.
There was and is no alternative to the messy incremental politics that produced Obamacare. Liberals such as then–House Majority Speaker Nancy Pelosi didn’t make unpalatable compromises because they held pallid aspirations for health reform. They compromised because they knew that they could not impose their will on querulous colleagues, because they needed 60 Senate votes, because millions of Americans needed help, and because it is better to win messily than to lose gloriously.
Much now rides on the government’s ability to fix healthcare.gov. Definite progress has been made. The federal exchange will be better by year’s end, but it will be months, not a few weeks, before the website really works the way it should. The White House’s cautionary messages on enrollment efforts and its one-year delay in online small business enrollment exemplify the many challenges with getting Obamacare off the ground. So these are anxious times. If the ACA fails, hopes for universal coverage will be set back a generation. Now’s not the time for liberals supporters to turn against Obamacare, or against each other.
By: Henry Aaron and Harold Pollack, The New Republic, November 28, 2013
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